Osteoarthritis Of Weight-bearing Joints Research Articles

Assessing the causal relationship of birth weight and childhood obesity on osteoarthritis: a Mendelian randomization study.

Obesity is associated with osteoarthritis (OA), but few studies have used fetal origin to explore the association. Our study aims to disentangle the causality between birth weight, childhood obesity, and adult OA using Mendelian randomization (MR). We identified single nucleotide polymorphisms (SNPs) related to birth weight (n = 298,142) and childhood obesity (n = 24,160) from two genome-wide association studies contributed by the Early Growth Genetics Consortium. Summary statistics of OA and its phenotypes (knee, hip, spine, hand, thumb, and finger OA) from the Genetics of Osteoarthritis Consortium (n = 826,690) were used to estimate the effects of SNPs on OA. Multivariable MR (MVMR) was conducted to investigate the independent effects of exposures. It turned out that genetically predicted standard deviation increase in birth weight was not associated with OA. In contrast, there was a marginally positive effect of childhood obesity on total [odds ratio (OR) = 1.07, 95% confidence interval (CI) = 1.00, 1.15 using IVW], knee (OR = 1.13, 95% CI = 1.05, 1.22 using weighted median), hip (OR = 1.13, 95% CI = 1.04, 1.24 using IVW), and spine OA (OR = 1.12, 95% CI = 1.03, 1.22 using IVW), but not hand, thumb, or finger OA. MVMR indicated a potential adulthood body mass index-dependent causal pathway between childhood obesity and OA. In conclusion, no association of birth weight with OA was suggested. Childhood obesity, however, showed a causality with OA in weight-bearing joints, which seems to be a general association of obesity with OA.

Assessing the Burden of Osteoarthritis in Africa and the Middle East: A Rapid Evidence Assessment.

This rapid evidence assessment (REA) was conducted to assess the burden of weight-bearing joint osteoarthritis in the developing countries of Africa and the Middle East. Our REA methodology used a standardized search strategy to identify observational studies, published between January 1, 2010, and April 23, 2020, reporting on outcomes pertaining to the epidemiology and humanistic or economic burden of weight-bearing osteoarthritis. Relevant data from the included studies were used for qualitative analysis. Among the 20 publications reporting on knee osteoarthritis in 10 countries in Africa and the Middle East, 2 also reported on hip, and 1 on foot osteoarthritis. Prevalence of symptomatic/radiographic knee OA was 9-14% among rheumatology outpatients and 31-34% among those with mixed etiology osteoarthritis. Prevalence of knee OA diagnosed by magnetic resonance imaging was 70% among patients ≥40 years of age attending a hospital in Saudi Arabia. Quality-of-life outcomes were reported in 16 publications and suggested a substantial humanistic burden of osteoarthritis, including worse pain, function, and quality of life, and more depression; comparisons between studies were hampered by the variety of tools and scoring scales used, however. No studies reported on economic outcomes. This REA indicates a substantial burden of osteoarthritis in weight-bearing joints in Africa and the Middle East, consistent with publications from other regions of the world.

Osteoarthritis Medication and Overview: A Narrative Review

Osteoarthritis, the most common form of joint disease, is primarily a disease of aging. Ninety percent of all people have radiographic features of osteoarthritis in weight-bearing joints by age 40. Symptomatic disease increases with age. Risk factors for this disorder include gender, genetics, obesity, and work history. Osteoarthritis develops in women more often than in men. This arthropathy is characterized by cartilage degeneration and bony hypertrophy at the articular margins. Inflammation is usually minimal. Hereditary and mechanical factors may be involved in the pathogenesis. This review provides an overview of counseling osteoarthritis and its treatment and management.

FUNCTIONAL OUTCOME IN EARLY OSTEOARTHRITIS OF KNEE WITH TWO DOSES OF PLATELET RICH PLASMA OUR EXPERIENCE.

Background: Osteoarthritis (OA) is a degenerative disorder of synovial joints in which there is gradual softening and disintegration of articular cartilage accompanied by the new growth of cartilage and bone at the joint margins(Osteophytes), cyst formation and sclerosis in the subchondral bone, mild synovitis, and capsular brosis. It differs from simple wear and tears in that it is asymmetrically distributed, often localized to only one part of a joint i.e., weight bearing, and often associated with abnormal loading rather than frictional wear. It is a dynamic phenomenon and shows features of both destruction and repair. Cartilage softening and disintegration are accompanied from the very outset by hyperactive new bone formation, osteophyte formation and remodeling. Osteoarthritis is an age-related phenomenon, and it affects more than 80% of people greater than 55 years of age. Body mass index (BMI) plays a vital role in osteoarthritis in weight-bearing joints. People with obese or overweight were approximately 4.6 times more likely to have knee OA than normalweight individuals. In addition people with metabolic and endocrine disorders are also more prone for osteoarthritis at an early age. Methods: Sixty patients suffering from grade1and 2 osteoarthritis knee joint who attended the outpatient department of orthopaedics, King George hospital, Visakhapatnam between November 2018 to October 2020 were included in the study. Informed and written consent was taken from the patients. General physical examination was done. Neurovascular status of both lower limbs was also examined. X-ray of both knee joints in antero-posterior and lateral views were taken in standing position. Routine pre-injection WOMAC and VAS score were recorded. Under aseptic conditions, two platelet-rich plasma (PRP) injections were injected into the knee joint at four weeks interval. Functional status of the knee was evaluated using WOMAC and VAS score at one, three and six week's interval. This study is a anlyticl comparative study. Results: There is a signicant difference in the VAS score and WOMAC score before giving an injection and after giving an injection, in patients with grade 1 and grade 2 osteoarthritis. The visual analogue score showed a mean of 7.16 at pre-injection period, which decreased to 5.95 at 1st week and 4.81 at 3rd week and 4.06 at six weeks follow up. Conclusion: In the present study the effectiveness of two aliquots of PRP injection was evaluated. Although studies including more than 2 PRP injections and more advanced stages of osteoarthritis were compared, the time frame was xed to 6 weeks. The functional outcome of the patient was better after 2nd dose of PRP. The present study concluded that two doses of PRP injection decreases the joint pain, alleviates the symptoms and enhances the activity of daily living and quality of life in short term duration.

A Study of Efficacy and Tolerability of Rosehip Extract (Gopo) vs. Ibuprofen (a nsaid) in Treatment of Osteoarthritis in Weight Bearing Joints

Introduction: Osteoarthritis is the most common form of arthritis. Osteoarthritis is a joint failure, which occurs due to pathological change in all structure joint. Aim: The aim of the study was to compare the efficacy and tolerability of Rosehip Extract and ibuprofen along with individual effect of both drugs. Materials and Methods: This was an open, randomized, prospective study to compare ROSE HIP Extract and IBUPROFEN for treatment of Osteoarthritis in 100 patients. In this study two comparative groups (50 each) were taken. First group was prescribed 400 mg TDS Ibuprofen and the other group was given Rose hip extract in the form of 275 mg capsule BD. The pain assessment was done through Womac scale and visual analogue scale. The data was collected for efficacy and tolerability for both drugs at 14 days and 3 months. Result: In ibuprofen group, the mean score of pain intensity on womac scale on visit 1 was 39.2 ± 9.58 which was decreased to 11.62 ± 4.97 in the last visit. On VAS scale on visit 1 was 7.26 ± 1.426 and was decreased to 3.36 ± 1.467 at visit 3. In rosehip group. The mean score of pain intensity on WOMAC scale on visit 1 was 38.44 ± 8.45, 30.88 ± 8.068 which was decreased to 26.68 ± 8.474. The mean score of pain intensity at on VAS scale on visit 1 was 7.02 ± 1.06, 5.84 ± 1 and was decreased to 4.6 ± 1.16 at the end of study. Conclusion: Ibuprofen is a better choice than rosehip because it had shown better improvement. Both rosehip and ibuprofen were well tolerated.

Does Running Cause Osteoarthritis in the Hip or Knee?

Running is an excellent activity to promote general health and well-being. However, running injuries are common, and concern is sometimes raised that running might lead to osteoarthritis in weight-bearing joints. This article reviews the relevant in vitro and in vivo literature that looks at possible associations between running and the development of osteoarthritis. Also reviewed is the limited literature on running barefoot and with minimalist footwear. Low- and moderate-volume runners appear to have no more risk of developing osteoarthritis than nonrunners. The existing literature is inconclusive about a possible association between high-volume running and the development of osteoarthritis. The early literature on running barefoot and running with minimalist footwear has primarily focused on biomechanics but has not yet focused on any effect on cartilage health. Experienced and beginner runners should be encouraged to allow the body adequate time to adapt to changes in gait biomechanics caused by changing footwear, which can be done by slowly increasing running mileage in the new footwear. Clinicians can improve the health of runners by encouraging appropriate treatment of musculoskeletal injuries, encouraging maintenance of an optimal body mass index, and correcting gait abnormalities caused by deficits in flexibility, strength, or motor control along the kinetic chain.

Intraarticular Treatments for Osteoarthritis: New Perspectives

To date, no targeted treatments for osteoarthritis have been developed. Therefore the challenge for the next years is to find a treatment that may slow down the progression of the disease. Osteoarthritis of the weight-bearing joints, such as knee OA, is more a local mechanical driven disease than a generalized one. To reach a non-vascularised tissue such as the cartilage, local intra-articular administration of drugs should be considered. The purpose of this review is to evaluate the advantages of local intra-articular drug administration compared with a systemic one in patients with osteoarthritis of weight-bearing joints. New perspectives of such strategy are reviewed, including anti-cytokine therapy, gene therapy, delivery of growth factors, stem cells therapy and new lubricant agents such as lubricin. The main goal in the future will be to increase the residence time of the drug in the joint while improving its diffusion within the target tissues. One key question will be how to better define the patients likely to benefit by such an approach and when the treatment is most likely to work. Most importantly, the treatment strategy must be selected according to the pattern in an individual patient. Finally, with all intra-articular treatments, the risk/benefit ratio must be carefully evaluated.

Prevalence of Osteoarthritis of Weight Bearing Joints in Relation to Body Weight in Both Genders

Background and objective: Obesity is an important and increasing public health problem, being a risk factor for overall mortality and major chronic disease. To determine relationship between different measures of body mass index and incidence of hip and knee osteoarthritis in male and female. Methods: Comparison of prevalence of primary osteoarthritis of knee and hip. Between age and sex matched control from out patient clinic of Erbil and Rizgary teaching hospital over period of eleven months starting on Jan 2007.this constituted one hundred and eighty five subjects of normal body `mass index. And one hundred and sixty subjects with high body mass index. Subjects fulfilling our inclusion criteria under went clinical evaluation and radiology of their knee and hip joints, we assessed by chi-squared test, differences in frequency of osteoarthritis between those with normal body mass index and those with high body mass index and between male and female. Results: Obesity was a stronger predictor of osteoarthritis of knee joint with no sex and age difference. In the prevalence of osteoarthritis of hip joint. No link between obesity and hip osteoarthritis was found in this study. Conclusions: Obesity in 35-45 year old men and female will predispose to primary osteoarthritis of the knee.

Association of radiological hand osteoarthritis with bone mineral mass: a population study

A number of previous studies have reported an inverse relationship between osteoarthritis and osteoporosis. However, the association has remained controversial because osteoarthritis in hand joints seems to associate differently from osteoarthritis in weight-bearing joints with bone mineral mass. We studied osteoarthritis in distal interphalangeal (DIP) joints and osteoarthritis in the base of the thumb (CMC-1) for their cross-sectional associations with metacarpal cortical bone mineral mass, and for their prediction of calcaneal broadband ultrasound attenuation. A population sample of 8000 Finns aged 30 yr and over was invited to a comprehensive health examination in 1978-1980; 90% complied. Hand radiographs were taken from 3568 participants to diagnose osteoarthritis in various hand joints, and to determine two indicators of cortical bone mineral mass, the combined cortical thickness (CCT) and the metacarpal index (MCI). Calcaneal broadband ultrasound attenuation was measured 20 yr later in 340 of these participants with the Sahara sonometer. In the cross-sectional setting, osteoarthritis in the DIP joints and osteoarthritis in the base of the thumb (CMC-1) were significantly associated with low CCT and low MCI. These associations were proportional to the radiological severity of osteoarthritis. In the follow-up setting, symmetrical DIP osteoarthritis adjusted for age, sex, body mass index, smoking, education, workload and MCI significantly predicted low values of broadband ultrasound attenuation. Our results indicate a direct relation of both radiological DIP osteoarthritis and CMC-1 osteoarthritis with low cortical bone mineral mass, in proportion to the severity of osteoarthritis. The presence of symmetrical DIP osteoarthritis, a possible indicator of generalized osteoarthritis, suggests an increased risk of osteoporosis over time.

Effects of exercise and diet on knee strength in older overweight and obese adults with knee osteoarthritis.

0638 INTRODUCTION: Previous studies have shown a strong association between obesity and knee osteoarthritis (OA). Felson and colleagues (2000) identified biomechanical factors associated with OA in weight-bearing joints, including obesity, muscular weakness, and joint laxity. Studies indicate that both obese adults (Kitagawa, 1978) and adults with knee OA (Messier et. al., 1992) are weaker than age-matched healthy controls. Short term resistance training has been shown to improve strength in older adults (Morganti, 1995), and long term resistance training in older adults with knee OA has shown significant, but modest improvements in function and strength compared to walking or a control group (Ettinger et.al.,1997). PURPOSE: Therefore, the purpose of our study was to determine the effects of exercise and dietary weight loss on muscular strength in older overweight (BMI = 28–30) and obese (BMI > 30) adults with knee OA. METHODS: A cohort of 316 older overweight and obese adults (BMI > 28) with radiographic evidence of knee OA were randomized to one of four groups: diet (D), exercise (E), diet and exercise (D&E), or healthy lifestyle control (HL) (The Arthritis Diet and Activity Promotion Trial (ADAPT)). Exercise sessions consisted of two 15-minute bouts of walking separated by 20 minutes of moderate intensity resistance training. The E and D&E groups underwent 6 months of facility-based exercise. Subsequently, participants had the option to continue in the facility-based program for an additional 12 months, transition to a home based exercise program, or combine the facility and home based programs. Dietary intervention focused on reducing fat and total calories. Weight loss goal was 5% of body weight. Bi-lateral knee strength data (concentric/eccentric flexion, concentric/eccentric extension) were collected on a randomized subset of this cohort (n = 156 at baseline) using a Kin-Com isokinetic dynamometer set at a speed of 30 deg/s. Data were collected at baseline (BAS), 6 months (FU6), and upon completion of the intervention (FU18). DATA ANALYSIS: Data were averaged over a range of 80–40 deg knee flexion (0 = extension). Knee flexion/extension strength were analyzed using the average values over this range of motion. The effects of diet and/or exercise programs on muscular strength measured at 6 and 18 months post-randomization were determined by twoway repeated measures analysis of covariance. Estimates of intervention effects were obtained at each follow-up observation. When group-by-time interactions were nonsignificant, average intervention effects over the follow-up period were estimated and tested for significance.

Effects of exercise and diet on knee strength in older overweight and obese adults with knee osteoarthritis.

0638 INTRODUCTION: Previous studies have shown a strong association between obesity and knee osteoarthritis (OA). Felson and colleagues (2000) identified biomechanical factors associated with OA in weight-bearing joints, including obesity, muscular weakness, and joint laxity. Studies indicate that both obese adults (Kitagawa, 1978) and adults with knee OA (Messier et. al., 1992) are weaker than age-matched healthy controls. Short term resistance training has been shown to improve strength in older adults (Morganti, 1995), and long term resistance training in older adults with knee OA has shown significant, but modest improvements in function and strength compared to walking or a control group (Ettinger et.al.,1997). PURPOSE: Therefore, the purpose of our study was to determine the effects of exercise and dietary weight loss on muscular strength in older overweight (BMI = 28–30) and obese (BMI > 30) adults with knee OA. METHODS: A cohort of 316 older overweight and obese adults (BMI > 28) with radiographic evidence of knee OA were randomized to one of four groups: diet (D), exercise (E), diet and exercise (D&E), or healthy lifestyle control (HL) (The Arthritis Diet and Activity Promotion Trial (ADAPT)). Exercise sessions consisted of two 15-minute bouts of walking separated by 20 minutes of moderate intensity resistance training. The E and D&E groups underwent 6 months of facility-based exercise. Subsequently, participants had the option to continue in the facility-based program for an additional 12 months, transition to a home based exercise program, or combine the facility and home based programs. Dietary intervention focused on reducing fat and total calories. Weight loss goal was 5% of body weight. Bi-lateral knee strength data (concentric/eccentric flexion, concentric/eccentric extension) were collected on a randomized subset of this cohort (n = 156 at baseline) using a Kin-Com isokinetic dynamometer set at a speed of 30 deg/s. Data were collected at baseline (BAS), 6 months (FU6), and upon completion of the intervention (FU18). DATA ANALYSIS: Data were averaged over a range of 80–40 deg knee flexion (0 = extension). Knee flexion/extension strength were analyzed using the average values over this range of motion. The effects of diet and/or exercise programs on muscular strength measured at 6 and 18 months post-randomization were determined by twoway repeated measures analysis of covariance. Estimates of intervention effects were obtained at each follow-up observation. When group-by-time interactions were nonsignificant, average intervention effects over the follow-up period were estimated and tested for significance.

The comorbidities of obesity

AbstractObesity is a major risk factor for a number of diseases. It has direct effects on glucose and lipid metabolism and on blood pressure, leading via these to type 2 diabetes, coronary heart disease and cerebrovascular disease. These comorbidities are particularly associated with excess intra‐abdominal fat. Other important diseases which obesity increases the risks of include obstructive sleep apnoea, osteoarthritis of weight‐bearing joints and a number of types of cancer. In addition to these medical comorbidities obesity has many adverse social and psychological costs. Copyright © 2001 John Wiley & Sons, Ltd.

Exercise and osteoarthritis.

The relation of exercise to osteoarthritis is one of great interest and importance. In this paper, we review two recent studies. One reported that older individuals with normal knee and hip joints who jog for recreational activities do not have an increased risk for the development of osteoarthritis in weight-bearing joints. However, in another case-control study of women with hip osteoarthritis, the risk of hip osteoarthritis increased twofold with high levels of participation in recreational activities before the age of 50 years and fourfold for women with high levels of sporting activities and occupational physical loads. Therefore, participation in certain types of sporting activities and occupations that increase loading to the hip joint before the age of 50 years may be associated with an increased risk of hip osteoarthritis. However, recreational jogging in individuals 60 or more years of age with normal knee and hip joints does not increase the risk for the development of osteoarthritis. These studies add to our knowledge base regarding lifetime and current risk factors for the development of knee and hip osteoarthritis from exercise.