Osteoarthritis Pain Research Articles

Metacarpophalangeal hyperextension in trapeziometacarpal osteoarthritis: Relationship to first metacarpal head shape, and clinical impact

PurposeThe aim of this study was to determine whether the shape of the first metacarpal head influences metacarpophalangeal hyperextension, and to evaluate the influence of metacarpophalangeal hyperextension on hand pain and function in patients with trapeziometacarpal osteoarthritis. Methods362 patients with painful basal thumb osteoarthritis were evaluated over a 2-year period. Pain rating on a visual analog scale, trapeziometacarpal and metacarpophalangeal motion, and grip and pinch strength were evaluated. The shape of the metacarpal head was assessed on strict lateral radiographs using the “A/r” ratio. ResultsRound metacarpal heads had significantly greater and more frequent metacarpophalangeal hyperextension than flat heads (28° vs. 8°, and 78% vs. 29%). Metacarpophalangeal hyperextension adversely impacted trapeziometacarpal motion in antepulsion (27° vs. 32°), abduction (25° vs. 30°) and pinch strength (3.6 vs. 4.6 KgF). ConclusionOur findings indicate that the shape of the metacarpal head influences metacarpophalangeal hyperextension in trapeziometacarpal osteoarthritis. Metacarpophalangeal hyperextension adversely impacted pinch strength and trapeziometacarpal motion. Level of EvidenceLevel IV, Retrospective case series.

EFFECT OF PRE-EXERCISE EDUCATION ON PAIN RESPONSES TO A SINGLE EXERCISE SESSION IN PEOPLE WITH KNEE OSTEOARTHRITIS: A RANDOMISED CONTROLLED TRIAL

INTRODUCTION & AIMS In pain-free individuals, pre-exercise education about exercise-induced hypoalgesia (EIH) reduces experimental pain following a single exercise session. However, its effect in people with chronic pain remains unexplored. This study aimed to determine if EIH education influences pain during and following exercise in people with knee osteoarthritis (OA). METHODS Participants were randomised into an intervention group (INT) who received 15-minutes of explicit EIH education or a control group (CON) who received 15-minutes of general information about knee OA. Following education, participants’ knowledge and beliefs about exercise and pain were assessed using five questions scored on a Likert scale. Participants then undertook a single 15-minute, low-moderate intensity home-based strength exercise session delivered online. Pain was assessed on a 0-10 scale before, during, and immediately following exercise. RESULTS 40 people with knee OA (67 ± 10.8 years old; BMI: 27.6 ± 6.5) completed the study. Education did not significantly influence participants’ knowledge or beliefs about exercise and pain. Pain reduced during exercise in both groups (mean difference [95% CI]; INT = -0.50 [-1.39 to 0.39]; CON = -1.58 [-2.55 to -0.62]), with a moderate effect (Cohen’s d) in favour of CON (-1.08 [-2.35 to 0.18], d = 0.54). Pain also reduced following exercise in both groups (INT = -0.95 [-1.77 to -0.12]; CON = -0.98 [-1.74 to -0.22]), with no difference between groups (0.03 [-1.06 to 1.12], d = 0.02). CONCLUSION A single exercise session reduces pain in people with knee OA, but this was not influenced by pre-exercise education about EIH. Given the chronic nature of OA pain, any intervention that can potentiate the benefits of exercise, even if marginal, may be beneficial. Therefore, further research is needed to understand if and how EIH can be modulated in people with knee OA.

Relationship Between Two Years of Muscle Strength Decrease and Volume Loss of Menisci and Cartilage According to Knee Pain in Mild and Moderate Knee Osteoarthritis.

To explore the relationship between two-year changes in muscle strength and cartilage according to knee pain in mild and moderate knee Osteoarthritis (OA). 279 participants were retrospectively obtained from the Osteoarthritis Initiative. Western Ontario McMaster University (WOMAC) and Knee Injury and Osteoarthritis Outcome Score were used to assess pain and function. Five muscles strength (maximum extensor and flexor, normalized maximum extensor and flexor, and extensor/flexor ratio) were measured from isometric strength test. Menisci and cartilage volumes were measured from MRI to assess two-year of OA progression. Mild and moderate knee OA progression was characterized by patellofemoral cartilage loss and meniscal degeneration. For WOMAC pain >2 participants, decrease in extensor strength and normalized extensor strength were positively correlated with medial meniscus volume loss (r = 0.261, P = 0.021; r = 0.232, P = 0.041, respectively). The extensor/flexor ratio changes were positively associated with WOMAC function changes (r = 0.291, P = 0.013) over two-year. The study observed a positive correlation between quadriceps strength decrease and medial meniscus degeneration in mild and moderate knee OA patients with WOMAC pain >2. These findings suggested quadriceps-hamstrings balance possibly plays a protective role in knee function for participants with weaker quadriceps and severe pain.

The Comparison Close Kinetic Chain Exercise And Open Kinetic Chain Exercise After Infra Red To Increasing Functional Ability In Primary Osteoarthritis Genu At Bhayangkara Kediri Hospital

Osteoarthritis is a degenerative health disorder characterized by stiffness and inflammation of the joints, characterized by damage to the cartilage, which can cause pain in the joints of the hands, neck, back, lower body, back and often the knee joints. Pain in genuine osteoarthritis can last a long time causing limitations in the ability to function functional activities. One non-pharmacological method is kinetic chain exercise. This study aims to determine the comparison of close kinetic chain exercise and open kinetic chain exercise after giving infrared to increase functional ability in conditions of primary genu osteoarthritis. This research uses a quasi experimental design with a pre and post test two group design approach. The sample for this research was 30 respondents. 15 respondents were treated with close kinetic chain exercise after giving infrared and 15 respondents were treated with open kinetic chain exercise after giving infrared. There is an effect of close kinetic chain exercise after administering infrared on increasing functional ability in primary genu osteoarthritis conditions at Bhayangkara Kediri Hospitalwith a significance of 0.001< α (α=0.05).There is an effect of open kinetic chain exercise after administering infrared on improving functional abilities in primary genu osteoarthritis conditions at Bhayangkara Kediri Hospital with a significance of 0.006< α (α=0.05).There is a difference in the effect of close kinetic chain exercise after giving infrared and open kinetic chain exercise after giving infrared on increasing functional ability in primary genu osteoarthritis conditions at Bhayangkara Kediri Hospital with a significance value of 0.035< α (α=0.05). Close kinetic chain exercise after giving infra red is more effective than open kinetic chain exercise after giving infra red in improving the ability of primary genu osteoarthritis conditions at Bhayangkara Kediri Hospital in 2023.

IL24 Expression in Synovial Myofibroblasts: Implications for Female Osteoarthritis Pain through Propensity Score Matching Analysis.

(1) Introduction: Despite documented clinical and pain discrepancies between male and female osteoarthritis (OA) patients, the underlying mechanisms remain unclear. Synovial myofibroblasts, implicated in synovial fibrosis and OA-related pain, offer a potential explanation for these sex differences. Additionally, interleukin-24 (IL24), known for its role in autoimmune disorders and potential myofibroblast production, adds complexity to understanding sex-specific variations in OA. We investigate its role in OA and its contribution to observed sex differences. (2) Methods: To assess gender-specific variations, we analyzed myofibroblast marker expression and IL24 levels in synovial tissue samples from propensity-matched male and female OA patients (each n = 34). Gene expression was quantified using quantitative polymerase chain reaction (qPCR). The association between IL24 expression levels and pain severity, measured by a visual analog scale (VAS), was examined to understand the link between IL24 and OA pain. Synovial fibroblast subsets, including CD45-CD31-CD39- (fibroblast) and CD45-CD31-CD39+ (myofibroblast), were magnetically isolated from female patients (n = 5), and IL24 expression was compared between these subsets. (3) Results: Females exhibited significantly higher expression of myofibroblast markers (MYH11, ET1, ENTPD2) and IL24 compared to males. IL24 expression positively correlated with pain severity in females, while no correlation was observed in males. Further exploration revealed that the myofibroblast fraction highly expressed IL24 compared to the fibroblast fraction in both male and female samples. There was no difference in the myofibroblast fraction between males and females. (4) Conclusions: Our study highlights the gender-specific role of myofibroblasts and IL24 in OA pathogenesis. Elevated IL24 levels in females, correlating with pain severity, suggest its involvement in OA pain experiences. The potential therapeutic implications of IL24, demonstrated in autoimmune disorders, open avenues for targeted interventions. Notwithstanding the limitations of the study, our findings contribute to understanding OA's multifaceted nature and advocate for future research exploring mechanistic underpinnings and clinical applications of IL24 in synovial myofibroblasts. Additionally, future research directions should focus on elucidating the precise mechanisms by which IL24 contributes to OA pathology and exploring its potential as a therapeutic target for personalized medicine approaches.

Effectiveness of Foam Rolling with Hip Strengthening versus Conventional Treatment in Iliotibial Band Tightness Among Osteoarthritis Patients

Background: The iliotibial band (ITB) tightness contributes to pain and functional limitations in osteoarthritis (OA) patients. The effectiveness of foam rolling (FR) combined with ITB stretching exercises versus conventional treatment methods targeting ITB tightness has not been thoroughly investigated. This study aimed to evaluate the impact of these modalities on passive range of motion (PROM) during hip adduction in OA patients. Methods: Three groups of OA patients (Foam Rolling alone-Group A, Conventional Exercises + Foam Rolling-Group B, and Hip strengthening + Foam Rolling-Group C) were assessed over 14 treatment sessions using the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) scores and Ober's test for ITB tightness. Group A received foam rolling with hip strengthening, Group B underwent conventional treatment, and Group C was treated with a combination of methods. Results: All groups showed a marked decrease in WOMAC scores, indicating an improvement in pain and knee function. Group A exhibited a significant reduction in ITB tightness, with the mean Ober's test score initially increasing but then decreasing markedly by the 14th session. Group B and Group C also showed improvements, but Group A's protocol was the most effective in reducing ITB tightness. Conclusion: The study demonstrated that foam rolling with hip strengthening exercises is significantly effective in reducing ITB tightness and improving function in OA patients. This combination therapy may be considered a superior approach to conventional treatment methods for managing ITB-related symptoms in this population.

Effect of vibrating foam roller on hamstring flexibility, pain and function in chronic knee osteoarthritis: a randomized controlled trial

Effect of vibrating foam roller on hamstring flexibility, pain and function in chronic knee osteoarthritis: a randomized controlled trial

Microbial Symphony: Exploring the Role of the Gut in Osteoarthritis-Related Pain. A Narrative Review.

One of the most common musculoskeletal disorders, osteoarthritis (OA), causes worldwide disability, morbidity, and poor quality of life by degenerating articular cartilage, modifying subchondral bone, and inflaming synovial membranes. OA pathogenesis pathways must be understood to generate new preventative and disease-modifying therapies. In recent years, it has been acknowledged that gut microbiota (GM) can significantly contribute to the development of OA. Dysbiosis of GM can disrupt the "symphony" between the host and the GM, leading to a host immunological response that activates the "gut-joint" axis, ultimately worsening OA. This narrative review summarizes research supporting the "gut-joint axis" hypothesis, focusing on the interactions between GM and the immune system in its two main components, innate and adaptive immunity. Furthermore, the pathophysiological sequence of events that link GM imbalance to OA and OA-related pain is broken down and further investigated. We also suggest that diet and prebiotics, probiotics, nutraceuticals, exercise, and fecal microbiota transplantation could improve OA management and represent a new potential therapeutic tool in the light of the scarce panorama of disease-modifying osteoarthritis drugs (DMOADs). Future research is needed to elucidate these complex interactions, prioritizing how a particular change in GM, i.e., a rise or a drop of a specific bacterial strain, correlates with a certain OA subset to pinpoint the associated signaling pathway that leads to OA.

Clinical Assessment of Osteoarthritis Pain: Contemporary Scenario, Challenges, and Future Perspectives.

The multifaceted nature of osteoarthritis (OA) pain presents a challenge in understanding and managing the condition. The diverse pain experiences, progression rates, individual responses to treatments, and complex disease mechanisms contribute to heterogeneity in the clinical studies outcomes. The lack of a standardized methodology for assessing and classifying OA pain challenges healthcare practitioners. This complicates the establishment of universally applicable protocols or standardized guidelines for treatment. This article explores the heterogeneity observed in clinical studies evaluating OA pain treatments, highlighting the necessity for refined methodologies, personalized patient categorization, and consistent outcome measures. It discusses the role of the multidimensional nature of OA pain, underlying pain mechanisms, and other contributing factors to the heterogeneity in outcome measures. Addressing these variations is crucial to establishing a more consistent framework for evidence-based treatments and advancing care of the patient with OA pain.

Neuropathic pain in patients with osteoarthritis of the hip before and after total hip arthroplasty.

The pain associated with osteoarthritis (OA) was thought to be nociceptive; however, neuropathic pain is also observed. We investigated the relationship between hip OA and neuropathic pain using the PainDETECT questionnaire (PDQ). A total of 159 hips of 146 consecutive patients who underwent total hip arthroplasty (THA) with a diagnosis of OA were enrolled in this study. The prevalence of each pain phenotype was evaluated preoperatively and at 6 months postoperatively using the PDQ. Patient characteristics and numerical rating scale (NRS) scores were compared between a group with possible neuropathic pain (NP group) and a group with nociceptive pain (non-NP group). Before THA, neuropathic, unclear, and nociceptive pain was observed in 18, 36, and 105 hips, respectively. The prevalence in the NP group was 54 hips, accounting for approximately one-third of all hips, which decreased significantly to seven hips after THA. A significantly higher NRS score was observed in the NP group, both before and after THA. Approximately one-third of the patients with hip OA had neuropathic pain. Therefore, neuropathic pain should be considered when treating patients with hip OA.

Transdermal Delivery of Ketoprofen for Osteoarthritis Treatment and Management: A Literature Review on Current Progression

Arthritis, a diverse spectrum of joint disorders, is characterized by chronic pain and inflammation. Osteoarthritis (OA), the most prevalent form, leads to disabling pain, functional limitations, and reduced mobility. Nonsteroidal anti-inflammatory drugs (NSAIDs) are widely used for managing OA pain, with ketoprofen recognized as one of the effective options. However, oral administration of ketoprofen may cause gastrointestinal irritation. Addressing this issue, Transdermal Drug Delivery Systems (TDDS) emerge as a promising alternative route of administration. TDDS facilitates delivery of various drugs through the skin without undergoing first-pass metabolism. Recent studies have centered on enhancing ketoprofen’s transdermal delivery, particularly focusing on different methods (such as patches, gels, electroporation technology, and stratum corneum bypass methods), with microneedles emerging as a promising approach for delivering anti-inflammatory drugs through transdermal routes. This review aims to explore recent advancements in transdermal drug delivery systems for managing OA. The utilization of transdermal ketoprofen presents innovative opportunities for future research and development in novel drug delivery systems.

E008 Review of rheumatology care for women of childbearing age

Abstract Background/Aims Autoimmune rheumatic diseases are frequently diagnosed in women of childbearing age. Managing these conditions during pregnancy is complex because commonly used disease-modifying antirheumatic drugs (DMARDs) can pose risks. Specialized care for this patient group is crucial, necessitating adherence to established rheumatology practice standards and British Society for Rheumatology (BSR) guidelines. Our main objective is to review management of childbearing age females with rheumatic diseases attending Basildon hospital as per BSR guidelines. Methods The data for this retrospective study was collected from the electronic records of female patients attending the rheumatology outpatient clinic at Basildon Hospital between September and December 2022. We reviewed age, the specific rheumatological diagnosis, disease duration, disease activity, current medications, and whether general advice or pregnancy-specific advice was provided. Results Out of the initial cohort of 63 female patients, 48 (76%) aged between 18-55 years were selected as women of childbearing age, The median age was 46 years, with 65% in the age groups of 31-50 years, 25% in group 51-55 years and 10% 18-30 years age group. 58% of patients had inflammatory arthritis, 18.7% had connective tissue disease, 18.7% had other conditions such as hypermobility, osteoarthritis, and regional pain syndrome, 2.3% were diagnosed with vasculitis and 2.3% with polymyalgia rheumatica. Breakdown of inflammatory arthritis patients revealed rheumatoid arthritis in 64%, psoriatic arthritis 15% and ankylosing spondylitis 12%. Axial spondyloarthropathy, palindromic rheumatism, and juvenile idiopathic arthritis, each accounted for 3%. Regarding prescribed medications, 66% of the individuals were on conventional DMARDs, biologics 24%, corticosteroids 6% and 4% were on other treatments. The DMARDs prescribed were methotrexate 27%, hydroxychloroquine 19%, sulfasalazine 13%, mycophenolate 3% and leflunomide 1%. The majority of patients had disease activity in remission or mild, each accounting for 23%. Moderate and severe disease activity were reported in 21% each of the audited sample. Patients received advice specifically related to pregnancy 29%, while 71% did not have documented pregnancy-related guidance. 70% of females of reproductive age received general advice. Conclusion The study highlights a gap in pregnancy-related advice among the childbearing age patients as only 29% received guidance on pregnancy. This underpins the need for proactive counselling and education for female patients in routine practice, work in partnership with obstetric teams, and primary care to reduce potential pregnancy related complications and improve outcomes. Disclosure M. Mohareb: None. S. Ahmed: None. A. Bharadwaj: None. A. Nandagudi: None.

Retraction: PKCδ null mutations in a mouse model of osteoarthritis alter osteoarthritic pain independently of joint pathology by augmenting NGF/TrkA-induced axonal outgrowth

Retraction: PKCδ null mutations in a mouse model of osteoarthritis alter osteoarthritic pain independently of joint pathology by augmenting NGF/TrkA-induced axonal outgrowth

Evaluation of the efficacy of complex analgesic therapy, including a combination of B vitamins, in patients with combination of osteoarthritis and chronic non-specific low back pain (results of an open-label pilot clinical trial)

The vitamin B1, B6 and B12 complex (VBC) is frequently used to treat acute and chronic low back pain.Objective: to investigate the effect of a combination of a non-steroidal anti-inflammatory drug (NSAID) and a VBC on the main manifestations of nociceptive system dysfunction in patients with combination of osteoarthritis (OA) and chronic non-specific low back pain (NSLBP).Material and methods. The study group consisted of 99 patients (82% women, mean age 63.6±17.2 years) with OA of various localization andNSLBP who had moderate to severe pain (≥4 on a numerical rating scale, NRS 0–10). All patients received etoricoxib 60 mg/day (up to 14 days) and a course of intramuscular (IM) injections of VBC (a drug for parenteral administration containing solutions of thiamine 100 mg, pyridoxine 100 mg, cyanocobalamin 1.0 mg and lidocaine 20 mg) 2.0 ml №10. Treatment outcome was assessed after 14 days.Results and discussion. During treatment, the vast majority of patients showed a significant improvement: the median severity of pain on movement (NRS) decreased from 6.3 [5.0; 8.0] to 3.7 [3.0; 5.0], p=0.0001; functional impairment – from 3.8 [2.0; 6.0] to 2.2 [1.0; 3.0], p=0.001; fatigue – from 5.6 [4.0; 8.0] to 3.5 [0.0; 2.0], p=0.0001. 71.6% of patients rated the treatment results as good or excellent. Six patients had adverse reactions: 2 – local pain at the site of the intramuscular injections, 1 – arterial hypertension, 3 – epigastric pain. No serious adverse events were recorded.Conclusion. The combined use of NSAIDs and VBC can provide significant improvement in patients with a combination of OA and NSLBP.

Self-Administered Acupressure for Probable Knee Osteoarthritis in Middle-Aged and Older Adults

The effects of self-administered acupressure (SAA) on knee osteoarthritis (OA) pain remain unclear. To evaluate the effectiveness of SAA taught via a short training course on reducing knee OA pain in middle-aged and older adults. This randomized clinical trial was conducted among community-dwelling individuals in Hong Kong who were aged 50 years or older with probable knee OA from September 2019 to May 2022. The intervention included 2 training sessions for SAA with a brief knee health education (KHE) session, in which participants practiced acupressure twice daily for 12 weeks. The control group (KHE only) received only education about maintaining knee health on the same schedule and duration. The primary outcome was the numerical rating scale (NRS) pain score at 12 weeks. Other outcomes included Western Ontario and McMaster University Osteoarthritis Index, Short Form 6 Dimensions (SF-6D), Timed Up and Go, and Fast Gait Speed tests. A total of 314 participants (mean [SD] age, 62.7 [4.5] years; 246 [78.3%] female; mean [SD] knee pain duration, 7.3 [7.6] years) were randomized into intervention and KHE-only groups (each 157). At week 12, compared with the KHE-only group, the intervention group had a significantly greater reduction in NRS pain score (mean difference [MD], -0.54 points; 95% CI, -0.97 to -0.10 points; P = .02) and higher enhancement in SF-6D utility score (MD, 0.03 points; 95% CI, 0.003 to 0.01 points; P = .03) but did not have significant differences in other outcome measures. The cost-effectiveness acceptability curve demonstrated a greater than 90% probability that the intervention is cost-effective at a willingness to pay threshold of 1 GDP per capita. In this randomized clinical trial, SAA with a brief KHE program was efficacious and cost-effective in relieving knee pain and improving mobility in middle-aged and older adults with probable knee OA. ClinicalTrials.gov Identifier: NCT04191837.

Painful distortions: people with painful knee osteoarthritis have biased visuospatial perception of the environment.

Visuospatial perception is thought to be adaptive-ie, hills are perceived as steeper when capacity is low, or threat is high-guiding appropriate interaction with the environment. Pain (bodily threat) may similarly modulate visuospatial perception, with the extent of modulation influenced by threat magnitude (pain intensity, fear) and associated with behaviour (physical activity). We compared visuospatial perception of the environment between 50 people with painful knee osteoarthritis and 50 age-/sex-matched pain-free control participants using 3 virtual reality tasks (uphill steepness estimation, downhill steepness estimation, and a distance-on-hill measure), exploring associations between visuospatial perception, clinical characteristics (pain intensity, state and trait fear), and behaviour (wrist-worn accelerometry) within a larger knee osteoarthritis group (n = 85). People with knee osteoarthritis overestimated uphill (F 1,485 = 19.4, P < 0.001) and downhill (F 1,480 = 32.3, P < 0.001) steepness more so than pain-free controls, but the groups did not differ for distance-on-hill measures (U = 1273, P = 0.61). There was also a significant group x steepness interaction for the downhill steepness task (F 4,480 = 3.11, P = 0.02). Heightened overestimation in people with knee osteoarthritis relative to pain-free controls increased as downhill slopes became steeper. Results were unchanged in a replication analysis using all knee osteoarthritis participants (n = 85), except the downhill steepness interaction was no longer significant. In people with knee osteoarthritis, higher state fear was associated with greater over-estimation of downhill slope steepness (rho = 0.69, P < 0.001), and greater visuospatial overestimation (distance-on-hill) was associated with lower physical activity levels (rho = -0.22, P = 0.045). These findings suggest that chronic pain may shift perception of the environment in line with protection, with overestimation heightened when threat is greater (steeper hills, more fearful), although impact on real-world behaviour is uncertain.

People with painful knee osteoarthritis hold negative implicit attitudes towards activity.

Negative attitudes/beliefs surrounding osteoarthritis, pain, and activity contribute to reduced physical activity in people with knee osteoarthritis (KOA). These attitudes/beliefs are assessed using self-report questionnaires, relying on information one is consciously aware of and willing to disclose. Automatic (ie, implicit) assessment of attitudes does not rely on conscious reflection and may identify features unique from self-report. We developed an implicit association test that explored associations between images of a person moving/twisting their knee (activity) or sitting/standing (rest), and perceived threat (safe vs dangerous). We hypothesised that people with KOA would have greater implicit threat-activity associations (vs pain-free and non-knee pain controls), with implicit attitudes only weakly correlating with self-reported measures (pain knowledge, osteoarthritis/pain/activity beliefs, fear of movement). Participants (n = 558) completed an online survey: 223 had painful KOA (n = 157 female, 64.5 ± 8.9 years); 207 were pain free (n = 157 female, 49.3 ± 15.3 years); and 99 had non-KOA lower limb pain (n = 74 female, 47.5 ± 15.04 years). An implicit association between "danger" and "activity" was present in those with and without limb pain (KOA: 0.36, 95% CI 0.28-0.44; pain free: 0.13, 95% CI 0.04-0.22; non-KOA lower limb pain 0.11, 95% CI -0.03 to 0.24) but was significantly greater in the KOA group than in the pain free ( P < 0.001) and non-KOA lower limb pain ( P = 0.004) groups. Correlations between implicit and self-reported measures were nonsignificant or weak (rho = -0.29 to 0.19, P < 0.001 to P = 0.767). People with painful KOA hold heightened implicit threat-activity associations, capturing information unique to that from self-report questionnaires. Evaluating links between implicit threat-activity associations and real-world behaviour, including physical activity levels, is warranted.

Bicycling over a Lifetime Is Associated with Less Symptomatic Knee Osteoarthritis: Data from the Osteoarthritis Initiative.

This study aimed to evaluate the relationship between a history of bicycling and symptomatic and structural outcomes of knee osteoarthritis (OA), the most common form of arthritis. This was a retrospective, cross-sectional study within the Osteoarthritis Initiative (OAI), where we investigated OAI participants with complete data on bicycling, knee pain, and radiographic evidence of knee OA. We used a self-administered questionnaire at the 96-month OAI visit to identify participation in bicycling during four time periods throughout a participant's lifetime (ages 12-18, 19-34, 35-49, and >50 yr). Using logistic regression, we evaluated the influence of prior bicycling status (any history, history for each time period, number of periods cycling) on three outcomes at the 48-month OAI visit: frequent knee pain, radiographic OA (ROA), and symptomatic radiographic OA (SOA), adjusting for age and gender. A total of 2607 participants were included: 44.2% were male, mean age was 64.3 (SD, 9.0) yr, and body mass index was 28.5 (SD, 4.9) kg·m -2 . The adjusted risk ratios for the outcome of frequent knee pain, ROA, and SOA among those who reported any history of bicycling compared with non-bicyclers were 0.83 (0.73-0.92), 0.91 (0.85-0.98), and 0.79 (0.68-0.90), respectively. We observed a dose-response among those who participated in bicycling during more time periods. People who participated in bicycling had a lower prevalence of frequent knee pain, ROA, and SOA. The benefit appeared cumulative. This study indicates that bicycling may be favorable to knee health and should be encouraged.

Derotational distal femur osteotomy with medial patellofemoral ligament reconstruction can get good outcomes in the treatment of recurrent patellar dislocation with excessive TT-TG and increased femoral anteversion.

Surgery is the main treatment for recurrent patellar dislocation (PD). However, due to the complexity of anatomical factors, there is still a lack of consensus on the choice of combined surgical methods. This study aimed to compare the clinical and radiological outcomes of medial patellofemoral ligament reconstruction combined with derotational distal femur osteotomies (MPFLR + DDFO) and combined with tibial tubercle osteotomies (MPFLR + TTO) for recurrent PD with increased femoral anteversion angles (FAA) and excessive tibial tubercle-trochlear groove (TT-TG) distance. In this retrospective analysis, MPFLR + DDFO and MPFLR + TTO patients from 2015 to 2020 were included. Group A (MPFLR + DDFO, n = 42) and B (MPFLR + TTO, n = 46) were formed. Clinical outcomes included physical examinations, functional outcomes (Kujala, Lysholm, International Knee Documentation Committee (IKDC), visual analog scale (VAS) and intermittent and persistent osteoarthritis pain scale (ICOAP), Tegner scores), and complications. The Caton-Deschamps index (CD-I), patellar title angle, patellar congruence angle, patella-trochlear groove distance, TT-TG distance, and FAA were used to assess radiological outcomes. All clinical outcomes improved significantly in both groups, but Group A had significantly better postoperative scores than Group B (Kujala: 89.8 ± 6.4 vs. 82.9 ± 7.4, P < 0.01; Lysholm: 90.9 ± 5.1 vs. 81.3 ± 6.3, P = 0.02; IKDC: 87.3 ± 9.0 vs. 82.7 ± 8.0, P < 0.01; Tegner: 6.0 (5.0, 9.0) vs. 5.0 (4.0, 8.0), P = 0.01). However, there was no significant difference in the VAS and ICOAP scores between the two groups. No dislocation recurrences occurred. Radiological outcomes improved significantly in both groups, but Group A had better outcomes. After surgery, the patellar height of 88.5% (23/26) patients in Group A and 82.8% (24/29) patients in Group B was restored to normal (the Caton-Deschamps index <1.2). Both MPFLR + TTO and MPFLR + DDFO obtained satisfactory clinical and radiological outcomes in the treatment of recurrent PD with increased FAA and excessive TT-TG. However, the outcomes of MPFLR + DDFO were better and should be considered a priority. MPFLR + TTO may be not necessary for such patients.

The effect of low dose intra-articular S(+) ketamine on osteoarthritis in rats: an experimental study

BackgroundThis study aimed to investigate the analgesic impact of S(+)-ketamine on pain behavior and synovial inflammation in an osteoarthritis (OA) model. MethodsAnimals were grouped as follows: OA-Saline (n = 24) and OA-Ketamine (n = 24), OA induced via intra-articular sodium monoiodoacetate (MIA); a Non-OA group (n = 24) served as the control. On the 7th day post OA induction, animals received either saline or S(+)-ketamine (0.5 mg.kg−1). Behavioral and histopathological assessments were conducted up to day 28. ResultsS(+)-ketamine reduced allodynia from day 7 to 28 and hyperalgesia from day 10 to 28. It notably alleviated weight distribution deficits from day 10 until the end of the study. Significant walking improvement was observed on day 14 in S(+)-ketamine-treated rats. Starting on day 14, OA groups showed grip force decline, which was countered by S(+)-ketamine on day 21. However, S(+)-ketamine did not diminish synovial inflammation. ConclusionLow Intra-articular (IA) doses of S(+)-ketamine reduced MIA-induced OA pain but did not reverse synovial histopathological changes. IRB approval number23115 012030/2009-05.