Prevalence Of Knee Osteoarthritis Research Articles

Prevalence, Risk Factors, and Quality of Life of Knee Osteoarthritis in Urban Community in Indonesia: A COPCORD Study.

This study evaluates the prevalence, risk factors, and quality of life of patients with knee osteoarthritis (OA) in the Indonesian population. A cross-sectional study of 3597 adults (≥ 18 years old) was conducted in 2023 involving 15 different cities in Indonesia. Knee OA was classified according to the clinical ACR criteria. The COPCORD questionnaire was used for all subjects. The quality of life (QoL) was assessed using the WOMAC score. The prevalence of knee OA was 15.0%. Banda Aceh has the highest prevalence of knee OA at 70.79%, whereas Bandung has the lowest (4.18%)-the odds of having knee OA increased with age. The adjusted odds ratio (aOR) were 5.01 (95% CI 2.47-10.15, p < 0.001) for participants aged 40-49 years and 72.19 (95% CI 36.32-143.51, p < 0.001) for participants aged 70 years or over, compared to participants under 40 years. Knee OA was higher among female participants (aOR = 1.91; 95% CI 1.53-2.39, p < 0.001). Married and divorced participants had higher odds of having knee OA compared to those who never married (aORs 2.56 (95% CI 1.37-4.77, p = 0.003) and 2.40 (95% CI 1.23-4.68, p < 0.010), respectively). Knee OA is less likely found among participants with elementary school education background (aOR 0.37; 95% CI 0.22-0.64, p < 0.001) and those with senior high school (aOR 0.49; 95% CI 0.29-0.83, p = 0.007). The total WOMAC score was 25.9 ± 18.7 from all participants, indicating moderate impairment in QoL. The prevalence of knee OA in several urban districts in Indonesia was 15.0%, with most patients having moderate impairment in QoL. Several sociodemographic factors were associated with the odds of having knee OA.

&lt;b&gt;THE PREVELENCE OF KNEE OSTEOARTHRITIS&lt;/b&gt;&lt;b&gt; &lt;/b&gt;&lt;b&gt;IN INDUSTRIAL WORKERS OF INDUSTRIAL STATE HAYATABAD PESHAWAR&lt;/b&gt;

ABSTRACT OBJECTIVE: To find the prevalence of knee Osteoarthritis among the industrial workers of Industrial State Hayatabad, Peshawar, Pakistan, Background: prevalence of knee osteoarthritis among industrial workers, with a sample size of 123, the cross-sectional study was conducted at the Industrial State in Hayatabad, Peshawar. To collect the data, 41 individuals from each industry were interviewed in a sequential order Methodology: It was a cross-sectional study to investigate the prevalence of knee osteoarthritis among industrial workers in Peshawar's Bottling Hayatabad, a questionnaire was used with a sample size of 123 participants. Data were gathered in a sequence with 41 participants from each industry. The collected data was analysed by using SPSS version 22 to obtain the prevalence of knee pain. RESULTS: According to our data the results reveals that a total of 123 subjects participate in our study in which n= 87 (71.8%) reported positive response toward KOA. the most frequently affected age group for KOA was age group 40-55 years of age (old) n=15(96.29%) out of total 16 participants. In working frame frequently affected group of participants was those who work for 15-20 years reported positive response towards KOA n= 9 (100%) 0ut of 9 participants, According to the results of our study all the participants who work for 12 hours daily reported high prevalence of KOA n=7 (81.81%) out of 9 total participants. Among the affected subjects most of the participants n=40 (46.35%) subjects have mild pain, while the most frequently contributing position for KOA was standing where n=34 (38.82%). Effects on ability to sit or stand was n=64 (74.24%), effects on ability to lift objects was n=64(74.24%). CONCLUSION: This study concludes that KOA is most common in industrial workers of industrial state who worked for 12 hours daily and the most frequently contributing position for KOA is standing followed by sit to stand position KEY WORDS: Industrial workers, Knee pain, KOA

Therapeutic Utility of Mulligan Traction Straight Leg Raise Stretch and Proprioceptive Exercises in Osteoarthritis Treatment.

Background Given the increasing incidence and severity of knee osteoarthritis (OA), it is crucial to investigate and refine therapeutic approaches. Aim The objective of this study is to evaluate the effectiveness and potential synergistic effects of proprioceptive exercises combined with Mulligan traction straight leg raise (MT-SLR) in treating OA. This includes improving symptoms such as functional mobility, pain reduction, and relevant serological markers, highlighting the potential of this approach to enhance overall patient outcomes. Methods A pragmatic, community-based, parallel-group, double-blinded, randomized clinical trial was conducted from August 2023 to March 2024. A probability convenience sampling technique was used to calculate the sample size. A total of 130 pre-diagnosed OA patients were randomly assigned to three groups via the lottery method. Group A received proprioceptive exercises, group B received the MT-SLR, and group C received both proprioceptive exercises and MT-SLR. The Pain Catastrophizing Scale (PCS), Numerical Pain Rating Scale, Western Ontario and McMaster University Osteoarthritis Index (WOMAC), erythrocyte sedimentation rate (ESR), flexion, CRP, bone electrolytes in blood (calcium, magnesium, and phosphorus), and X-rays were used to quantify pain, stiffness, functional activities, biochemical parameters, and radiographic findings at baseline and after the 24th session. Data were analyzed using IBM SPSS Statistics for Windows, Version 23.0 (Released 2015; IBM Corp., Armonk, NY, USA), with a p-value of <0.05 considered statistically significant. Results Out of the 130 participants, 126 were analyzed at the 24th session, comprising 50 males and 76 females. After 24 sessions, Group C (combined therapy) exhibited the most significant improvements across all parameters (p = 0.000), including flexion range of motion, WOMAC Pain, activities of daily living, stiffness, and PCS, outperforming both Group A (p = 0.011) and Group B (p = 0.005). Group C also demonstrated the greatest reductions in ESR (p < 0.001), CRP (p < 0.001), and IL-6 (p < 0.001), along with the highest improvements in calcium, magnesium, and phosphorus levels (p < 0.005). X-ray assessments revealed that Group C had the most notable joint space recovery, while Group B showed no changes. Conclusions In the treatment of knee OA, proprioceptive exercises have been found to be more effective than the MT-SLR stretch. Given the rising prevalence and severity of knee OA, this study emphasizes the need to explore and refine treatment strategies. The findings indicate that combining MT-SLR with proprioceptive exercises yields superior results compared to either intervention alone. The group receiving the combined therapy showed the most significant improvements across several key measures, including functional mobility, pain reduction, and relevant serological markers, highlighting the potential of this approach to enhance overall patient outcomes. The notable differences in performance between the treatment groups suggest that a more comprehensive, integrative approach to knee OA could lead to better management outcomes.

Influence of Age and Weight Change Patterns on Knee Osteoarthritis

Background: Knee osteoarthritis is a globally alarming condition. People are now dependent and adapting to new living standards and not taking all the necessary precautions to lead day-to-day life, somehow this is accelerating the degenerative process in the body. So, aiming to find out the prevalence of knee osteoarthritis will help improve the activity of daily living performance and reduce the economic burden of society due to knee osteoarthritis. Methodology: An observational descriptive analytic study, the target population was individuals between the age group 25 to 50 years of both genders. Results: From a total of 5514 individual participants, those aged &lt;40 years had a 7.28%, and ages &gt;40 years had a 16.32% prevalence of knee osteoarthritis. Participants with BMI level &lt;25 kg/m2 had 5.08%, and others having BMI of &gt;25 kg/m2 had a 22.23% prevalence of knee osteoarthritis. Conclusion: The participants of the age group ≥40 years and with BMI ≥25 kg/m2 reported a high prevalence of knee osteoarthritis.Abbreviations: Knee osteoarthritis (KOA), &amp; body mass index (BMI).

Prevalence and risk factors of knee osteoarthritis: a cross-sectional survey in Nanjing, China.

Knee osteoarthritis (KOA) presents a significant public health challenge due to its hazards and increasingly severe trends. Addressing this challenge requires targeted investigation into the prevalence and identification of risk factors for KOA across different regions, especially in populous and vast China. Therefore, a cross-sectional survey was conducted in Nanjing, China, with the aim of investigating the prevalence and risk factors of KOA among individuals aged 50 and above. A total of 1,045 subjects were selected using the stratified random sampling method and diagnosed with KOA based on the diagnostic criteria established by the Chinese Medical Association. Data on 14 potential risk factors were collected through a self-designed questionnaire and standardized on-site tests. The association between KOA and these risk factors was explored using t-tests, Chi-square tests, and logistic regression analysis. The prevalence of KOA among the subjects was 23.64%. Multiple logistic regression models indicated that the risk of KOA was significantly higher among women (OR: 5.34, 95% CI: 3.13-9.11), subjects aged 60-69 (OR: 1.83, 95% CI: 1.25-2.69) and over 70 (OR: 2.87, 95% CI: 1.80-4.59), individuals with high school education and above (OR:2.22, 95% CI: 1.37-3.60), those with flatfoot (OR: 1.74, 95% CI: 1.10-2.74), and subjects classified as overweight (OR: 1.91, 95% CI: 1.21-3.04) and obese (OR: 4.63, 95% CI: 2.18-9.85) based on their BMI status. Additionally, the models identified weight (OR: 1.04, 95% CI: 1.01-1.08), 30-s chair stand performance (OR: 0.94, 95% CI: 0.91-0.97), and single-leg stand performance (OR: 0.96, 95% CI: 0.93-0.99) as independent risk factors for KOA. The prevalence of KOA is remarkable in Nanjing city. The risk factors for KOA include women, older age, higher education, flatfoot, increased weight and BMI, as well as poor performance in 30-s chair stand and single-leg stand tests.

Exploring the Burden of Knee Osteoarthritis in Rural South India: Community Prevalence, Risk Factors, and Functional Assessment Among Adults Aged 40 and Above.

Background The rising prevalence of osteoarthritis (OA) will create significant challenges for low-resource public health systems in countries like India, leading to increased disability and reduced quality of life. Limited access to imaging and specialized orthopedic care in rural areas often delays diagnosis and treatment until the disease has progressed to advanced stages, further burdening the economy. Objectives To estimate the community prevalence and assess the risk factors associated with OA among adults aged 40 and older in rural areas of South India and to determine their functional assessment among OA-diagnosed patients. Methods A community-based cross-sectional study was conducted in rural Tiruvallur district, Tamil Nadu, South India, from September 2017 to August 2018 among 427 people aged 40 and above. People with rheumatoid arthritis, reactive arthritis, old trauma of knee joint, and who have undergone total knee replacement were excluded from the study. A validated semi-structured questionnaire was used which consisted of the socio-demographic profile of the individuals, risk factors of knee OA, American College of Rheumatology (ACR) criteria for diagnosis of knee OA, Western Ontario and McMaster Universities Arthritis Index (WOMAC) scale and Visual Analog Scale (VAS) for functional assessment. A chi-square test and odds ratio were used to determine the significant risk factors and multivariate binomial logistic regression was performed to identify the predictors of knee OA. Results The mean age of the study population was 60 years ranging from 42 to 89 years with 48% males and 52% females. The community prevalence of knee OA was 34.6%. The significant predictors for the development of OA were diabetes, obesity, Indian toilet use, and hypertension in women. The level of pain among OA patients was higher for standing from a sitting position and while climbing upstairs. The mean WOMAC score of OA subjects was 57.38 (± 12.16) ranging from 25 to 78. Conclusion The study reveals a high prevalence of knee OA among over one-third of individuals aged 40 and above in rural South India, with significant risk factors including obesity, diabetes, hypertension, menopause, sedentary lifestyles, and Indian-style toilets. Severe functional impairment, indicated by high WOMAC scores, underscores limited healthcare access, emphasizing the need for community interventions in lifestyle modification and chronic disease management.

Advanced Bi-CNN for Detection of Knee Osteoarthritis using Joint Space Narrowing Analysis

The prevalence of knee osteoarthritis is significantly increasing due to the expanding global ageing population and the rising incidence of obesity. Many researchers use artificial intelligence analytics for knee osteoarthritis (KOA) prediction and treatment. The majority of research is restricted to particular patient groups or attributes, such MRI, X-ray, or questionnaire groups. In our research we propose the use of advanced ortho bilinear convolutional neural network (CNN) classifier to enhance the precision of knee osteoarthritis detection through joint space narrowing analysis. Recognizing the critical need for accurate and early diagnosis in osteoarthritis, this study introduces a sophisticated approach leveraging the unique capabilities of bilinear CNNs (BiCNN). By integrating bilinear interactions within the CNN architecture, the model aims to capture convoluted spatial and channel-wise dependencies in knee radiographic images, thereby improving the capability to understated changes in osteoarthritis progression, particularly within the joint space. The proposed bilinear CNN classifier technique promises to refine the precision of knee osteoarthritis detection, providing clinicians with a powerful tool for identifying joint space narrowing with improved accuracy. Based on the experiment over unseen images, the recall was 93.04%, precision 96.33%, F1 Score was 95.46% and overall accuracy was 94.28%. Results show the superiority of the proposed method compared to other state-of-the-art methods. Hence the proposed method can be used for KOA diagnosis and KL grading in real time scenarios.

Association between thyroid function and osteoarthritis: A population-based cohort study

ObjectivesPrevious genetic and animal studies indicated a causal role of thyroid hormones in osteoarthritis (OA), which has not been observed in the general population. We aimed to investigate whether thyroid-stimulating hormone (TSH) and free thyroxine (FT4) were associated with hand, hip, or knee OA. MethodsParticipants from the Rotterdam Study with baseline TSH, FT4, and joint radiographs were included. We used multivariable regression models to investigate the association of thyroid function with the prevalence, severity, incidence, and progression of OA. We conducted stratified analyses by sex, age, body mass index (BMI) and weight-bearing physical activity. ResultsAmong 9054 participants included (mean age 65 years, 56.3% women), higher FT4 concentrations were associated with an increased risk of prevalent knee OA (OR 1.04 per pmol/L, 95% CI 1.01-1.06, corresponding to an OR of 1.62 across the reference range [i.e., 14pmol/L changes] of FT4) and more severe knee OA. There was a positive association between FT4 and overall progression of knee OA (OR 1.03 per pmol/L, 1.00-1.07). No association of TSH with hand, hip, or knee OA was identified. Stratified analysis revealed an association between FT4 and prevalent knee OA among individuals with BMI≥30 kg/m2 (OR 1.05 per pmol/L, 1.01-1.08) and those with high levels of weight-bearing physical activity (OR 1.05 per pmol/L, 1.01-1.10). ConclusionsOur study indicated that higher FT4 concentrations may increase the risk of knee OA. This association might be greater in individuals with extra joint loading, such as those with obesity.

Measure of risk of fall in severe knee osteoarthritis patients using Techbalance device

Objectives Knee Osteoarthritis prevalence increase is due to rise of life expectancy and ageing of the population. Ageing also affects gait and balance leading to increase of fall risk. To track this risk, newer and portable devices using accelerometers and gyroscopes are used in monitoring falls, because postural stability and balance compromise increase risk of falls (RF). The combination of accelerometer and gyroscope in portable devices are defined as Inertial Mobility Unity (IMU). Our study aims to assess RF using an IMU (Techbalance®) in patients with knee osteoarthritis. Methods Cross-sectional study in 133 eldery patients with knee osteoarthritis. The sample is divided in 2 groups, Group 1: no previous fall in the last year, Group 2: history of fall in the last year. Techbalance assessment of RF generates two scores: TechFragilidade is a clinical evaluation of frailty of the patient. TechEscore consists in 14 tasks to evaluate balance and posture assisted by a smartphone-like device IMU positioned on the girdle of the patient (center of mass). The RF assessment using the Techbalance was compared to both low-risk and high-risk of falls and the statistics analysis were performed with Chi-square, Mann-Whitney, and Spearman tests. Results Mean age was 65 (± 6,3) years. TechEscore and TechFragilidade scores correlate positively to risk of fall ( p&lt;0.05 e &lt;0.01, respectively) and negatively with SF12 physical ( p&lt;0.05). TechFragilidade score (r = 0,313, p &lt; 0,01) has a higher correlation to risk of fall than TechEscore score (r = 0,247, p &lt; 0,01) ( z = 2,004; p &lt; 0,023). Conclusion Our study showed that Techbalance was able to correlate RF in knee osteoarthritis patients combining frailty assessment and balance and postural evaluation using an IMU.

The association of osteoarthritis with metabolic disorders

Osteoarthritis (OA) is the most common form of synovial joint arthritis that causes chronic pain and disability to a large number of people worldwide. Most often, osteoarthritis affects the joints of the knees, hips, spine and hands. The Global Burden of Disease (GBD, 2021) estimates that osteoarthritis will be the fourth leading cause of disability by 2030, with enormous healthcare costs for treatment, as well as significant indirect costs due to loss of productivity and premature retirement. The aim of our research is to determine in what way prevalent metabolic syndrome is among participants with osteoarthritis of one of the synovial joints (knees, hips, hands), and whether metabolic disorders are a risk factor for the development and worsening of osteoarthritis. A prospective clinical study was conducted at the Public Health Institution Health Center Živinice, from July 2022 to May 2024, on a random sample of 200 participants with a confirmed clinical diagnosis of osteoarthritis (OA), who were divided into a group with metabolic syndrome and a group without metabolic syndrome based on the NCEP ATP III panel criteria for metabolic syndrome. The prevalence of knee osteoarthritis is significantly higher compared to the prevalence of hip and hand osteoarthritis, and it is greater among participants with a higher BMI (in participants with the highest BMI, knee osteoarthritis occurs with a 100% probability) and with the presence of metabolic syndrome, especially in more severe forms, specifically radiologically confirmed osteoarthritis, regardless of age and gender. Unlike OA knees the prevalence of OA hips and hands shows no correlation with BMI and metabolic syndrome. Multiple comparative analysis of differences in the average severity of osteoarthritis of the knee of subjects with normal glycemia / prediabetes / diabetes type 2 it showed a statistically significant difference in the average severity of knee osteoarthritis in subjects with regular blood sugar compared to subjects with prediabetes/diabetes mellitus type 2 regardless of age and gender. This means that with an increase in blood sugar levels, the degree of severity of osteoarthritis of the knee increases, since each subsequent Group has a higher average value of this indicator (p&lt;0.05; CI 95%).

Effectiveness of Ultrasound with Isometric Quadriceps Exercise and Retro walking in Osteoarthritis

Introduction: Knee osteoarthritis is a non-inflammatory, painful and degenerative joint disease; pathologic changes in osteoarthritis involve progressive hyaline joint cartilage loss with concomitant changes in subchondral bone and development of osteophyte. About symptomatic knee osteoarthritis affect 13% of women and 10% of men aged 60 years and older. Men have a lower prevalence of knee osteoarthritis than women. The tool used to measure pain intensity, physical functions in this study is WOMAC scale and to assess the range of motion by Universal goniometer. Aim : To Evaluate the Effectiveness of Ultrasound with Isometric quadriceps exercise and retro walking in osteoarthritis of knee. Method : A Total 30 both male and female participants between 45 to 65 years of age selected from RJS Group of institute of kopargaon , Kothari hospital kopargaon by using purposive sampling method according to the inclusion criteria. The total duration of the study is 3 weeks .total 30 participants allocated into two groups A and B 15 in each group. In group A were intervention Ultrasound with isometric quadriceps exercise and group B Ultrasound with retro walking were given for 3 weeks. Pre intervention and post intervention by WOMAC score and universal goniometer were taken analyzed compared using paired’ test. RESULT: As per statistical analysis both groups shown significant improvement but group B ( Ultrasound with Retro walking )was having most significant improvement as compare to group A ( Ultrasound with Isometric quadriceps exercises). CONCLUSION : This study concluded that Ultrasound with Retro walking was effective in participants with Osteoarthritis of knee .Hence there is reduction of pain, improving range of motion at knee joint and functional mobility, Activity of daily living in participants with osteoarthritis of knee.

Is Sports Participation Associated with the Knee Osteoarthritis?

Background: Osteoarthritis is affecting most of the population globally and knee osteoarthritis is the most common joint of the body getting involved. People nowadays are becoming fitness freaks, but without proper planning of fitness protocols and food habits, they end up with knee osteoarthritis. So, aiming to find out the prevalence of knee osteoarthritis in the growing society will help in improving the lives of human beings and make them perform well in daily life and on the field. Methodology: An observational descriptive analytic study, the target population was sports and non-sports individuals. Results: Sports individuals had a 6.52% KOA prevalence which (43.75% - males) and (56.25% - females). Non-sports individuals had 14.87% of KOA prevalence, of which (45.34% - males) and (54.65% - females). Conclusion: There was a high prevalence of knee osteoarthritis in non-sports individuals as compared to sports individuals and higher in females than males.

Weight, height, waist circumference: association with knee osteoarthritis findings from the osteoarthritis initiative.

Global prevalence of knee osteoarthritis is more than 300 million. Uncontrollable risk factors include age, sex, and height. Controllable risk factors include trauma, weight, and waist circumference. Our goal was to determine the association between knee osteoarthritis and anthropometric measures that include weight, height, and waist circumference. Using 4,602 participants (45-79 years) from the Osteoarthritis Initiative, we analyzed the association between knee osteoarthritis and anthropometry collectively and by sex. We calculated female and male tertiles (3 groups) for anthropometry. Anthropometric measures were correlated with knee osteoarthritis (P ≤ 0.05) except the correlation between height and activities and height and quality of life. When comparing female weight tertiles, there were associations (P's < 0.001) between knee osteoarthritis and weight, but when comparing male weight tertiles, these associations were primarily between the lowest weight and highest weight groups. There were significant associations between knee osteoarthritis and height among female tertiles, with no differences among male tertiles. There were knee osteoarthritis/waist circumference tertile associations (P's < 0.001) for the lowest and highest waist circumference groups. Higher weight in female participants was a stronger predictor of increases in knee osteoarthritis discomforts when compared to waist circumference, while weight and waist circumference were almost equivalent in predicting increases in knee osteoarthritis for male participants. Height did not predict increases in knee osteoarthritis with the exception of female symptoms and quality of life. Quality of life for both sexes was the most unfavorable with female participants reporting a more unfavorable quality of life than male participants.

Just-in-Time Adaptive Interventions for Behavior Change in Physiological Health Outcomes and the Use Case for Knee Osteoarthritis: Systematic Review.

The prevalence of knee osteoarthritis (KOA) in the adult population is high and patients profit from individualized therapy approaches. Just-in-time adaptive interventions (JITAIs) are upcoming digital interventions for behavior change. This systematic review summarizes the features and effectiveness of existing JITAIs regarding important physiological health outcomes and derives the most promising features for the use case of KOA. The electronic databases PubMed, Web of Science, Scopus, and EBSCO were searched using keywords related to JITAIs, physical activity (PA), sedentary behavior (SB), physical function, quality of life, pain, and stiffness. JITAIs for adults that focused on the effectiveness of at least 1 of the selected outcomes were included and synthesized qualitatively. Study quality was assessed with the Quality Assessment Tool Effective Public Health Practice Project. A total of 45 studies with mainly weak overall quality were included in this review. The studies were mostly focused on PA and SB and no study examined stiffness. The design of JITAIs varied, with a frequency of decision points from a minute to a day, device-based measured and self-reported tailoring variables, intervention options including audible or vibration prompts and tailored feedback, and decision rules from simple if-then conditions based on 1 variable to more complex algorithms including contextual variables. The use of frequent decision points, device-based measured tailoring variables accompanied by user input, intervention options tailored to user preferences, and simple decision rules showed the most promising results in previous studies. This can be transferred to a JITAI for the use case of KOA by using target variables that include breaks in SB and an optimum of PA considering individual knee load for the health benefits of patients.

Postoperative rehabilitation after knee arthroplasty

Postoperative rehabilitation after knee arthroplasty plays adecisive role in restoring the function and mobility of the affected joint. However, there is still disagreement regarding the setting, structure and content of rehabilitation after knee arthroplasty, and the evidence on the individual measures is largely unclear. The aim of this article is to provide an evidence-based overview of the current status of rehabilitation after knee arthroplasty and to critically discuss the points that are still unclear. In view of the increasing prevalence of knee osteoarthritis and the rising number of knee endoprosthesis implantations, the optimization and scientific processing of postoperative rehabilitation is more important than ever in order to be able to offer scientifically sound, practice-oriented and cost-effective rehabilitation measures in the future. This review is based on asystematic literature search in Medline, Cochrane Library and Web of Science databases on the topic of postoperative rehabilitation after knee arthroplasty. Regarding specific treatment components, duration and frequency after knee arthroplasty, the evidence is unclear. Passive therapies should only be used supportive to active interventions. Educational programmes before and after knee arthroplasty can play acrucial role in outcome and patient satisfaction. Regular strength training should always be combined with centrally oriented components, such as motor imagery, to achieve better movement visualization and central anchoring. There is still afrequent lack of scientific evidence regarding individual therapeutic measures, their intensity, frequency, duration, exercise selection and their specific implementation in rehabilitation after knee arthroplasty. In the future, digital diagnostic and training tools will become established in both inpatient and outpatient therapy, supporting the urgently needed data collection for the scientific analysis of individual therapeutic measures.

Sex Differences in Ambulatory Biomechanics: A Meta-Analysis Providing a Mechanistic Insight into Knee Osteoarthritis.

Females typically present with a higher prevalence of knee osteoarthritis (KOA), and such a higher prevalence may be due to unique knee biomechanics during walking. However, the sex-dependent ambulatory mechanics has been yet to be clarified. To address this critical knowledge gap, this study implemented a series of computational approaches 1) to identify sex-related knee joint biomechanics during ambulation in persons with KOA and 2) to compare these biomechanical measures between individuals with versus without KOA, stratified by sex. We searched five electronic databases for studies reporting sex-specific knee biomechanics in persons with and/or without KOA. Summary estimates were computed using random-effects meta-analysis and stratified by sex. The systematic review identified 18 studies (308 males and 383 females with KOA; 740 males and 995 females without KOA). A series of meta-analyses identified female-specific knee biomechanics in a disease-dependent manner. Females with KOA had lower first peak knee adduction moment and peak knee adduction compared with male counterparts. On the other hand, healthy females had lower peak knee flexion moment than male counterparts. Effect estimate in each meta-analysis displayed poor quality of evidence according to the GRADE approach. The current study is the first to consider sex as a biological variable into ambulatory mechanics in the development of KOA. We discovered that sex-dependent alterations in knee biomechanics is a function of the presence of KOA, indicating that KOA disease may be a driver of the sex-dependent biomechanical alterations or vice versa. Although no strong conclusion can be drawn because of the low quality of evidence, these findings provide new insight into the sex differences in ambulatory knee biomechanics and progression of KOA.

Association between intra-articular hyaluronic acid injections in delaying total knee arthroplasty and safety evaluation in primary knee osteoarthritis: analysis based on Health Insurance Review and Assessment Service (HIRA) claim database in Republic of Korea

BackgroundThe prevalence of knee osteoarthritis (KOA), a progressive degenerative disease, is gradually increasing, and it is a progressive degenerative disease. In patients with mild-to-moderate KOA, intra-articular hyaluronic acid (IA-HA) has been shown to be an effective non-operative treatment option that can provide significant pain relief and symptom improvement by increasing intra-articular viscoelasticity. This study aimed to evaluate the efficacy of IA-HA injections in delaying total knee arthroplasty (TKA) and the safety of IA-HA according to IA-HA type and combination with intra-articular corticosteroid (IA-CS) using a large health insurance claim database.MethodsFor this retrospective cohort study, the study population included patients aged ≥ 50 years with a first diagnosis of KOA between 2009 and 2014, who underwent TKA by 2020, using the Health Insurance Review and Assessment Service claim database in Republic of Korea. IA-HA injections were categorized as single or multiple injection regimen agents. Cox proportional hazard models estimated hazard ratios (HR) for TKA risk, adjusted for covariates. Logistic regression assessed the occurrence of adverse events after IA-HA administration.ResultsIn all, 36,983 patients were included. Patients who received IA-HA injections had a significantly longer time to TKA compared to those who did not (mean delay of approximately 1 year). The IA-HA group had a significantly lower risk of TKA (HR: 0.61, 95% CI: 0.60–0.62) than non-IA-HA group after adjusting for covariates, which included age, sex, medical history, number of hospital beds, and CS injection. Single injection IA-HA regimen agents showed the longest time to TKA and lowest risk (HR: 0.56, 95% CI: 0.53–0.59). TKA risk decreased with the number of IA-HA cycles. Adverse events occurred in 6.7% of IA-HA cases without CS, with very low incidence of infection. Multiple injection regimen agents (multiple injection regimen 7.0% vs. single injection regimen 3.6%) and concurrent IA-CS use (concurrent IA-CS use 13.9% vs. IA-HA only 6.7%) were associated with higher infection risk.ConclusionIA-HA injections were associated with a significant delay in TKA among patients with KOA. Single-injection regimen agents had the lowest TKA risk. Infection risk increased with multiple injections and concurrent IA-CS use. These findings could suggest the use of IA-HA as an effective non-operative intervention option for managing KOA and delaying TKA. Careful selection of IA-HA type and consideration of concurrent IA-CS use could play a role in delaying the time to TKA and reducing complications.

Relationship between serum vitamin D levels and the prevalence of knee osteoarthritis: A retrospective study on 3424 subjects.

The extent of the association between vitamin D deficiency and knee osteoarthritis remains inadequately understood. This study aimed to elucidate the relationship between vitamin D levels and knee osteoarthritis through a cross-sectional analysis. This retrospective study involved an analysis of knee radiographs and serum 25-hydroxyvitamin D3 (25-(OH) vitamin D3) levels in a cohort of 3424 individuals (2901 women and 523 men). Knee osteoarthritis severity was evaluated using the Kellgren-Lawrence radiological scoring system. Of the participants, 49.2% (n= 1,683) were diagnosed with knee osteoarthritis. Among these patients, the levels of adjusted 25-(OH) vitamin D3 were significantly lower (p< 0.001). Regression analysis revealed a significant association between vitamin D deficiency and knee osteoarthritis, with an adjusted odds ratio (OR) of 1.7 (95% CI: 1.5-2.0; p< 0.001). Notably, a stronger association was observed between vitamin D deficiency and knee osteoarthritis in women under 65 compared to those aged 65 and above. The findings of this study indicate a higher prevalence of vitamin D deficiency in patients with knee osteoarthritis. Maintaining adequate serum 25-(OH) vitamin D3 levels may prevent knee osteoarthritis, especially in women below 65.

Prehabilitation before total knee arthroplasty

Prehabilitation before knee joint replacement surgery is gaining increasing importance due to the rising prevalence of knee osteoarthritis. The aim is to optimize the preoperative condition to improve postoperative recovery and reduce complications. This review is based on asystematic literature search in the databases Medline, Cochrane Library, and Web of Science on the topic of prehabilitation in knee joint replacement. The current evidence shows heterogeneous results regarding the effectiveness of prehabilitation before knee joint replacement; some studies report improved postoperative outcomes such as reduced pain, increased function, and shorter hospital stays through preoperative training measures, while others found no significant differences. Additional preoperatively modifiable risk factors such as reduced physical fitness, substance abuse, nutritional status, comorbidities, and psychological factors should already be addressed during prehabilitation. Digital therapy and education measures offer apromising solution for the implementation of prehabilitation programs and are well received by patients. Overall, the evidence for preoperative training before knee joint replacement remains heterogeneous. Despite positive indications, evidence on exercise content, duration, frequency, and setting remains incomplete, requiring acritical review of current meta-analyses and systematic reviews. Modern prehabilitation before knee joint replacement should include musculoskeletal training and address preoperative risk factors to improve postoperative outcomes.

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.