Prevalence Of Knee Osteoarthritis Research Articles

Advanced Interventional Procedures for Knee Osteoarthritis: What Is the Current Evidence?

The prevalence of knee osteoarthritis (OA) is the highest among all joints and likely to increase over the coming decades. Advances in the repertoire of diagnostic capabilities of imaging and an expansion in the availability and range of image-guided interventions has led to development of more advanced interventional procedures targeting pain related to OA pain while improving the function of patients presenting with this debilitating condition. We review the spectrum of established advanced interventional procedures for knee OA, describe the techniques used to perform these procedures safely, and discuss the clinical evidence supporting each of them.

Prevalence and Risk Factors of Osteoarthritis in Korea: A Cross-Sectional Study.

Background and Objectives: The goal of this study is to determine the prevalence of knee osteoarthritis (OA) and risk factors for the disease in Korean adults over the age of 50, as well as to provide basic data for OA prevention through management. Materials and Methods: Based on 2010-2013 data from the Korean National Health and Nutrition Survey, 7962 adults over the age of 50 who participated in radiological tests and health surveys for the diagnosis of osteoarthritis were chosen as participants. Results: The risk factors for OA occurrence were investigated using complex sample multiple logistic regression analysis. According to the findings, the prevalence of knee OA in Korea was 33.3% in this study, with the risk of OA being higher in women, the elderly, people with a lower education level, and people with obesity. Conclusions: To reduce the incidence of OA, interventions and lifestyle changes are needed to prevent the onset of disease in participants with risk factors for OA, such as older women, low education levels, and obesity.

Fast-track knee pathway – A cost effective, quality improvement initiative for knee osteoarthritis

BACKGROUND: The prevalence of knee osteoarthritis is increasing due to population growth, ageing and other risk factors. However, the majority of patients can successfully manage their symptoms using conservative management strategies with only a minority requiring surgery. In 2019, a patient waited four years to be seen if deemed routine for an elective orthopaedic out-patient appointment in a large acute hospital in Ireland. OBJECTIVE: To establish a Fast-Track Knee Pathway in an Irish healthcare setting, creating a more efficient channel into elective orthopaedics for patients requiring surgical intervention whilst providing community-based care for those with non-surgical needs. METHODS: – Establishment of a dedicated community-based physiotherapy and dietetic service for knee osteoarthritis. – Implementation of a Rapid Access Knee Clinic in elective orthopaedic clinics. – Economic evaluation of the Fast-Track Knee Pathway’s cost effectiveness compared with the traditional pathway. RESULTS: 403 patients with knee osteoarthritis were removed from physiotherapy waiting lists with 9 patients requiring referral onwards to the Rapid Access Knee Clinic. On average there was a 64% reduction in wait time to access an orthopaedic consultant across 4 pilot sites. An incremental cost-effectiveness ratio of € 22,535.03 per QALY was estimated. Comparing this to the national accepted threshold of € 45,000 per QALY the Fast-Track Knee Pathway can be considered cost-effective. CONCLUSION: The Fast-Track Knee Pathway provides a fully integrated pathway of care for patients with knee osteoarthritis, facilitating earlier access to orthopaedic intervention. An economic evaluation concluded that this model of care is more cost-effective than the traditional pathway.

Metabolic syndrome is not associated with erosive hand osteoarthritis: a cross-sectional study using data from the PROCOAC cohort

To delineate the phenotype of erosive hand osteoarthritis (EHOA) in a Spanish population and assess its correlation with metabolic syndrome. We conducted a cross-sectional study using baseline data from the Prospective Cohort of Osteoarthritis from A Coruña (PROCOAC). Demographic and clinical variables, obtained through questionnaires, clinical examinations, and patient analytics, were compared among individuals with hand OA, with and without EHOA. We performed appropriate univariate and multivariate stepwise regression analyses using SPSS v28. Among 1039 subjects diagnosed with hand OA, 303 exhibited EHOA. Multivariate logistic regression analysis revealed associations with inflamed joints, nodular hand OA, and total AUSCAN. Furthermore, the association with a lower prevalence of knee OA remained significant. The influence of metabolic syndrome (MetS) on EHOA patients was analyzed by including MetS as a covariate in the model. It was observed that MetS does not significantly impact the presence of EHOA, maintaining the effect size of other factors. In conclusion, in the PROCOAC cohort, EHOA is associated with nodular hand OA, inflammatory hand OA, and a higher total AUSCAN. However, EHOA is linked to a lower prevalence of knee OA. Importantly, in our cohort, no relationship was found between EHOA and MetS.

Computerized diagnosis of knee osteoarthritis from x‐ray images using combined texture features: Data from the osteoarthritis initiative

AbstractThe prevalence of knee osteoarthritis (KOA) cases has witnessed a significant increase on a global scale in recent years, emphasizing the need for automated diagnostic computer systems to aid in early‐stage osteoarthritis (OA) diagnosis. The accurate characterization of knee KOA stages through feature extraction poses significant research challenges due to the complexity of identifying relevant attributes. In this study, the development of a KOA diagnostic system is presented, leveraging a combination of Gabor, and Tamura parameters using the Canonical Correlation Analysis algorithm. Two feature selection algorithms, namely Principal Component Analysis and Relief, were employed for KOA classification. Furthermore, various classifiers, including K‐Nearest Neighbors, AdaBoost, Bagging, and Random Forest, were used to assess the proposed feature extraction approach. The diagnostic system was assessed using a dataset comprising 688 x‐ray images sourced from the OA initiative (OAI) dataset, consisting of 344 images from healthy subjects (Grade 0) and 344 images from pathological patients (Grade 2). To mitigate overfitting, a 10‐fold cross‐validation method was utilized. The experimental results indicate that the combination of Tamura and Gabor parameters with the Random Forest classifier achieved remarkable performance in KOA diagnosis, yielding an accuracy of 94.59%, and an area under the curve of 98.3%. Notably, the combined Gabor and Tamura models exhibited superior performance compared to individual models, as well as existing techniques reported in the literature.

Does Playing Football (Soccer) Really Increase the Risk of Knee Osteoarthritis? A Systematic Review and Meta-analysis.

OBJECTIVE: To evaluate the relationship between football (soccer) participation and tibiofemoral knee osteoarthritis (OA), considering the influence of competitive level and previous knee injuries. DESIGN: Etiology systematic review with meta-analysis. LITERATURE SEARCH: PubMed, Embase, AMED, and Cochrane were searched for relevant publications. STUDY SELECTION CRITERIA: Studies of football players that included a control group consisting of mainly sedentary nonfootball players, and the relationship of knee OA, were considered. The studies had to report radiographically verified knee OA and specify football activity. DATA SYNTHESIS: Eleven studies, involving 1805 football players and 4022 control individuals were included. Subgroups consisting of data regarding level of play and previous injuries were also synthesized. RESULTS: The overall prevalence of knee OA among football players was increased among professional and recreational players, compared with controls. When knee injuries were excluded, there was no difference in knee OA between football players and controls (OR = 1.25; 95% CI: 0.61, 2.54). Football players with a previous knee injury had a greater risk of knee OA when compared with football players with no history of previous knee injury (OR = 4.16; 95% CI: 1.97, 8.77). CONCLUSION: Football players were at increased risk of knee OA. However, after excluding participants with a history of previous knee injury, there were no differences in knee OA between football players and controls. Previous knee injury was important for developing knee OA. Playing football, in the absence of major knee injuries, did not increase the risk of knee OA. J Orthop Sports Phys Ther 2024;54(5):1-12. Epub 26 February 2024. doi:10.2519/jospt.2024.12029.

The prevalence of bilateral and ipsilateral radiographic osteoarthritis is high in White, Asian and Native Hawaiian/Pacific Islanders presenting for unilateral knee or hip arthroplasty.

It is estimated that one-third of patients presenting with unilateral joint pain have contralateral osteoarthritis (OA) at first presentation. Most studies have primarily examined White patient cohorts. The purpose of this study was to determine the prevalence of contralateral joint OA for patients presenting for unilateral total knee (TKA), unicompartmental knee (UKA) or total hip arthroplasty (THA) among Asian, Native Hawaiian/Pacific Islander and White patients. Bilateral radiographic reports at initial presentation of 2,312 subjects who underwent unilateral arthroplasties (332 UKAs, 933 TKAs and 1,047 THAs) were reviewed. The presence of contralateral OA was recorded and compared by racial group and type of arthroplasty performed. Parametric statistical analyses were performed to determine differences between groups. Multivariable analyses were completed for each arthroplasty group to determine the influence on the presence of contralateral OA, presented as odds ratios and 95% confidence intervals. Contralateral joint OA was present in 86.7%, 90.4% and 70.4% of UKA, TKA and THA patients, respectively. Concurrent hip OA was present in 41.6% and 59.5% of UKA and TKA patients. No racial differences in the prevalence of contralateral knee OA were found for knee arthroplasty patients. White patients (74.6%) had a greater prevalence of contralateral hip OA compared to Asians (66.5%, p = 0.037) amongst THA recipients. Increased age and body mass index were significantly associated with the presence of contralateral knee OA. Increased age, being male and being White were significant contributors for the presence of contralateral hip OA. The prevalence of contralateral joint OA and concurrent hip OA is high in all three racial groups. Due to the extensive prevalence of contralateral and concurrent knee and hip OA, bilateral radiographic evaluation should be considered for all patients presenting with unilateral hip or knee pain due to OA.

Association Between Pain and Radiological Changes in Patients with Knee Osteoarthritis

Background: Knee osteoarthritis (OA) is a leading cause of disability worldwide, characterized by joint degeneration, pain, and functional limitations. Despite the prevalence of knee OA, the relationship between radiographic changes and the severity of pain remains complex. Previous studies have offered conflicting views on the association between structural joint alterations and clinical symptoms. Objective: The aim of this study was to investigate the association between radiographic degenerative changes in the knee, as classified by the Kellgren and Lawrence grading system, and the severity of resting pain measured using the Numeric Pain Rating Scale (NPRS). Methods: This cross-sectional study was conducted on 70 patients diagnosed with knee OA at multiple healthcare facilities in Lahore, Pakistan, from July 2022 to January 2023. Participants aged between 40 and 80 years, both males and females, were included. The severity of knee OA was determined using the Kellgren-Lawrence grading system through X-ray evaluations. Pain severity was assessed using the NPRS. Data were analyzed using SPSS version 25.0, with chi-square tests applied to explore the association between radiographic grades of knee OA and pain severity. Results: The distribution of knee OA severity among participants was as follows: Grade I (22.9%), Grade II (25.7%), Grade III (32.9%), and Grade IV (18.6%). Pain severity reported by participants was predominantly mild (55.7%), followed by moderate (37.1%) and severe (7.1%). Statistical analysis revealed a significant association between the grade of knee OA and the severity of resting pain (Chi-square = 30.06, p < 0.0001), indicating that higher grades of knee OA were correlated with increased pain severity. Conclusion: The study confirmed a significant association between radiographic degenerative changes in knee OA and the severity of resting pain. These findings suggest the need for comprehensive clinical assessments in patients with knee OA, incorporating both radiographic evaluations and pain severity measures to guide management and treatment strategies.

Mediating effect of lower extremity muscle on the relationship between obesity and osteoarthritis in middle-aged and elderly women in Korea: based on the 2009-2011 Korea National Health and Nutrition Examination Survey.

This study investigated whether the lower extremity muscle mass index (LMI) mediates the relationship between general obesity, central obesity, and knee osteoarthritis in middle-aged and elderly women in Korea. Data of 2,843 women aged ≥50 years were collected from the Korean National Health and Nutrition Examination Survey conducted between 2009 and 2011. General obesity and central obesity were evaluated based on body mass index (BMI) and waist circumference (WC), calculated through anthropometric measurements and body composition assessments. LMI was calculated by dividing the muscle mass in both legs-measured using the dual-energy X-ray absorptiometry-by body weight. Knee osteoarthritis was defined as a Kellgren-Lawrence scale (KL) grade of ≥2 as assessed through radiographic images. Knee osteoarthritis prevalence, indicated by KL grades, was significantly higher in the general obesity and central obesity groups compared to the normal group, and conversely, lower with varying LMI levels. Using mediation analysis with bootstrapping and adjusting for covariates, we found that LMI mediated the relationship between BMI and KL (β, 0.005; 95% confidence interval [CI], 0.000 to 0.010) and WC and KL grade (β, 0.002; 95% CI, 0.001 to 0.003), explaining 4.8% and 6.7% of the total effects of BMI and WC on KL grade, respectively. The study suggested that LMI partially mediates the link between general obesity and/or central obesity and knee osteoarthritis, proposing that a higher proportion of lower limb muscle mass relative to body weight can alleviate the increased risk of knee osteoarthritis caused by obesity.

Hyperacute Serum and Knee Osteoarthritis.

The knees are the most frequently affected weight-bearing joints in osteoarthritis (OA), impacting millions of people globally. With increasing life spans and obesity rates, the prevalence of knee OA will further mount, leading to a significant increase in the economic burden. The usual treatment modalities utilized to manage knee OA have shortcomings. Over the last decade, the field of regenerative medicine involving the use of biologics, such as autologous peripheral blood-derived orthobiologics, including hyperacute serum (HS), has evolved and shown potential for managing knee OA. In this manuscript, we qualitatively present the in vitro, pre-clinical, clinical, and ongoing studies investigating the applications of HS in the context of knee OA. Seven in vitro studies and one clinical study fit the scope of our manuscript. The results demonstrated that the administration of HS is potentially safe and efficacious in terms of increasing the viability of osteoarthritic chondrocytes, reducing pain and inflammation, and improving function in patients with knee OA. However, due to insufficient literature, pre-clinical studies to better understand the mechanism of action are required. In addition, adequately powered, multi-center, non-randomized, and randomized controlled trials with longer follow-up are warranted to establish the safety and efficacy of HS for the management of knee OA and to justify its clinical use.

The Epidemiology of Posttraumatic Osteoarthritis of the Knee in the United States: An Analysis of 948,853 Patients From 2000 to 2022.

Posttraumatic osteoarthritis of the knee (PTOAK) is a known sequela of bony and soft-tissue articular knee injuries, although its historically reported prevalence is highly variable with no recent population-based studies. The TriNetX/US Collaborative Network database was queried to identify adult patients diagnosed with a history of knee trauma using ICD-10-CM coding. Primary outcomes measured were yearly incidence proportion (IP), incidence rate (IR), and prevalence of knee osteoarthritis in the United States from 2000 to 2022. Chi square analyses were conducted to compare outcomes across categorical data. Regression modeling was performed to project PTOAK epidemiology to 2030. Statistical significance was held at P < 0.05 for all analyses. Nine hundred forty-eight thousand eight hundred fifty-three patients meeting criteria were identified. As of 2022, the IP of PTOAK was 5.93%, IR was 2.26 × 10 -4 cases/person-day, and prevalence was 21.1%. By strata in 2022, posttraumatic knee OA is most prevalent among the 54 to 59-year-old age group (50.9%), 60 to 64-year-old age group (50.3%), 50 to 54-year-old age group (49.7%), female patients (24.2%), and White patients (23.1%). Regression analyses revealed that the IP, IR, and prevalence of PTOAK have increased exponentially from 2000 to 2022. By 2030, the model predicts that the IP will further increase to 10.7% (95% PI = 9.79% to 11.7%), IR will be 3.79 × 10 -4 cases/person-day (95% PI = 3.28 × 10 -4 to 4.29 × 10 -4 ), and prevalence of PTOAK in the United States will be 40.6% (95% PI = 39.1% to 42.0%). These findings echo earlier, smaller scale studies but reveal an alarming rise in PTOAK prevalence, potentially doubling by 2030. The financial burden of knee OA treatment in the United States is already substantial, costing between $5.7 and $15 billion USD annually. This projected increase in prevalence could further increase healthcare expenditures by $1 to 3 billion by 2030. These results emphasize the need for additional research into factors contributing to PTOAK, evidence-based preventive public health interventions, and the development of multidisciplinary system-based care delivery optimization pathways.

Prevalence of Knee OA and its Association with Low Back Pain

Background: Knee osteoarthritis (OA) is a prevalent musculoskeletal condition known to impact quality of life and daily functioning significantly. Previous studies have identified a potential association between knee OA and low back pain, but this relationship requires further exploration to understand its implications fully. Objective: The objective of this study was to investigate the correlation between knee OA and low back pain, specifically examining the impact of knee pain on quality of life, daily functioning, and the severity of low back pain. Methods: A cross-sectional study was conducted with 377 OA patients aged between 45 to 75 years, selected via non-probability convenient sampling from various hospitals in Sialkot. Exclusion criteria included a history of knee surgery or recent trauma, mental retardation, or diabetes. Data were collected using the Oswestry Low Back Disability Index and the KOOS Urdu version. Statistical analysis was performed using SPSS version 26, focusing on descriptive statistics, mean and standard deviation for quantitative data, and the chi-square test for associations, with a significance threshold set at a p-value greater than 0.05. Results: The study found that the prevalence of knee OA varied by age group, with the highest prevalence (46.6%) in the 45-54 age group. Female participants predominated (75.9%). Severity levels of knee OA were classified as mild (32.6%), moderate (42.2%), and severe (21.8%). Significant correlations were observed between knee OA and low back pain, with correlation coefficients of 0.480 for pain effects on QOL, 0.441 for pain during SRF, 0.571 for pain during AODL, and 0.437 for the total score of pain. Conclusion: The study confirms a significant correlation between knee OA and low back pain, highlighting the need for integrated management approaches for patients suffering from these conditions. Addressing both knee and back pain concurrently could lead to better patient outcomes and improved quality of life.

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.

Epidemiology of knee Osteoarthritis in the young adults

The prevalence of knee osteoarthritis (KOA) has been seen to grow due to the rising proportions of both the aging population and individuals affected by obesity, in comparison to previous decades. The disease is expected to result in a global rise in the disability population and escalated healthcare expenditures. Although the prevalence of KOA is predominantly associated with the elderly population, it is imperative to acknowledge that individuals under the age of 45 may also be susceptible to having this disorder. Recently, an estimated significant increase in the prevalence of KOA among younger age groups has been observed. This can have significant consequences for these young patients, including loss of employment, diminished quality of life, increased medical expenses, and melancholy. Nevertheless, there is a scarcity of epidemiological research pertaining to KOA among individuals below the age of 45. Therefore, based on the data of the Global Burden of Disease (GBD) study 2019, this paper analyses the incidence and prevalence of KOA among young and middle-aged adults (below 45 years of age). Additionally, it will present a concise summary of the risk factors associated with KOA and outline preventive measures. Young women, obese individuals, and those with a prior knee injury history have a higher chance of acquiring KOA. The education of patients is critical in the prevention of KOA.

The Prevalence of Knee Osteoarthritis and Its Association With Obesity Among Individuals in Saudi Arabia.

Introduction This research, set in 2023 in Saudi Arabia, addresses the rising prevalence of knee osteoarthritis (OA)among obese individuals. It explores associations with age, BMI, and gender, aiming to enhance our understanding of this pressing health issue within the Saudi context and contribute to global research on OA and obesity. Methodology A retrospective cohort study was conducted at King Saud Hospital andBuraydah Central Hospital in the Al-Qassim region from November 2022 to February 2023. It included the patients' records that fit the inclusion criteria during the study period. A data collection sheet was used to collect data, and datawas analyzed using SPSS Statistics version 27.0.1 (IBM Corp. Released 2020. IBM SPSS Statistics for Windows, Version 27.0. Armonk, NY: IBM Corp.). Results In 2023, a study on knee OAamong 267 obese individuals in Saudi Arabia yielded significant findings. The median age of participants was 60 years, with an average weight of 77.00 kg (IQR:15) and a median BMI of 29.14, categorizing participants as overweight. Ninety percent (n=240) of knee OA cases occurred in individuals classified as "obese" (n=118) or "overweight (n=122)". Furthermore, OA primarily affected both knees in 79.4% (n=212) of cases. Conclusion Study participants, predominantly older and female, reflect OA's age-related and gender-specific prevalence trends. Notably, excess weight and a higher BMI highlight the role of obesity as a significant OA risk factor. Bilateral knee involvement is common, with a strong link between OA and obesity.

Effect of the telemedicine-supported multicomponent exercise therapy in patients with knee osteoarthritis: study protocol for a randomized controlled trial

IntroductionThe rising prevalence of knee osteoarthritis is placing a considerable strain on the global healthcare system. To address this issue, telemedicine-supported multicomponent exercise therapy has emerged as a promising approach. This therapy combines exercise, patient education, and health coaching to empower knee osteoarthritis patients to manage their condition from the comfort of their homes. Nevertheless, there are some existing limitations in the current research on this approach, including challenges related to patient compliance and the absence of objective evaluation methods.Methods and analysisPatients diagnosed with knee osteoarthritis, who have not undergone knee surgery in the past year, will be recruited for a randomized controlled trial. The trial will include an intervention group and a control group. The intervention group will receive an mHealth app-based multicomponent exercise therapy, consisting of exercise therapy, patient education, and health coaching. Meanwhile, the control group will receive usual care, involving drug therapy and patient education. The primary outcome of the trial will be the measurement of pain intensity, assessed using a visual analog scale at baseline and at 4, 8, and 12 weeks of the post-intervention. To analyze the data, a two-factor, four-level repeated measures ANOVA will be used if the assumptions of homogeneity of variance and sphericity are met. If not, a mixed effects model will be employed.DiscussionThe aim of the study is to evaluate the effectiveness of multicomponent exercise therapy aimed at enhancing pain self-management for knee osteoarthritis patients in the comfort of their own homes. The intervention incorporate wearable devices equipped with advanced deep learning systems to monitor patients' adherence to the prescribed at-home exercise regimen, as well as to track changes in outcomes before and after the exercise sessions. The findings from this trial have the potential to enhance both the accessibility and quality of care provided to knee osteoarthritis patients, offering valuable insights for future improvements in their treatment and management.Trial registrationChinese Clinical Trials Registry, ChiCTR2300073688. Registered on 19 July 2023, https://www.chictr.org.cn/bin/project/edit?pid=199707. World Health Organization International Clinical Trials Registry Platform, https://trialsearch.who.int/Trial2.aspx?TrialID=ChiCTR2300073688.

Conventional Radiography of Grade III Knee Osteoarthritis: A Case Report

Introduction: Osteoarthritis (OA) is the most common form of inflammatory joint disease. It occurs most frequently in the knees, hips, the spine (vertebrae), and ankles. Radiological prevalence of knee OA in Indonesia reaches 15.5% in men and 12.7% in women aged between 40-60 years. X-ray imaging is routinely used in clinical practice to confirm knee OA diagnosis and in clinical research to monitor the progression of knee OA. Case report: A 62-year-old female patient presented with knee pain in both knees that had been ongoing for the past 6 months. The pain was described as throbbing and stabbing, the right knee worse affected than the left. Palpation elicited tenderness, crepitus in both joints and did not reveal any deformities. Radiological AP/Lateral X-ray of the right knee revealed evidence of osteophytes, sclerosis and narrowing joint space, leading to the impression of Grade III osteoarthritis in the right knee. Discussion: Joint pain is the chief complaint that leads patients with knee osteoarthritis to seek medical attention. Pain typically worsens with movement and decreases with rest. In diagnosing OA, an AP/Lateral radiographic examination of the right knee is conducted, revealing the presence of osteophytes, subchondral bone sclerosis and accompanied by slight joint narrowing. This impression aligns with the Grade III OA criteria according to the Kellgren-Lawrence grading system. Conclusion: Diagnosis of osteoarthritis involves a comprehensive approach combining medical history, physical examination, and diagnostic tests. Radiographic examinations including conventional radiography play a significant role in diagnosing OA. In the early stages of the disease, joint radiographs may still appear normal. The severity of knee OA can be evaluated using the Kellgren-Lawrence (KL) grading scheme which ranges from grade 0 to grade 4. Keywords: Knee Osteoarthritis, Conventional Radiography, The Kellgren-Lawrence Grading

Static Balance Reliability Test with One Leg Stance Test in Knee Osteoarthritis Patients

Introduction: Osteoarthritis (OA) is the most common joint inflammation that often occurs in the knee region and its prevalence increases with age. The prevalence of knee OA is the highest compared to other regions. Static balance is one of the problems in OA patients which is evaluated by the One leg stance test, but the reliability of this measuring instrument for patients with knee OA has not been reported in Indonesia. Research objective: To determine the reliability of the intra rater and inter rater one leg stance test as a measure of static balance in patients with knee osteoarthritis. Materials and methods: The research method used was an observational study with a methodological research approach. There were 58 respondents who signed informed consent and were involved in this study. Results/findings: Intra rater reliability showed a very high internal consistency in both right and left eye open positions (?&gt;0.9) with ICC=0.8-0.9. Whereas OLS in closed eyes shows moderate to low internal consistency and moderate ICC. The results of the inter-rater reliability analysis showed very high internal consistency and ICC for the right and left leg open eyes. Whereas in closed eyes it has internal consistency and moderate to high ICC for the right and left. Conclusion: The ability to maintain static balance in the closed eye position is something that is not easy for patients with knee OA to do, possibly due to pain and also reduced function in the elderly, this is indicated by the low consistency value for OLS in the closed eye position.

Network meta-analysis of 7 acupuncture therapies for knee osteoarthritis.

With the progression of society aging demographic, the prevalence of knee osteoarthritis (KOA) continues to rise steadily, exerting a significant impact on individuals' quality of life. Acupuncture therapy has garnered extensive utilization in the management of osteoarthritis; however, a comprehensive systematic review integrating acupuncture with traditional Chinese medicine remains absent. This study compared the clinical efficacy of 7 acupuncture methods (electroacupuncture, conventional acupuncture, warm needle, floating needle, fire needle, needle knife, and silver needle) for the treatment of KOA through a network meta-analysis. This study examined the databases-PubMed, EMbase, The Cochrane Library, the China Biology Medicine, Chinese Journal Full-text Database, Wanfang Database, and VIP Database-for randomized controlled trials of the 7 methods for KOA treatment. The search time spanned from the database establishment to March 5, 2022. The primary outcome indicator was the total effective rate, and the secondary outcome indicator was the visual analog scale. After the layer-by-layer screening, the quality of the literature was assessed using the Cochrane systematic reviewer manual 5.1.0 bias risk assessment tool for randomized controlled trials. After data extraction, the R4.0.1 software was used for network meta-analysis. Based on the network meta-analysis, the ranking of interventions based on the surface under the cumulative ranking curve for the total effective rate is as follows: silver needle (0.99) > floating needle (0.97) > needle knife (0.66) > fire needle (0.56) > warm needle (0.44) > conventional acupuncture (0.35) > electroacupuncture (0.13). Regarding the improvement in visual analog scale scores, the surface under the cumulative ranking curve ranking is as follows: silver needle (0.97) > conventional acupuncture (0.67) > needle knife (0.64) > floating needle (0.51) > warm needle (0.44) > fire needle (0.14) > electroacupuncture (0.09). Based on the network meta-analysis, silver needle therapy emerged as the most efficacious and analgesic intervention for KOA. Nevertheless, given the notable variations in the quality and quantity of studies encompassing diverse treatment modalities, the findings of this research necessitate further substantiation through forthcoming high-quality multicenter, large-sample, randomized double-blind trials.

Prevalence and Characteristics of Knee Osteoarthritis Among the General Public in Saudi Arabia.

Background Knee osteoarthritis (OA) is a chronic and progressive knee joint condition that is influenced by multiple factors. This research aims to examine the prevalence and characteristics of knee OA among the general public in Saudi Arabia. Methodology This cross-sectional online survey was conducted in September 2023 in Saudi Arabia. This research used a previously developed questionnaire to validate the diagnosis of OA, which was performed in accordance with the diagnostic criteria established by the American College of Rheumatology (ACR). The Western Ontario and McMaster Universities Arthritis Index questionnaire (WOMAC) was used to examine the severity and characteristics of knee OA patients. A binary logistic regression analysis was conducted to determine the variables that influence the severity of knee OA and the likelihood of developing OA. Results A total of 1,019 individuals participated in this study. Around one-third of the participants (34.5%) fulfilled the ACR criteria for knee OA diagnosis. Overall, the mean WOMAC score was 34.1 (18.8) out of 96, which represents 35.5% of the maximum obtainable score and demonstrates a low degree of knee OA severity. The mean pain sub-scale score was 7.4 (3.8) out of 20, which represents 37.0% of the maximum obtainable score and demonstrates a low level of pain intensity. The mean stiffness sub-scale score was 2.7 (1.8) out of 8, which represents 33.8% of the maximum obtainable score and demonstrates a low degree of stiffness in joints. The mean physical function sub-scale score was 24.0 (14.0) out of 68, which represents 35.3% of the maximum obtainable score and demonstrates a low level of physical function difficulty. Females, older participants (above 40 years), those with high body mass index (28.8 kg/cm2 and higher), non-smokers, those with comorbidities, those who did not practice daily physical activity, those who had a family history of knee OA, and those who suffered from flat feet, rheumatoid arthritis, gout, lupus, or back or hip pain were more likely to develop knee OA and have severe OA (p < 0.05). Conclusions Thefindings of this study demonstrated a significant prevalence rate of kneeOA and highlighted a discrepancy between the rates obtained by diagnostic criteria and those determined through clinical diagnosis. Several significant factors that contribute to the development of OAencompass lifestyle choices such as food and exercise, familial predisposition, genetic influences, and the presence of comorbidities. To effectively tackle this intricate matter, it is imperative to adopt a patient-centered strategy and prioritize early intervention.