Prevalence Of Knee Osteoarthritis Research Articles

Effectiveness and safety of electrical moxibustion for knee osteoarthritis: A multicenter, randomized, assessor-blinded, parallel-group clinical trial

BackgroundThe prevalence of knee osteoarthritis (KOA) is increasing, and it has emerged as a major health issue. Studies have been reported that moxibustion is effective for treating KOA, but conventional moxibustion is difficult to control the intensity of stimulation and causes smoke, harmful gases, or odors. An electrical moxibustion (EM) device was developed to solve these problems, so we conducted this study to evaluate the effectiveness and safety of EM as a treatment for KOA. MethodsThis is a multicenter, randomized, assessor-blinded, parallel-group clinical trial. Participants with KOA were randomly allocated into EM, traditional indirect moxibustion (TIM), or usual care groups. The moxibustion groups were received 12 sessions of moxibustion treatment at six acupuncture points (ST36, ST35, ST34, SP9, EX-LE4, SP10) over a period of 6 weeks. The usual care group was received usual treatment and self-care. The primary outcome was the degree of pain measured by numerical rating scale (NRS). The second outcomes were measured using visual analog scale, Korean version of the Western Ontario and McMaster Universities osteoarthritis index, patient global assessment, European quality of life five dimension five level scale, and warm sense threshold and heat pain threshold. For safety assessment, laboratory test and adverse events (AEs) were recorded. ResultsA total of 138 participants were assigned. While there was no significant NRS change in the usual care, EM and TIM showed significant decrease after treatment. Compared to the usual care, the mean change of NRS in the EM and TIM was significantly different, but there was no significance between two groups. Regarding secondary outcomes, EM and TIM also showed significant difference compared to the usual care, but there was no significance between two groups. Regarding safety assessment, while usual care showed significant safety among three groups, EM showed seven treatment-related AEs by four participants compared TIM’s 10 events by 10 participants. In addition, there was no blister caused by burns in the EM, which occurred four cases in the TIM. ConclusionThis study shows that EM is effective to improve the pain and function by KOA with a certain level of safety.

Metabolic syndrome, hypertension, and hyperglycemia were positively associated with knee osteoarthritis, while dyslipidemia showed no association with knee osteoarthritis.

Metabolic syndrome (MetS) is a clustering of at least three of the following four medical conditions: obesity, hypertension, dyslipidemia, and hyperglycemia. We aimed to discover the relationships between these diseases and osteoarthritis (OA) of the knee. We searched four databases (EMBASE, PubMed, Cochrane Library, and MEDLINE), as well as articles on websites and conference materials. Study effect estimates and their 95% confidence intervals (CIs) were extracted and calculated. Sensitivity analyses were undertaken to determine inter-study heterogeneity. Finally, we tested for publication bias to determine whether the outcome of the meta-analysis was robust. A total of 1609 articles were identified, 40 of which were included. In radiological studies, the relationships with OA were increased for people with the following diseases: metabolic syndrome (OR 1.418, 95% CI 1.162 to 1.730), hypertension (OR 1.701, 95% CI 1.411 to 2.052), and hyperglycemia (OR 1.225, 95% CI 1.054 to 1.424). In symptomatic studies, the outcomes were similar in metabolic syndrome (OR 1.174, 95% CI 1.034 to 1.332) and hypertension (OR 1.324, 95% CI 1.186 to 1.478) studies, while there were no associations in hyperglycemia (OR 0.975, 95% CI 0.860 to 1.106) studies. There was no correlation between dyslipidemia and OA, whether in radiological studies (OR 1.216, 95% CI 0.968 to 1.529) or symptomatic studies (OR 1.050, 95% CI 0.961 to 1.146). In both studies, metabolic syndrome and hypertension were positively associated with knee OA, and dyslipidemia showed no correlations. Hyperglycemia was associated with OA in radiological studies, while results were reversed in symptomatic studies. Key Points • The hypothesis that metabolic syndrome and its components increase the risk for knee osteoarthritis is attractive; thus, this meta-analysis may help us find out the answer. • There were lots of large-scale studies here, and the total participants were considerable; and this meta-analysis was relatively robust because of reasonable heterogeneity and publication bias. • Targeted education and effective management of risk factors may be helpful for reducing the prevalence of knee osteoarthritis.

Single-leg forward hopping exposures adversely affect knee joint health among persons with unilateral lower limb loss: A predictive model

Single-leg hopping is an atypical, yet convenient, method of ambulation for individuals who have sustained unilateral lower limb-loss. Hopping is generally discouraged by therapists but many patients report hopping, and the potential deleterious effects of frequent hopping on knee joint health remains unclear. Mechanical fatigue due to repeated exposures to increased or abnormal loading on the intact limb is thought to be a primary contributor to the high prevalence of knee osteoarthritis among individuals with unilateral lower limb amputation. We aimed to compare knee joint mechanics between single-leg hopping and walking at self-selected paces among individuals with unilateral lower limb-loss, and estimated the associated probability of knee cartilage failure. Thirty-two males with traumatic unilateral lower limb-loss (22 transtibial, 10 transfemoral) hopped and walked at a self-selected pace along a 15-m walkway. Peak knee moments were input to a phenomenological model of cartilage fatigue to estimate the damage and long-term failure probability of the medial knee cartilage when hopping vs. walking. We estimate that each hop accumulates as much damage as at least 8 strides of walking (p < 0.001), and each meter of hopping accumulates as much damage as at least 12 m of walking (p < 0.001). The 30-year failure probability of the medial knee cartilage exceeded a “coin-flip” chance (50%) when performing more than 197 hops per day. Although a convenient mode of ambulation for persons with unilateral lower limb-loss, to mitigate risk for knee osteoarthritis it is advisable to minimize exposure to single-leg forward hopping.

Predominant lifetime occupation and associations with painful and structural knee osteoarthritis: An international participant-level cohort collaboration

With adults working to older ages, occupation is an important, yet less modifiable domain of physical activity to consider in the risk of knee osteoarthritis (OA). This study aimed to investigate the association between predominant lifetime occupation and prevalent knee OA. Participant-level data were used from five international community-based cohorts: Johnston County Osteoarthritis Project, the Hertfordshire Cohort Study, the Multicenter Osteoarthritis Study, the Tasmanian Cohort Study and Framingham Osteoarthritis Study. Self-reported predominant occupation was categorized into sedentary, light, light manual and heavy manual levels. Cross-sectional associations between predominant lifetime occupation and knee OA outcomes including prevalence of radiographic knee OA (RKOA), symptomatic RKOA and knee pain, were assessed using logistic regression, accounting for cohort clustering. Data for 7391 participants were included. 24.7% reported sedentary lifetime occupation, 30.0% light, 35.9% light manual and 9.4% heavy manual. 43.3% presented with RKOA, 52.1% with knee pain and 29.0% with symptomatic RKOA. There was over a two-fold increase in the odds of having RKOA, knee pain and symptomatic RKOA in those whose with heavy manual compared to sedentary occupations ((odds ratio (OR): 2.14; 95% confidence interval (CI): 1.79, 2.58), (OR: 2.19; 95% CI: 1.78, 2.70), (OR: 2.41; 95% CI: 1.94, 2.99) respectively). This large international multi-cohort study demonstrated an association of heavy manual work with RKOA, symptomatic RKOA and knee pain. Measures that protect workers and are designed to reduce heavy manual related activities remain a priority to reduce the risk of knee OA.

Individuals with high bone mass have increased progression of radiographic and clinical features of knee osteoarthritis

High bone mass (HBM) is associated with an increased prevalence of radiographic knee OA (kOA), characterized by osteophytosis. We aimed to determine if progression of radiographic kOA, and its sub-phenotypes, is increased in HBM and whether observed changes are clinically relevant. A cohort with and without HBM (L1 and/or total hip bone mineral density Z-score≥+3.2) had knee radiographs collected at baseline and 8-year follow-up. Sub-phenotypes were graded using the OARSI atlas. Medial/lateral tibial/femoral osteophyte and medial/lateral joint space narrowing (JSN) grades were summed and Δosteophytes, ΔJSN derived. Pain, function and stiffness were quantified using the WOMAC questionnaire. Associations between HBM status and sub-phenotype progression were determined using multivariable linear/poisson regression, adjusting for age, sex, height, baseline sub-phenotype grade, menopause, education and total body fat mass (TBFM). Generalized estimating equations accounted for individual-level clustering. 169 individuals had repeated radiographs, providing 330 knee images; 63% had HBM, 73% were female, mean (SD) age was 58 (12) years. Whilst HBM was not clearly associated with overall Kellgren-Lawrence measured progression (RR=1.55 [0.56.4.32]), HBM was positively associated with both Δosteophytes and ΔJSN individually (adjusted mean differences between individuals with and without HBM 0.45 [0.01.0.89] and 0.15 [0.01.0.29], respectively). HBM individuals had higher WOMAC knee pain scores (β=7.42 [1.17.13.66]), largely explained by adjustment for osteophyte score (58% attenuated) rather than JSN (30% attenuated) or TBFM (16% attenuated). The same pattern was observed for symptomatic stiffness and functional limitation. HBM is associated with osteophyte progression, which appears to contribute to increased reported pain, stiffness and functional loss.

Quantitative analysis of the joint space narrowing speed in each Kellgren-Lawrence grade of knee osteoarthritis

Purpose: The knee is the large joint most frequently affected by osteoarthritis (OA), and knee OA is one of the major causes of joint dysfunction and physical disability in the elderly. The prevalence of knee OA was respectively reported to be 42.6% and 62.4% among Japanese men and women older than 40 years, while it was 33.0% in the Framingham study. In the outpatient clinic, we sometimes find that the speed of knee OA progression is not constant in a patient. Previous research was conducted a meta-analysis that revealed a negative correlation between joint space narrowing or the risk of Kellgren-Lawrence (K-L) progression and follow-up time, but detailed information about the speed of knee OA progression is still lacking.

Occupational risk in knee osteoarthritis: a systematic review and meta-analysis

Purpose: Prevalence of knee osteoarthritis has been associated with work-related repetitive joint movements and excess knee load, but little is known of the relationship between specific job titles and risk of knee osteoarthritis; especially light to moderate physically demanding occupations. This review aims to assess the association between occupational exposures and knee osteoarthritis (OA).

The correlation of dairy products and radiographic progression of knee osteoarthritis of Tibetan in plateau region

Purpose: Knee osteoarthritis (KOA) is the most common joint disease targeting articular cartilage which leads to dysfunction and disabilities. Radiography is the gold standard for diagnosing OA using the Kellgren-Lawrence(KL) grading system. We have found that the prevalence of KOA was higher in plateau region of China , until now, there are no such studies concerning the risk factors of radiographic progression of KOA of inhabitants in plateau region. Therefore, our aim was to investigate the risk factors of radiographic progression of KOA patients of Tibetan in plateau region.

The role of sex hormones and inflammation in the causal pathway of high bmi to knee oa the role of sex hormones and inflammation in the causal pathway of high bmi to knee OA

Purpose: There is consistent evidence of the high impact of increased BMI on knee OA and knee pain. There is also some evidence that hormone levels are associated to OA, though this relationship is influenced by BMI. We hypothesized that the decreasing hormone levels may play a role in the causal pathway that leads to a higher prevalence and incidence of knee OA and pain at least in women. Therefore, we tested this hypothesis by using Structural Equation Modeling (SEM) in men and women independently. The aim of this study was to explore the causal relationships between sex hormones, inflammation factors and BMI in radiographic knee OA (RKOA) and chronic knee pain (CKP). Methods: We used the Rotterdam Study cohort, a population based prospective study with participants aged 45 and older. The participants underwent an interview on pain questionnaire, blood and radiographic measurements at baseline as well as follow-up radiographic measurements. In our study for prevalent radiographic knee OA (RKOA) we included a total of 12,546 observed knees of which 606 were knee OA cases. For incident radiographic knee OA, from the 11,940 knees without OA, 4,090 were lost to follow-up, so we included 7,850 knees without knee OA at baseline from which 533 developed knee OA during a median follow-up time of 5 years. RKOA was defined as a KL score of 2 or higher. Participants provided answers during a home interview about current musculoskeletal pain in the knees, hips, hands and lower back. If present, the duration was also recorded. We included 5,897 participants in our analysis for prevalent chronic knee pain (CKP). There were 2,349 participants with CKP and 3,548 with no pain in either of their knee joints. CKP was defined as having pain in the knee joint for more than 3 months. We estimated the direct and indirect effects of BMI, CRP, estradiol and sex hormone binding globulin (SHBG) on prevalence and incidence of RKOA and CKP by using SEM. SEM is a multivariate statistical analysis technique that is used to analyze structural relationships. Results: Our results from the SEM analysis on the prevalence of RKOA (Figure 1), show that BMI has a significant association with an effect estimate of 0.1 on RKOA in women. The indirect effects from BMI through estradiol or through SHBG to RKOA were also present only in women but with a much smaller effect estimate (estimate=0.004 through estradiol, estimate=0.01 through SHBG) compared to the direct effect of BMI. In contrast, we found an indirect effect from BMI through CRP to RKOA (estimate=-0.01) only in men. In case of CKP, we did not find indirect effects of BMI though the sex hormones or CRP in neither women nor men. BMI has a strong direct effect on CKP in both women (estimate = 0.18) and men (estimate = 0.15) as shown in Figure 2. The SEM models showed good indices of fit: CFI (Comparative Fit Index) and the RMSEA (Root Mean Square Error of Approximation). CFI should be above 0.95 and RMSEA below 0.05. For the RKOA model: CFI=0.98 and RMSEA=0.046. For the CKP model: CFI=0.98 and RMSEA=0.038. Conclusions: We found indeed indirect effects of BMI on RKOA through estradiol and SHBG in women, but not in men. However, the contribution of the path through sex hormones is negligible to the total effect of BMI on RKOA. In men we found a (small) indirect effect of BMI on RKOA through CRP, a well-known inflammation factor. Curiously, this effect was protective.View Large Image Figure ViewerDownload Hi-res image Download (PPT)

Erosive hand osteoarthritis phenotype: clinical and proteomic characterization

Purpose: Erosive hand osteoarthritis (EHOA) is often considered a more severe form of hand OA that includes pain and inflammation. However, more data are needed regarding the different hand OA phenotypes, especially erosive and non-erosive, to conclude if they represent two different subsets of hand OA or even different degrees of affectation of the same disease. The purpose of this work is to define a specific clinical pattern of patients with EHOA and identify putative biochemical markers associated with this phenotype. Methods: This cross-sectional study was conducted in the Prospective Cohort of Osteoarthritis A Coruna (PROCOAC). This cohort consists of 1136 subjects, from which 834 were diagnosed of hand OA following ACR criteria. After reviewing the x-rays, the cohort was split into patients with and without erosive hand OA. Then, both clinical and demographic data within each group were subsequently analyzed. A Univariate analysis comparing different variables between both groups, followed by a stepwise regression logistic regression analysis was performed to characterize the clinical pattern of EHOA. The identification of biochemical markers was carried out following a two-step workflow: in a first discovery phase, a proteomic approach based on peptide labelling with Isobaric tags for relative and absolute quantitation (iTRAQ) was employed using two different sets of sera (n=20) from EHOA or non-EHOA patients. In a second validation phase an independent set of 346 individual serum samples from the PROCOAC cohort (EHOA, n=127; non-EHOA, n= 219) was used to quantify serum concentrations of the extracellular matrix protein 1 (ECM1) by ELISA. The Mann-Whitney test was carried out in order to look for significant differences between EHOA and non-EHOA groups. All the statistical analyses were performed using SPSS software v.24. Results: The univariate analysis showed that EHOA patients were younger (p<0.001), smokers (p=0.011), with lower both body mass index (p=0.006) and arterial hypertension (p=0.002); increased frequency of inflammatory symptoms in hands (p<0.001), more presence of nodular hand OA (p=0.001) but lower frequency of other forms of hand OA, specially thumb-base (p=0.005) and metacarpophalangeal (p=0.036). In addition, these patients also showed a lower number of damaged joints (p<0.001), specially the knee (p<0.001). The stepwise logistic regression model (Table 1) confirmed the strong association of age (OR=0.963;95%CI=0.937-0.989;p=0.005), inflammatory symptoms (OR=4.575;95%CI=2.621-7.985;p<0.001), increased prevalence of nodal OA (OR=2.125;95%CI=1.118-4.037;p=0.021) and, in patients over 64 years old, MetS (OR=2.029;95%CI=1.183-3.478;p=0.010) with the erosive phenotype. In addition, erosive patients show a lower prevalence of knee OA (OR=0.416;95%CI=0.252-0.687;p=0.001) and to carry this phenotype at baseline does not confer a significant increased risk for radiographic knee OA progression over time). Regarding the proteomic analysis for the identification of potential biomarkers associated with the EHOA phenotype, a total of 257 different proteins were identified in the serum samples with more than two peptides and a total score ≥2 at 95% confidence. Thirty-six proteins were found quantitatively altered between those patients with or without EHOA. A significant reduction (p=0.029) of ECM1 concentrations was found in the serum from patients with the EHOA phenotype (0.154 ± 0.010 μg/ml vs 0.169 ± 0.007 μg/ml) (Figure 1). Conclusions: A specific clinical pattern of patients with EHOA has been defined. It has been associated with altered levels of 36 proteins in serum. Particularly, decreased amounts of ECM1 have been found in patients with this erosive phenotype.View Large Image Figure ViewerDownload Hi-res image Download (PPT)

Intraarticular injection of processed lipoaspirate cell has anti-inflammatory and analgesic effects in murine monoiodoacetate-induced osteoarthritis

Purpose: Osteoarthritis (OA) of the knee is common and one of the major causes of joint dysfunction and physical disability in the elderly. OA of the knee is associated with knee-related disabling symptoms in about 10% of UK men and women aged more than 55 years, and about 25% of these patients suffer debilitating disability. It was reported that 49.5% of elderly Japanese had radiographically-evident bilateral OA of the knee (Kellgren and Lawrence (K/L) grade ≥2). Furthermore, the estimated the prevalence of knee OA in Japan is 42.6% and 62.4%.

Evaluation of Periarticular Pathology Surrounding Knee Joint Tissues in an Osteoarthritis Rat Model

Osteoarthritis (OA) is a multifactorial disease associated with pathological changes in a wide variety of musculoskeletal tissues, including articular cartilage degeneration, synovitis, ligament tears as well as muscle wasting. Cartilage is known as a predominant pathology, however the association between the pathogenesis of OA around the knee joint tissues and pain is limited. Infrapatellar fat pad (IFP) fibrosis and muscle atrophy are the main features of chronic OA phenomenon that cause joint pain, stiffness and impairment of skeletal muscle, which contributing to locomotor restriction in OA patients. Despite a high prevalence of knee OA, there is still a lack of comprehensive information explaining the interplaying mechanisms among these OA features. Although various animal models of OA have been characterized, none of them can truly represent all aspects of the OA features. Monoiodoacetate (MIA)‐induced OA is one of the most common animal model used in the OA research, in which intra‐articular injection of MIA can lead to articular cartilage destruction and development of pain‐like behaviour. This study aimed to characterize and determine the suitable time point, at which MIA could significantly induce the development of IFP fibrosis and hind limb muscle atrophy in this OA rat model. IFP and soleus muscle were collected for histological analysis at 4 and 8 weeks post‐OA induction. In addition, pain‐related behavior was also evaluated using hind limb weight distribution test. Semi‐quantitative analysis of Masson’s trichrome staining revealed that the percentage of IFP fibrosis area was not significantly different at 4 weeks compared to 8 weeks post‐OA induction. In addition, there was a significant (p&lt;0.05) reduction of soleus muscle fiber cross‐sectional area at 4 and 8 weeks of OA‐induced groups compared to their relative controls; however, the muscle fiber atrophy was more pronounced at 4 weeks compared to 8 weeks. Moreover, there was a significant reduction in the mean values of percent weight borne on the injured hind limb for the OA‐induced group compared to the saline group throughout the study period (p&lt;0.05). Interestingly, pain response significantly reversed at 8 weeks compared to 4 weeks (p&lt;0.001), suggesting that this reversal in pain response could be the contributing factor on alleviation of soleus muscle atrophy under chronic OA pain. These results suggested that at 4 weeks post‐MIA injection is sufficient and suitable period to investigate OA‐related pain, IFP fibrosis and muscle atrophy. Taken together, a MIA‐induced OA rat can be used as a representative model in translational research to understand IFP fibrosis and hind limb muscle atrophy in OA as an integrated musculoskeletal disease.

Occupation and risk of knee osteoarthritis and knee replacement: a longitudinal, multiple-cohort study

Purpose: Most data from observational studies suggest that occupations that involve repetitive and/or excessive levels of knee loading, such as farming, mining and floor-laying, carry an increased risk of knee osteoarthritis (OA). Similarly, specific work-place physical activities (e.g. heavy lifting) have been associated with increased knee OA prevalence. There is, however, limited data on the effect of occupational exposures on knee OA incidence and progression to total knee replacement (TKR).

The prevalence of and demographic factors associated with radiographic knee osteoarthritis in Korean adults aged ≥ 50 years: The 2010-2013 Korea National Health and Nutrition Examination Survey.

To reduce the social burden of knee osteoarthritis (OA) by addressing it in the early stages in the population at greatest risk, the epidemiology of knee OA needs to be understood and associated demographic factors need to be identified. We evaluated the weighted prevalence of and demographic factors associated with radiographic knee OA in Korean adults. We analyzed data from 12,287 individuals aged ≥ 50 years who had radiographs of the knee taken in the 2010-2013 Korea National Health and Nutrition Examination Survey (KNHANES). Radiographic knee OA was defined based on the Kellgren-Lawrence grade, as follows: 0: No abnormal finding 1: Mild degenerative changes, minute osteophytes 2: Mild knee OA, definite osteophytes 3: Moderate knee OA, moderate joint-space narrowing and definite osteophytes 4: Severe knee OA, severe joint-space narrowing with subchondral sclerosis. We found that the prevalence of radiographic knee OA in the Korean adult population was 35.1%. Logistic regression analyses were performed to identify factors associated independently with radiographic knee OA, with age, sex, area of residence, education level, household income, and obesity serving as covariates. Women were at greater risk than men of having knee OA (OR 2.12, 95% CI 1.90-2.37, p < 0.001). Compared with subjects aged 50-59 years, adults aged ≥ 80 years were at 8.87-fold (95% CI 7.12-11.06, p < 0.001) greater risk of having knee OA. Residence in a rural area was associated with a greater risk of having radiographic knee OA than was residence in an urban area (OR 1.26, 95% CI 1.08-1.48, p = 0.004), regardless of knee OA severity (Kellgren-Lawrence grades ≥2, ≥3, and 4). Elementary school graduates had 1.71-fold (p < 0.001) greater risks of having knee OA than did college graduates. Household incomes ≤24th percentile were associated with a greater risk of having knee OA compared with those ≥75th percentile (OR 1.28, 95% CI 1.08-1.52, p = 0.004). Obesity was associated with an approximately two-fold greater risk of knee OA, regardless of knee OA severity (Kellgren-Lawrence grades ≥2, ≥3, and 4). Using data from the 2010-2013 KNHANES and defining knee OA as Kellgren-Lawrence grade ≥ 2, we found that the prevalence of radiographic knee OA was 35.1% (24.4% in men, 44.3% in women) in a representative sample of Korean adults aged ≥ 50 years, with the highest prevalence (78.7%) observed in women aged ≥ 80 years. Low socioeconomic status and traditional factors, including age, female sex, and obesity, were associated with the risk of knee OA.

Relationship of Pain, Function and Quality of Life with Disease Grading among Patients with Knee Osteoarthritis

Knee Osteoarthritis (KOA) is a global public health problem. The prevalence of KOA is on the rise leading to increased disease burden. Female and older adults have a higher risk of developing KOA. The diagnosis of KOA is usually based on specific clinical signs and symptoms or based on structural changes evident on radiographs. The clinical decision for management in these patients is based on X-ray grading. Recently there is a discussion on concordance between clinical and radiological findings in KAO patients. Therefore, it is necessary to identify a relationship between patient-reported findings and disease grading based on standard radiographs. This cross-sectional study recruited KAO patients from rural and urban parts of Phagwara and Jalandhar, Punjab, India. Participants were identified during medical and physiotherapy camps. Participants were included based on the American College of Rheumatology Criteria (ACR). Demographic characteristics, pain intensity, functional status, and Quality of Life (QOL) were assessed and documented. Disease grading was done based on presenting X-rays using grading proposed by Kellgren and Lawrence. The association between these variables was analyzed using R software and reported. We also predicted disease grading using QOL metrics. 120 Participants’ data were included in the final analysis. Findings suggest an association between demographic (age, height, weight and BMI) variables and disease grading. Pain, functional status, and QOL were found to be associated with disease grading. SF-Physical functioning and SF-General Health QOL metrics significantly predicted disease grading. The study’s findings suggest that disease grading based on X-rays shows an association with the participants’ clinical presentation.

Cigarette smoking and knee osteoarthritis in the elderly: Data from the Korean National Health and Nutritional Examination Survey.

The relationship between smoking and osteoarthritis (OA) has not been investigated in a large-scale study. The aim of this study was to examine the relationship between smoking and knee OA in the elderly. This study included 5117 subjects aged >60years who responded to questionnaires on their history of smoking and knee OA diagnosed by a physician taken from the Korean National Health and Nutritional Examination Survey (KNHANES-VI) 2013-2015. We classified all 5117 subjects into 2 groups (the OA group and non-OA group) and compared the demographics and characteristics between the 2 groups. A multivariate logistic regression analysis was conducted to investigate the possible association between knee OA and smoking. The prevalence of current smoking in the OA group (5.1%) was significantly lower than in the non-OA group (14.6%; p<0.001). Furthermore, the proportion of moderate smokers who smoked >10 cigarettes per day or heavy smokers who smoked >20 cigarettes per day was significantly higher in the non-OA group. In the multivariate analysis, current smoking history was a preventative factor for the prevalence of OA in a multivariate model that included age, sex, body mass index, waist circumference (OR: 0.752, 95% CI: 0.571-0.989, p=0.042). This large-scale national study highlights an inverse association between smoking and the prevalence of knee OA in the general Korean elder adult population, primarily in males. Further investigation of this relationship between smoking and knee OA is needed to determine smoking's specific mechanism of protection against knee OA.

Association of circulating microRNAs with prevalent and incident knee osteoarthritis in women: the OFELY study

ObjectivesIn the context of the scarcity of biomarkers for knee osteoarthritis (OA), we examined the associations of prevalent and incident OA with the expression levels of serum miRNAs in subjects with and without OA.MethodsWith a next-generation sequencing approach, we compared the miRome expression of 10 women with knee OA and 10 age-matched healthy subjects. By real-time qPCR, we analyzed the expression levels of 19 miRNAs at baseline selecting 43 women with prevalent knee OA (Kellgren Lawrence score of 2/3), 23 women with incident knee OA over a 4-year follow-up and 67 healthy subjects without prevalent or incident OA matched for age and body mass index.ResultsSerum miR-146a-5p was significantly increased in the group of prevalent knee OA compared with controls (relative quantification (RQ); median [Interquartile range] 1.12 [0.73; 1.46] vs 0.85 [0.62; 1.03], p = 0.015). The likelihood of prevalent knee OA was significantly increased (odds ratio [95% confidence interval (CI)] 1.83 [1.21–2.77], p = 0.004) for each quartile increase in serum miR-146a-5p. The women with miR-146a-5p levels above the median (0.851) had a higher risk of prevalent knee OA compared to those below the median [95% CI] 4.62 [1.85–11.5], p = 0.001. Moreover, we found a significant association between the baseline level of serum miR-186-5p and the risk of incident knee OA (Q4 vs Q1–3; odds ratio [95% CI] 6.13 [1.14–32.9], p = 0.034).ConclusionWe showed for the first time that miR-146a-5p and miR-186-5p are significantly associated with prevalent and incident knee OA, respectively.

Epidemiology of knee osteoarthritis in general practice: a registry-based study

ObjectivesThe present study investigated (1) trends in the prevalence and incidence of knee osteoarthritis over a 20-year period (1996–2015); (2) trends in multimorbidity and (3) trends in drug prescriptions.DesignRegistry-based study.SettingPrimary...

Prevalence, risk factors, and health seeking behavior for knee osteoarthritis among adult population in rural Jammu - A Community based Cross Sectional Study.

Context:Osteoarthritis (OA) is a degenerative joint disease, having multifactorial etiology affecting mainly the articular cartilage. Knee OA with its physical symptoms affects daily activities thereby deteriorating the quality of life. Most of the patients delay their visit to health sectors for seeking medical care in musculoskeletal conditions.Aims:To find the prevalence and determinants of osteoarthritis among the adult population in the rural area and to assess their health-seeking behavior.Settings and Design:A community-based, cross-sectional study.Methods and Material:A community-based, cross-sectional study was conducted among 232 adults living in a rural area in village Kirpind of R.S. Pura block, Jammu. Knee OA was diagnosed using the clinical criteria laid down by the American College of Rheumatology (ACR).Statistical Analysis Used:Descriptive statistics, OR with 95% CI, and Chi-square test were used for the purpose of analysis.Results:The overall prevalence of knee osteoarthritis was 35.7% (females: 44.5% Males: 23.1%). Age more than 60 years, female gender, history of trauma, BMI >30 were found to be significantly associated with higher odds of OA knee (P < 0.05). Descriptive statistics, OR with 95% CI and Chi-square test were used for the purpose of analysis.Conclusions:Strategies focusing on creating awareness among the rural elderly regarding the role of a balanced diet, exercise, and weight management along sensitization of primary health care providers concerning benefits of early screening, diagnosis, and referral should be undertaken to minimize this burden.

BONE MINERAL DENSITY AND TRABECULAR BONE SCORE IN POSTMENOPAUSAL WOMEN WITH KNEE OSTEOARTHRITIS AND OBESITY

The aim of the study was to investigate the relationship between bone mineral density (BMD) of lumbar spine, femoral neck, trabecular bone score (TBS) and body mass index (BMI), in postmenopausal women with knee osteoarthritis (OA). Materials and methods: The study group comprised 359 postmenopausal women aged 50-89 years. They were divided into 2 groups: I group - 117 postmenopausal women with symptomatic knee OA and II group -242 women with a normal functional activity of knee joints. Analysis of data was performed taking into account their BMD of lumbar spine (L1-L4) and femoral neck, measured by the Dual-energy X-ray absorptiometry (DXA) Hologic (Discovery WI, USA, 2016). TBS of L1-L4 was detected by TBS insight® software (MedImaps, Pessac, France), and BMI classified by World Health Organization (WHO). Results: In postmenopausal women with obesity prevalence of symptomatic knee OA was detected in 41.1% of cases. However, in women with normal BMI knee OA was revealed in 29.0% of women. The highest level of knee OA in obese women aged 70-79 years - 45.8%. According to a chi-squared (χ2) test, a significantly higher level of BMI was detected in postmenopausal women with OA (χ2=5.05, p=0.02). Conclusion: Women with a symptomatic OA had a significantly higher BMD of lumbar spine compared with women who had a normal functional activity of knee. Significant negative correlation were detected between TBS and BMI, and significant positive correlations between lumbar spine BMD and BMI.