Prevalence Of Symptomatic Osteoarthritis Research Articles

Risk of symptomatic osteoarthritis associated with exposure to ergonomic factors at work in a nationwide Italian survey

ObjectiveThe risk of developing osteoarthritis (OA) has been reported to increase with exposure to various ergonomic factors at work, although this finding is still debated in the literature. Aim of this study was to assess the association between prevalence of symptomatic OA and exposure to workplace ergonomic factors assigned through a job-exposures matrix (JEM).MethodsThe study population was composed of 24,604 persons of 40–69 years who participated in the National Health Survey 2013 and were employed at that occasion. Exposure to ergonomic factors was assigned to the study population through a JEM constructed from the Italian O*NET database, consisting of 17 physical factors, which were summed and averaged by job title (796 jobs) to obtain a combined exposure index. The outcome was self-reported OA characterized by moderate or severe limitations in daily activities. The relationship between OA prevalence and the combined exposure index in quartiles was examined using robust Poisson regression models adjusted for socio-demographics and potential confounders.ResultsIn the analysis adjusted for age and gender, the risk of OA was increased by approximately 20–30% in the second and third quartiles, and by 80% in the highest exposure quartile, compared to the least exposed, with a risk attenuation by approximately 15–20% controlling for other significant covariates.ConclusionOur results support a causal role of exposure to physical factors at work in the development of OA. As OA is associated with a great burden of disability, any effort should be made to reduce workers’ exposure to ergonomic factors.

Radiographic and Symptomatic Knee Osteoarthritis 32 to 37 Years After Acute Anterior Cruciate Ligament Rupture

Background: The long-term prevalence of knee osteoarthritis (OA) after anterior cruciate ligament (ACL) injury is unknown, especially in patients without a history of ACL surgery. Purpose: To (1) describe the prevalence of radiographic OA, symptomatic OA, and knee replacement surgery 32 to 37 years after acute ACL injury and to (2) compare the prevalence of radiographic OA, symptomatic OA, and knee symptoms between patients allocated to early ACL surgery or no ACL surgery and patients who crossed over to ACL surgery. Study Design: Cohort study; Level of evidence, 2. Methods: Participants aged 15 to 40 years at the time of ACL injury were allocated to surgical (augmented or nonaugmented ACL repair) or nonsurgical ACL treatment within 14 days of injury. At 32 to 37 years after the initial injury, 153 participants were followed up with plain weightbearing radiographs and completed 4 subscales from the Knee injury and Osteoarthritis Outcome Score (KOOS). Radiographic OA was defined as Kellgren and Lawrence grade 2 or higher. Symptomatic OA was defined as radiographic OA plus knee symptoms measured with the KOOS. Results: Participants allocated to ACL surgery (n = 64) underwent surgery at a mean ± SD of 5 ± 4 days (range, 0-11 days) after injury. Of the 89 participants allocated to no ACL surgery, 53 remained nonsurgically treated, 27 had ACL surgery within 2 years, and 9 had ACL surgery between 3 and 21 years after injury. In the total sample, 95 participants (62%) had radiographic tibiofemoral OA, including 11 (7%) who had knee replacement. The prevalence of radiographic tibiofemoral OA was lower in the group allocated to ACL surgery compared with the group who never had ACL surgery (50% vs 75%; P = .005). The prevalence of symptomatic OA (50% in the total sample) and patellofemoral radiographic OA (35% in the total sample) was similar between groups. Conclusion: Patients allocated to early ACL surgery, performed a mean 5 days after injury, had a lower prevalence of tibiofemoral radiographic OA at 32 to 37 years after injury compared with patients who never had ACL surgery. The prevalences of symptomatic OA, radiographic patellofemoral OA, and knee symptoms were similar irrespective of ACL treatment. Overall, the prevalence of OA after ACL injury was high. Registration: NCT03182647 (ClinicalTrials.gov identifier)

Rheumatic diseases in China.

IntroductionEpidemiological studies of rheumatic diseases have been conducted during the past 20 years in China. The aim of this study was to clarify prevalence rates of common rheumatic diseases in China.MethodsRelevant reports of population-based surveys conducted from 1980 to 2006 were retrieved. Studies using the World Health Organization-International League of Associations for Rheumatology COPCORD (Community Oriented Program for Control of Rheumatic Diseases) protocol and those that did not employ this protocol but were published in recognized journals were identified and analyzed.ResultsThirty-eight surveys including 241,169 adults from 25 provinces/cities were pooled for analysis. The prevalence of rheumatic complaints ranged from 11.6% to 46.4%, varying by locality, study protocol and age of the people surveyed. Prevalence of symptomatic osteoarthritis (OA) varied from 5.1% to 20.8%, with common sites of involvement being the lumbar spine, knee joint and cervical spine. Compared with rates of radiographic and symptomatic knee OA in the USA, elderly men in Beijing exhibited similar prevalence rates and elderly women exhibited a higher prevalence. The prevalence of hip OA and hand OA was much lower in Chinese than in Caucasian populations, but both kinds of OA were more common in coal miners. The prevalence of ankylosing spondylitis ranged from 0.2% to 0.54% among Han ethnic Chinese and were lower among mixed ethnic populations. The prevalence of psoriatic arthritis ranged from 0.01% to 0.1%, and that of reactive arthritis was 0.02%; undifferentiated spondyloarthropathy was identified in 0.64% to 1.2% of the individuals included in the surveys. The prevalence of rheumatoid arthritis (RA) ranged from 0.2% to 0.93%, with the highest rate being reported from a Taiwan urban area. In mainland China there were no significant differences in prevalence of RA between the northern and southern parts of China, or between different ethnic groups. The prevalence of hyperuricemia increased after the 1980s. The prevalence of gout was found to have increased in recent decades from 0.15% to 1.98%, apart from in the Taiwan aborigines, among whom the highest prevalence rate of 11.7% was recorded. The prevalence of primary Sjögren's syndrome in Beijing was 0.77% by the Copenhagen criteria and 0.33% by the San Diego criteria. The prevalence of soft tissue rheumatism was 2.5% to 5.7%. Fibromyalgia was seldom observed in China.ConclusionRheumatic diseases are common in China. The prevalence of rheumatic complaints varied with the locality surveyed. The prevalence of OA is comparable with that in Western countries but varies in terms of joint involvement. The prevalence of ankylosing spondylitis is similar to that in Caucasians. Except in Taiwan, the prevalence of RA in China is lower than that in developed countries. The prevalence of hyperuricemia and gout increased after the 1980s, but it remains lower than that in developed countries. More studies are required to evaluate prevalence rates among minority groups in the west and northwest parts of China, and further study is needed to address fibromyalgia in China.

Clinician's Corner: Osteoarthritis: A Lifestyle Medicine Assessment of Risks, Prevention, and Treatment

The prevalence of symptomatic osteoarthritis after the age of 55 years ranges from about 30% to 50% in men and 40% to 60% in women. With the increasing age of the population, it is estimated that in 20 years, osteoarthritis will be the fourth leading cause of disability in this country. Risk factors for osteoarthritis include previous knee surgery, occupational bending and lifting, knee injury, and obesity. Many have suggested that recreational activity and high-level sports involvement are associated with increased risk of osteoarthritis. Although high-impact exercises increase the risk of osteoarthritis, physicians need to still recommend appropriate lower impact aerobic exercise and strengthening exercises for all of our patients to improve their general health, including cardiovascular and musculoskeletal health. Clearly, more research is needed to help us understand how to modify the natural history of this condition in more stringent evidence-based fashion. However, lifestyle medicine approaches combined with conventional therapies are effective in decreasing the disability associated with chronic osteoarthritis.

Posttraumatic Osteoarthritis: A First Estimate of Incidence, Prevalence, and Burden of Disease

Although posttraumatic osteoarthritis (OA) is a common and important entity in orthopedic practice, no data presently exist regarding its prevalence or its relative burden of disease. A population-based estimate was formulated, based on one large institution's experience in terms of its fraction of patients with OA presenting to lower-extremity adult reconstructive clinics with OA of posttraumatic origin. The relative proportion of these patients undergoing total joint replacement provided a basis for extrapolating institutional experience with posttraumatic OA to a populationwide estimate because the numbers of lower-extremity total joint arthroplasty procedures performed were reliably tabulated both within the institution and populationwide. By this methodology, approximately 12% of the overall prevalence of symptomatic OA is attributable to posttraumatic OA of the hip, knee, or ankle. This corresponds to approximately 5.6 million individuals in the United States being affected by posttraumatic OA sufficiently severe to have caused them to present for care by an orthopedic lower-extremity adult reconstructive surgeon. Further, based on the relative prevalence of OA versus rheumatoid arthritis, and their relative impacts as assessed by the SF-36 (Short-Form 36) lower-extremity physical composite scores, about 85.5% of the societal costs of arthritis are attributable to OA. The corresponding aggregate financial burden specifically of posttraumatic OA is Dollars 3.06 billion annually, or approximately 0.15% of the total U.S. health care direct cost outlay.

Rheumatology in China--brief introduction of the development of Chinese rheumatology

arthritis ranged from 0.26 to 0.5%, with an average of 0.36%. A study conducted in both the Northern and Southern parts of China estimated that the prevalence of ankylosing spondylitis was 0.26%. The positive rate of HLA-B27 in patients of ankylosing spondylitis was >90%, while the rate in the general population was only 6-7%. Another survey conducted in 30 000 textile workers in Shanghai showed that the prevalence of systemic lupus erythematosus in males was 70 per 100 000 persons; and in females, the rate was 113 per 100 000 persons. Data from hospitals in Beijing showed that among patients with systemic lupus erythematosus who visited a doctor, those aged 14-39 yrs comprised 70% of the population, and the male to female ratio was 1:13 while the ratio was 1:4 in patients aged between 40 and 59 yrs. An epidemiology investigation of osteoarthritis conducted in 13 451 steel workers in Shanghai showed that the prevalence of symptomatic osteoarthritis was 2.2% and asymptomatic osteoar- thritis was 53%. The prevalence of osteoarthritis was 11, 27 and 62% in the age groups 30-39, 40-49 and 50-59 yrs, respectively. Looking at primary Sjogren's syndrome, an investigation was conducted in 1992 in all adults (total 2060) living in a suburban region of Beijing, including screening with anti-nuclear antibodies (ANA), rheumatoid factor and anti-SSA(Ro)/anti-SSB(La) as well as a questionnaire. For those who were positive in any of the screen tests, additional tests for keratoconjunctivitis sicca and salivary gland involvement were performed. The results showed that the prevalence of primary Sjogren's syndrome in the Beijing area was 0.77% based on the Copenhagen criteria and 0.29% based on the San Diego criteria. Therefore, we concluded that primary Sjogren's syndrome is not a rare disease in China. Recently, another investigation was conducted to explore the current therapeutic strategy for rheumatoid arthritis in China. Eleven regions and 56 hospitals took part in this study. So far, 2202 patients with rheumatoid arthritis have been registered, 436 males and 1766 females, with the average age of 48.66 16.05 (8-90) yrs and mean disease duration of 86.49 98.47 (1-664) months. The involved joints at the onset of disease were hand (61.76%), knee (35.6%), wrist (34.29%), shoulder (18.89%), foot (17.71%), ankle (17.57%), elbow (15.03%), hip (5.00%) and spine (3.95%). The first drug taken by patients was non-steroidal anti- inflammatory drugs (NSAIDs) (53.04%), disease-modifying anti-rheumatic drugs (DMARDs) (21.21%), glucocorticosteroids (16.89%), Chinese traditional medicine (9.49%) and drugs with unknown component (11.99%). The first DMARD prescribed was methotrexate (60.81%), sulphasalazine (22.55%), leflunomide (16.01%), hydroxychloroquine (7.88%) D-penicillamine (7.29%), etc. The average time from joint pain to joint function impair- ment was 36.38 66.63 months, and the time to joint deformity was 55.61 73.87 months. Investigation also revealed that the average time from joint pain to DMARDs prescription in patients without joint deformity was 36.33 68.48 months, while the time was 75.69 98.43 months in patients with joint deformity, suggesting that early prescription of DMARDs could effectively prevent joint destruction. With the development of the Chinese economy and improvement of the living standards of the Chinese people, gout, a formerly rare disease, has become more and more common and been increasingly recognized since the 1990s. An epidemiology survey on gout is underway. It is also noteworthy that with the development of the Chinese economy, government investment on medical research has increased. Chinese medical society becomes more open