Radiographic Evidence Of Osteoarthritis Research Articles

Kinetic Recovery of the Patient with Gonarthrosis

Osteoarthritis of the knee, also known as gonarthrosis, is indeed a common and growing concern, particularly as factors like increased life expectancy and rising obesity rates contribute to its prevalence. A few key points to highlight from the statistics you've provided: About 13% of women and 10% of men over the age of 60 are diagnosed with gonarthrosis; The prevalence significantly rises in people over the age of 70, where it affects 40% of this population. This reflects the impact of aging on joint degeneration; Gonarthrosis is more common in women than men. While exact reasons aren't fully clear, hormonal factors, differences in joint anatomy, and possibly physical activity differences may play a role in this disparity; Despite radiographic evidence of osteoarthritis, only a portion of individuals’ experience symptoms. This emphasizes that structural joint changes don't always equate to pain or functional limitations; One study suggests that only 15% of patients with radiographic evidence of gonarthrosis have symptoms, indicating that many individuals may have osteoarthritis without knowing it; The overall incidence of symptomatic gonarthrosis is about 240 cases per 100,000 people per year, making it a significant public health issue. [4]

Ultrasound-Guided Radiofrequency Ablation for Chronic Hip Pain Due to Osteoarthritis.

Hip osteoarthritis (OA) has a prevalence of 2.9% in Portugal and is a related cause of pain and disability. A sufficient number of patients report these symptoms even after total hip arthroplasty (THA), while others are contraindicated to such surgery and suffer from uncontrolled pain. Percutaneous denervation of hip nerve branches using radiofrequency ablation (RFA) has emerged as a powerful therapeutic avenue to consider for patients with chronic hip pain. Between January 2020 and March 2021, 26 patients with chronic hip pain received ultrasound-guided RFA with a pericapsular nerve group(PENG)block technique adaptation. Patients suffering from chronic hip pain for more than threemonths with radiographic evidence of osteoarthritis were included. A numeric rating scale (NRS) and pain medication reduction were defined as outcome variables assessed before treatment and at three-, six-, nine-, and 12-month follow-ups. All selected patients underwent the procedure. All the patients had hip osteoarthritis. Twelve-month follow-up data revealed a statistically significant decrease in the numeric rating scale. The mean NRS for pain was 2 after the procedure. Over 75% of patients reported >50% pain relief during the follow-up and 85% reduced pain medication consumption. No side effects were reported. Hip sensory articular branchRFA is a treatment option with interesting outcomes for chronic hip pain, as demonstrated by our study.

Evaluation of subchondral bone cysts in canine elbows with radiographic osteoarthritis secondary to elbow dysplasia.

To investigate whether subchondral bone cysts (SBCs) were present in dogs with radiographic elbow osteoarthritis (OA) and to investigate their relationship with radiographic OA severity. Retrospective cross-sectional study. Thirty-eight Labrador retrievers (total of 76 elbows). Elbow computed tomography (CT) images of 18 young (≤2 years old) and 20 old (>2 years old) Labrador retrievers, which presented for elbow-associated lameness, were reviewed. Radiographic elbow OA was graded into four groups based on the largest osteophyte size on CT. The presence, number, and maximum diameter of SBCs were determined. Subchondral bone cysts were only identified in elbows with osteophytic new bone formation. The number and size of SBCs were associated with radiographic OA severity (p < .001 and p = .041 respectively). Specifically, the rate at which SBCs were present increased for both moderate and severe OA in comparison with the mild OA (moderate OA RR = 2.46, 95% CI 2.08-2.92, p < .001; severe OA RR = 5.60, 95% CI 4.79-6.55, p < .001). For dogs with severe OA, there was an increased likelihood that their SBCs were larger than SBCs from dogs with mild OA (OR = 1.056, 95% CI 1.012-1.101, p = .012). No SBCs were observed in elbows without radiographic evidence of OA. Subchondral bone cysts were identified as a feature of radiographic elbow osteoarthritis in Labrador retrievers, and their number and size were indicative of the presence and severity of radiographic elbow OA. Subchondral bone cysts are a potential imaging biomarker for quantitative assessment for canine OA.

Serum nerve growth factor in horses with osteoarthritis-associated lameness.

Nerve growth factor (NGF) is a neurotrophin that is increased in osteoarthritic joints of horses. In humans, NGF has been associated with pain, and both synovial and serum NGF concentrations are increased in osteoarthritic patients. Studies in humans also have shown that serum NGF concentration can increase with stress. Serum NGF concentration should be evaluated in horses with osteoarthritis-associated lameness. Quantify and compare serum NGF concentration in horses with osteoarthritis-associated lameness and sound horses. Additionally, the impact of short-term stress on serum NGF concentration was investigated. Lame horses with radiographic evidence of osteoarthritis (n = 20), lame horses without radiographic changes in the affected joint (n = 20) and sound horses (n = 20). In addition, horses with acute fractures (n = 9) were sampled. To determine the effect of stress, serum from horses subjected to a stressful event (transportation, n = 5; stress confirmed by increased serum cortisol concentration) was analyzed. Cross-sectional clinical study (lame, sound, and fracture cohorts) and experimental longitudinal study (stress cohort). Serum NGF concentration was determined using a quantitative sandwich ELISA. Serum NGF concentration was increased in lame horses with radiographic evidence of osteoarthritis (P < .0001; median, 238 pg/mL; interquartile range [IQR], 63-945 pg/mL) and in lame horses without radiographic evidence of osteoarthritis in the painful joint (P < .05; median, 31 pg/mL; IQR, 31-95 pg/mL) compared with sound horses (median, 31 pg/mL; IQR, 31-46 pg/mL). Serum NGF concentration did not increase with short-term stress and was low in horses with fracture-associated pain. Serum NGF concentration was high in the cohort with advanced osteoarthritis and should be investigated as a marker for osteoarthritis-associated pain.

Clinically Relevant Subgroups Among Athletes Who Have Ruptured Their Anterior Cruciate Ligaments: A Delaware-Oslo Cohort Study.

To identify subgroups of individuals with anterior cruciate ligament (ACL) injuries based on patient characteristics, self-reported outcomes, and functional performance at baseline, and to associate subgroups with long-term outcomes after ACL rupture. A total of 293 participants (45.7% male, mean ± SD age 26.2 ± 9.4 years, days from injury 58 ± 35) were enrolled after effusion, pain, and range of motion impairments were resolved and quadriceps strength was at least 70% of the uninvolved limb. Mixture modeling was used to uncover latent subgroups without a prior group classification using probabilistic assignment. Variables include demographics, functional testing, and self-reported outcome measures. Radiographic evidence of osteoarthritis (OA; i.e., Kellgren/Lawrence grade of ≥1) in the involved knee at 5 years after injury was the primary outcome of interest. Chi-square tests assessed differences in the presence of radiographic OA in the involved knee between subgroups at 5 years after ACL rupture. Secondary outcomes of interest included radiographic OA in the uninvolved knee, return to preinjury sport by 2 years, operative status, and clinical OA (classified using Luyten et al criteria) at 5 years. Four distinct subgroups exist after ACL rupture (younger good self-report, younger poor self-report, older poor self-report, older good self-report) with 30%, 31%, 47%, and 53%, respectively, having involved knee OA. The percentage of radiographic OA was not significantly different between the groups (P=0.059). The prevalence of OA in all subgroups is highly concerning. These results suggest there are unique subgroupings of individuals that may guide treatment after ACL rupture and reconstruction by providing support for developing a patient-centered approach.

SURGICAL INTERVENTIONS FOR CHRONIC ULNAR COLLATERAL LIGAMENT INJURIES OF THE THUMB: A SYSTEMATIC REVIEW

There is no consensus for the appropriate surgical management of chronic ulnar collateral ligament (UCL) injuries of the thumb.A systematic review of Pubmed, MEDLINE, EMBASE and ePub Ahead of Print was performed in accordance with Preferred Reporting of Items in Systematic Review and Meta-analysis (PRISMA) guidelines and formal protocol registered with PROSPERO.Two authors collated data from 10 studies that met strict inclusion criteria, using various surgical techniques in 131 thumbs. Results were heterogenous and metanalysis of results not possible. These data were, therefore, qualitatively assessed and synthesised. Bias was assessed using the ROBINS-I tool.Direct repair, reconstruction with free tendon or bone-tissue-bone grafts and arthrodesis all demonstrated favourable outcomes with Patient Reported Outcome Measures. Direct repair can be safely performed more than two months following injury, with a positive mean Disabilities of the Arm, Shoulder and Hand (DASH) score of 13.5 despite evidence of radiographic osteoarthritis. Arthrodesis should be considered in heavy manual laborers or those at risk of osteoarthritis as it provides significant reduction in pain (Mean Visual Analogue Score of 1.2) when compared to other methods. Free tendon grafting has been criticised for failure rates and poor functional grip strength, however collated analysis of 97 patients found a single graft rupture and mean grip strength of 97% (of the contralateral thumb). Bone-tissue-bone grafting was the least effective method across all outcome measures.Studies included were at high risk of bias, however, it can be concluded that delayed direct repair can be performed safely, while arthrodesis may benefit certain patient subgroups. New findings suggest poor efficacy of bone-tissue-bone grafts, but that free tendon grafting with palmaris longus are in fact safe with good restoration of grip strength. The optimal graft and configuration are yet to be determined for reconstructive methods.

Current and Future Advanced Imaging Modalities for the Diagnosis of Early Osteoarthritis of the Hip.

Hip osteoarthritis (OA) can be idiopathic or develop secondary to structural joint abnormalities of the hip joint (alteration of normal anatomy) and/or due to a systemic condition with joint involvement. Early osteoarthritic changes to the hip can be completely asymptomatic or may cause the development hip symptomatology without evidence of OA on radiographs. Delaying the progression of hip OA is critical due to the significant impact of this condition on the patient’s quality of life. Pre-OA of the hip is a newly established term that is often described as the development of signs and symptoms of degenerative hip disease but no radiographic evidence of OA. Advanced imaging methods can help to diagnose pre-OA of the hip in patients with hip pain and normal radiographs or aid in the surveillance of asymptomatic patients with an underlying hip diagnosis that is known to increase the risk of early OA of the hip. These methods include the delayed gadolinium-enhanced magnetic resonance imaging (MRI) of cartilage (dGEMRIC), quantitative magnetic resonance imaging (qMRI- T1rho, T2, and T2* relaxation time mapping), 7-Tesla MRI, computed tomography (CT), and optical coherence tomography (OCT). dGEMRIC proved to be a reliable and accurate modality though it is limited by the significant time necessary for contrast washout between scans. This disadvantage is potentially overcome by T2 weighted MRIs, which do not require contrast. 7-Tesla MRI is a promising development for enhanced imaging resolution compared to 1.5 and 3T MRIs. This technique does require additional optimization and development prior to widespread clinical use. The purpose of this review was to summarize the results of translational and clinical studies investigating the utilization of the above-mentioned imaging modalities to diagnose hip pre-OA, with special focus on recent research evaluating their implementation into clinical practice.

Phenotype-Genotype analysis of caucasian patients with high risk of osteoarthritis.

Background: Osteoarthritis (OA) is a common cause of disability and pain around the world. Epidemiologic studies of family history have revealed evidence of genetic influence on OA. Although many efforts have been devoted to exploring genetic biomarkers, the mechanism behind this complex disease remains unclear. The identified genetic risk variants only explain a small proportion of the disease phenotype. Traditional genome-wide association study (GWAS) focuses on radiographic evidence of OA and excludes sex chromosome information in the analysis. However, gender differences in OA are multifactorial, with a higher frequency in women, indicating that the chromosome X plays an essential role in OA pathology. Furthermore, the prevalence of comorbidities among patients with OA is high, indicating multiple diseases share a similar genetic susceptibility to OA. Methods: In this study, we performed GWAS of OA and OA-associated key comorbidities on 3366 OA patient data obtained from the Osteoarthritis Initiative (OAI). We performed Mendelian randomization to identify the possible causal relationship between OA and OA-related clinical features. Results: One significant OA-associated locus rs2305570 was identified through sex-specific genome-wide association. By calculating the LD score, we found OA is positively correlated with heart disease and stroke. A strong genetic correlation was observed between knee OA and inflammatory disease, including eczema, multiple sclerosis, and Crohn’s disease. Our study also found that knee alignment is one of the major risk factors in OA development, and we surprisingly found knee pain is not a causative factor of OA, although it was the most common symptom of OA. Conclusion: We investigated several significant positive/negative genetic correlations between OA and common chronic diseases, suggesting substantial genetic overlaps between OA and these traits. The sex-specific association analysis supports the critical role of chromosome X in OA development in females.

Total Knee Arthroplasty for Osteoarthritis Is Uncommon after Intralesional Curettage in Giant Cell Tumor of Bone.

Giant cell tumor of bone (GCTB) is most often treated with intralesional curettage; however, periarticular lesions have been shown to increase risk for osteoarthritis. Additionally, the location of these lesions may occasionally preclude a joint-sparing procedure in recurrent tumors. This study sought to investigate rates of secondary arthroplasty in long-term follow-up of knee GCTB. Cases of knee GCTB treated at our institution were reviewed. Rates of recurrence and secondary arthroplasty were recorded, and Kaplan-Meier survival analyses were performed. The records of 40 patients were reviewed. Local recurrence occurred in 25% of patients. The 1-, 5-, and 10-year recurrence-free survival (RFS) probability was 87.4% (95% CI, 77.0-97.7), 72.4% (95% CI, 57.6-87.2), and 72.4% (95% CI, 57.6-87.2), respectively. Function improved after surgery with a mean preoperative MSTS score of 14.9 (standard deviation [SD] 8.4) and mean postoperative MSTS score of 25.1 (SD 5.6) (p <0.001). Three patients had evidence of radiographic osteoarthritis at the last follow-up though they did not require arthroplasty. Arthroplasty was performed as a secondary procedure in six patients. Five patients underwent arthroplasty for recurrent tumors after initial treatment with curettage and one patient underwent patellar arthroplasty for osteoarthritis after initial treatment with an allograft composite arthroplasty. Arthroplasty is performed as a secondary procedure in patients with GCTB at a relatively infrequent rate and more often for cases of recurrent disease than for osteoarthritis. Overall, patients treated for GCTB have improved functional outcomes after surgery than before. Large, multi-institutional studies may be required to assess the incidence of secondary osteoarthritis requiring arthroplasty as this was an infrequent finding in our cohort.

Understanding the Role of Inflammation in Secondary Osteoarthritis

Osteoarthritis (OA) is the most seen form of arthritis, affecting a population of about 3.3 to 3.6% worldwide. In the ranking, it is the 11th most incapacitating disease worldwide, and in about a 43million people, it causes mild to severe disability. Estimated that 80% of the population In the United States over 65 years old have radiographic evidence of OA, although only 60-70% of this subset has symptoms. There were about 1 million hospitalizations for OA in 2011, with a cumulative cost of nearly $15 billion. This makes A the second most expensive disease seen in the United States [1, 2]. Secondary OA can affect older adults, and it could also affect younger people, usually those under 35 years of age.&#x0D; Secondary OA has been regarded more as a mechanically-driven disease than an inflammatory disease. However, low-grade inflammation plays some part in cartilage degeneration and repair at many stages of arthropathy. In the past years, many published scientific papers on both animal models and human studies have indicated an increased role for both synovial inflammations and the activation of the membrane attack complexes of the complement system in the pathogenesis of secondary OA. There is also increasing evidence that significant risk factors for secondary OA have been linked with changes in systemic and local (at the articular cartilage chondrocyte level) cytokines and inflammatory mediators.&#x0D; However, it remains controversial whether or not the inflammatory mediators are primary or secondary regulators of the damage to the cartilage or defective repair mechanisms present in secondary Osteoarthritis because the pathways for signaling involved in inflammatory and biomechanical stress are very much similar. So, these pathways could also induce and increase the expression of cytokine and chemokine genes.&#x0D; Although research on the inflammatory mediators associated with Osteoarthritis has been done and much knowledge has been gained in the last decade, more studies are needed to define better the mechanisms by which these factors tip the balance between homeostasis and activation to promote cell death and matrix destruction. In response to stress and inflammatory insults, osteoarthritis chondrocytes produce a variety of matrix-degrading enzymes, including metalloproteinases and aggrecans. The expression of most of these enzymes of degradation is dysregulated in chondrocytes of patients with Osteoarthritis, and their increased activities and aberrant expression are the main contributors to cartilage degradation during osteoarthritis development and progression [3]. This student project aims to understand the role of inflammation in secondary Osteoarthritis.

Femoral neck shaft angle is not correlated with femoral version: A retrospective study of computed tomography scans

BackgroundAn understanding of femoral anteversion and neck-shaft angle (NSA) is essential to deliver optimal orthopaedic surgical care. Despite the importance, there is little research examining the relationship between femoral anteversion and the NSA in an adult population. This study sought to determine if there is a correlation between femoral neck shaft angle and version in skeletally mature adults using computed tomography (CT) scanograms. MethodsBetween January 2010 and June 2017, all skeletally mature patients who had received a CT scanogram of the lower extremity were reviewed. Exclusion criteria included: (1) radiographic evidence of osteoarthritis, (2) history of hip, femur, or knee surgery or trauma, (3) and anatomic abnormalities of the proximal femur including prior slipped capital femoral epiphysis or Legg-Calvé-Perthes disease. Both femoral version and NSA were measured by a musculoskeletal fellowship trained radiologist using CT scanograms. Correlation between femoral version and NSA was determined using coefficient of determination (R2) and Pearson correlation coefficient (r) for the group as a whole and for each sex. ResultsThere was no statistical correlation between femoral version and NSA for either the entire cohort or for each sex. For the entire cohort, R2 = 0.0016 and r was 0.04 (p=0.45), for females, R2 = 0.0005 and r was 0.0224 (p=0.72), and for males, R2 = 0.0342 and r was 0.185 (p=0.07). ConclusionThere was no correlation between femoral version and NSA. This finding is beneficial for surgeons to understand the proximal femoral anatomy. Patients with an increased femoral NSA should not be assumed to have increased femoral anteversion. Level of EvidenceLevel III, Retrospective Cohort Study

AN OPEN CLINICAL STUDY TO ASSESS THE COMBINED EFFECT OF JANUBASTHI AND MATRA BASTHI WITH SAIREYAKA TAILA IN JANUSANDHIGATAVATA W.S.R TO OSTEOARTHRITIS OF KNEE JOINT

Basti is considered the best modality of treatment in managing the disorders of Vata Dosha. As Sandhigatavata is also one among Vatavyadhi, Basti is the effective line of treatment, which is characterized by swelling, pain during flexion and extension of joints. Osteoarthritis is a common degenerative joint condition with a prevalence of about 22% to 39% in India. There is a steady rise in prevalence from age 30 such that by age 65, 80% of people will have radiographic evidence of osteoarthritis. It is caused by the degradation of the joints, the articular cartilages and subchondral bone. It is characterized by pain, stiffness and loss of flexibility of joints.1 By foregoing, Sandhi- gatavata can be readily correlated to Osteoarthritis. In contemporary medical science, they use NSAIDs for control of the symptoms. Acharya Sushrutha and Acharya Charaka have mentioned Snehana (Oleation) as a line of treat- ment in Sandhigatavata. So here an attempt is made through Janubasthi and Matrabasthi using Saireyaka Taila2 mentioned in Gada Nigraha under Vata Vyadhi for treating Janusandhigatavata in specific. Method: This study is an open-label, observational and clinical study containing 30 patients, who were posted for Janu Basti and Matra Basti with Saireyaka Taila for 9 days. The assessment was carried out before treatment, during treatment (5th day), after treatment (on 10th day) and after following up (28th day) and the gradings were noted. Results: Out of 30 patients in this study, 5 patients (17%) were getting Moderate Improvement and 25 patients (83%) were gettingGood Improvement. The overall effect of the treatment is 69.44%. Conclusion: It is concluded that the combined effect of Janubasti and Matrabasti with Saireyaka Taila is clinically and statistically significant in almost all the parameters. Keywords: Janu Basti, Matra Basti, Sandhivata, Osteoarthritis, Saireyaka Taila.

Outcomes of Bulk Fresh Osteochondral Allografts for Cartilage Restoration in the Knee.

Symptomatic osteochondral defects of the knee in young patients can cause substantial disability and predispose to osteoarthritis. Fresh osteochondral allografts (FOCAs) are a treatment option for such defects. With our institution having one of the longest-running FOCA programs, we investigated the long-term outcomes of bulk FOCA in the knee, focusing on graft survivorship, function, complications, and reoperation. A total of 244 patients underwent bulk FOCA in the knee from 1972 to 2018, with a mean age of 37.8 years (range, 10 to 75 years) and a mean follow-up of 9.0 years (range, 1.0 to 29.8 years). Cartilage defects were very large and uncontained, such that they were not amenable to plug transplantation. Survivorship according to Kaplan-Meier analysis was the primary outcome, and failure was defined as conversion to total knee arthroplasty, repeat allograft, graft removal, knee arthrodesis, or amputation. Functional outcome was evaluated with use of the modified Hospital for Special Surgery (mHSS) score, and radiographic evidence of osteoarthritis was classified with use of the Kellgren-Lawrence grading scale. Graft survivorship was 86.6% at 5 years, 73.3% at 10 years, 58.1% at 15 years, 43.7% at 20 years, 31.9% at 25 years, and 22.6% at 30 years. The most common complications were pain (14.8%), malalignment (13.9%), and stiffness (5.8%). A total of 93 grafts (38.1%) failed at a mean of 11.0 years (range, 0.5 to 34.0 years). The mean mHSS score improved significantly, from 68.7 (range, 19 to 91) preoperatively to 80.3 (range, 52 to 100) at the time of the latest follow-up (p < 0.001). Preoperative mHSS score had a negative correlation with Kellgren-Lawrence grade at the time of the latest follow-up. Multivariate analysis revealed that graft location (i.e., medial-sided or multiple grafts) and increased age were significantly negatively associated with survival. Ten-year survival was >80% in patients below 50 years old, but <40% in patients >60 years old. Bulk FOCA provided promising long-term graft survival and functional improvement in patients <50 years old. It can delay or prevent the need for total knee arthroplasty in young patients. Older patients and patients with a medial-sided graft, or multiple grafts within the same knee, had a less favorable prognosis. Therapeutic Level IV. See Instructions for Authors for a complete description of levels of evidence.

A Surgical Algorithm According to Pivot-Shift Grade in Patients With ACL Injury: A Prospective Clinical and Radiological Evaluation

Background:Some patients have a positive pivot-shift finding and rotational instability after anterior cruciate ligament (ACL) reconstruction (ACLR). Three major pathologies known to affect the pivot-shift examination include ACL tear, anterolateral ligament injury, and loss of posterior lateral meniscus root function.Purpose:To describe a surgical algorithm determining indications for lateral extra-articular tenodesis (LET) based on intraoperative pivot-shift examination to prevent postoperative pivot shift and rotational instability and to evaluate the 2-year clinical and functional outcomes.Study Design:Case series; Level of evidence, 4.Methods:The study included 47 consecutive patients (39 men and 8 women) who underwent operative treatment for ACL injury between 2016 and 2017. Pivot-shift examination was performed under anesthesia, and the pivot shift was graded as grade 1 (glide), grade 2 (clunk), or grade 3 (gross). According to the surgical algorithm, single-bundle ACLR was performed in patients with grade 1 pivot shift. In patients with grade 2 with loss of posterior lateral meniscus root function, concurrent lateral meniscal repair was performed, and in patients with grade 2 with an intact lateral meniscus posterior root, concurrent extra-articular iliotibial band tenodesis was performed. Patients with grade 3 underwent ACLR, lateral meniscal repair, and LET. Clinical and radiographic evaluations were performed.Results:The mean age was 27.2 years (range, 16-56 years). In total, 26 (55.3%) patients were evaluated as having pivot-shift grade 1; 16 (34%) patients, grade 2; and 5 (10.6%) patients, grade 3. A total of 7 (14.9%) patients underwent LET in addition to ACLR. Two of these patients had pivot-shift grade 2, and LET was performed since the lateral meniscus posterior root was intact. In 14 of 16 patients with grade 2, lateral meniscus root disruption was detected, and lateral meniscal repair was performed. One patient was excluded from the further follow-up because of graft failure. At a mean postoperative follow-up of 29 months in 46 patients, the pivot-shift examination was negative in all patients. The mean Lysholm and International Knee Documentation Committee subjective scores were 95.35 ± 4.40 and 82.87 ± 9.36, respectively. Radiographic evidence of osteoarthritis was not detected.Conclusion:Only 14.9% of patients needed LET. With proper ACL, lateral meniscal, and anterolateral ligament surgery, it was possible to prevent positive pivot-shift findings postoperatively.

Association between osteoarthritis-related serum biochemical markers over 11 years and knee pain in middle-aged adults

Purpose: In most cases, by the time clinical or radiographic evidence of osteoarthritis (OA) is established, significant and irreversible disease progression has already occurred, impairing the disease prognosis. Serum levels of cartilage and joint-specific biochemical markers such cartilage oligomeric matrix protein (COMP), matrix metalloproteinase (MMP)-3, and hyaluronan (HA) are associated with cartilage degradation, joint tissue degradation, and synovitis in patients with OA. Change in these OA-related biomarkers may precede the morphological and clinical manifestations of OA and therefore have been explored as predictive markers in OA.

Joint-adjacent Adipose Tissue by MRI is Associated With Prevalence and Progression of Knee Degenerative Changes: Data from the Osteoarthritis Initiative.

Adipose tissue has recently gained interest as an independent imaging biomarker for osteoarthritis. To explore 1) cross-sectional associations between local subcutaneous fat (SCF) thickness at the knee and the extent of degenerative changes in overweight and obese individuals and 2) associations between local fat distribution and progression of osteoarthritis over 4 years. Retrospective cohort study. 338 obese and overweight participants from the Osteoarthritis Initiative cohort without radiographic evidence of osteoarthritis. 3T: 3D-FLASH-WE; 3D-DESS-WE; T1w-SE; MSME. Baseline SCF thickness was measured in standardized locations medial, lateral and anterior to the knee and the average joint-adjacent SCF (ajSCF) was calculated. Right thigh SCF cross-sectional area was assessed. Quantitative cartilage T2 relaxation times and semi-quantitative whole organ MRI scores (WORMS) were obtained at baseline and 4-year follow-up. WORMSsum was calculated as sum of cartilage, bone marrow edema, subchondral cyst, and meniscal scores. Associations of SCF measures with baseline, and 4-year change in T2 and WORMS were analyzed using regression models. SCF measurements were standardized using the equation . Analyses were adjusted for age, sex, physical activity, and BMI. Cross-sectionally, significant associations between lateral SCF, lateral compartment WORMS and T2 were found ( , [95% CI]: 0.53, [0.12-0.95], P < 0.05; ΔT2 : 0.50, [0.02-0.98], P < 0.05). Moreover, greater lateral SCF was associated with faster progression of lateral WORMSsum gradings (OR=1.50, [1.05-2.15], P < 0.05). No significant positive associations were found for thigh SCF and WORMSsum (P=0.44) or T2 measurements (medial: P=0.15, lateral: 0.39, patellar: P=0.75). Joint-adjacent SCF thickness was associated with imaging parameters of knee osteoarthritis, both cross-sectionally and longitudinally, while thigh SCF was not, suggesting a spatial association of SCF and knee osteoarthritis. Based on these findings, joint-adjacent SCF may play a role in the development and progression of knee osteoarthritis. 4 TECHNICAL EFFICACY: Stage 5.

Can Radiographic Joint Space Accurately Predict Chondral Damage During Hip Arthroscopy?

The purpose of this study was to examine how pre-operative radiographic joint space correlated with intraoperative chondral damage in patients without radiographic evidence of osteoarthritis who underwent hip arthroscopy in the setting of labral tears and femoroacetabular impingement (FAI). Patients under the age of 50 years without prior hip conditions who underwent hip primary arthroscopy had their joint space and intraoperative chondral damage compared. A narrow joint space group was defined as those in the lowest decile of the average joint space. The demographics and presence of intraarticular findings of chondral damage were compared. Additionally, receiver operator characteristic (ROC) curves were used to assess joint space as a predictor of intraarticular damage. There were 1,892 in this analysis. The incidence of severe cartilage damage (Outer bridge III & IV) was not significantly different between the narrow and non-narrow groups. The ROC analysis for joint space at detecting chondral damage was poor. The ROC- area under the curve for joint space detecting any chondral defect (acetabular or femoral head) was 0.536 (CI = 0.506 – 0.565), with low sensitivity (0.492), specificity (0.582), negative predictive value (0.720), and positive predictive value (0.340). Spearman correlation could not demonstrate a correlation between joint space and cartilage damage (⍴Acetabular = 0.10, ⍴Femoral Head = 0.04). Interestingly, a gradual widening was observed between the medial and lateral joint spaces, with more pronounced findings in hips without damage. Being able to detect chondral health with an inexpensive s 23 screening tool such as radiography can be a valuable as a predictor of chondral health. However, the results of this study demonstrate that in patients with Tönnis 0 and 1, narrower joint space cannot predict actual intraoperative cartilage damage. However, if the lateral joint space has relative narrowing compared to the medial joint space, this may indicate acetabular cartilage damage.

Discordance between radiographic findings, pain, and superficial temperature in knee osteoarthritis.

IntroductionKnee pain is an imprecise marker of radiographic evidence of osteoarthritis (OA). These patients are more likely to develop central sensitisation to pain, a risk factor for chronic pain.ObjectivesThe aim of this study was to examine the associations among radiographic evidence of OA, self-reported pain, pressure pain thresholds (PPT), and superficial knee temperature in individuals with knee OA.Material and methodsThis cross-sectional study enrolled 25 patients with knee OA with clinic and radiographic diagnosis of bilateral OA (Kellgren-Lawrence grading scale 1–4 in X-ray images), but symptoms of pain and discomfort in only one of the knees, with pain perception in the symptomatic knee equal to or above 4 in a visual analogue scale. Volunteers underwent an evaluation including demographic data, superficial knee temperature (infrared thermography, mean superficial temperature of the region of the knee) and PPT (digital algometry at longus adductor, vastus lateralis, vastus medialis and tibialis anterior muscles, patellar tendon, and centre of the patella).ResultsComparisons between symptomatic and asymptomatic knees revealed no differences regarding Kellgren-Lawrence classification, knee superficial temperature, or PPT. Significant weak and moderate associations were found between radiographic classification of OA and PPT of both knees in almost all sites evaluated. Nonetheless, superficial temperature of the knee was not associated with PPT or Kellgren-Lawrence grading scale.ConclusionsPatients with bilateral knee OA presented no differences in symptomatic and asymptomatic knees regarding radiographic evidence, knee temperature, and PPT, indicating that central sensitisation may be present in them. Radiographic classification of OA was significantly associated with PPT in both knees.

Owner evaluation of quality of life and mobility in osteoarthritic cats treated with amantadine or placebo.

The aim of the study was to determine if amantadine improves owner-identified mobility impairment and quality of life associated with osteoarthritis in cats. Using a blinded, placebo-controlled, randomized, crossover design, 13 healthy client-owned cats with clinical and radiographic evidence of osteoarthritis and owner-identified mobility impairment were studied. Cats received 5 mg/kg amantadine or placebo q24h PO for 3 weeks each with no washout period in between. Locomotor activity was continuously assessed with a collar-mounted activity monitor system, and owners chose and rated two mobility-impaired activities using a client-specific outcome measures (CSOM) questionnaire on a weekly basis. Locomotor activity on the third treatment week was analyzed with two-tailed paired t-tests. The CSOM scores were analyzed using a mixed-effect model and the Bonferroni post-hoc test. Owner-perceived changes in quality of life were compared between treatments using the χ2 test. Statistical significance was set at P <0.05. Mean ± SD activity counts during the third week of each treatment were significantly lower with amantadine (240,537 ± 53,880) compared with placebo (326,032 ± 91,759). CSOM scores assigned by the owners were significantly better with amantadine on the second (3 ± 1) and third (3 ± 1) weeks compared with placebo (5 ± 2 and 5 ± 1, respectively). A significantly greater proportion of owners reported improvement in quality of life with amantadine compared with placebo. Amantadine significantly decreased activity, but improved owner-identified impaired mobility and owner-perceived quality of life in cats with osteoarthritis. Amantadine appears to be an option for the symptomatic treatment of osteoarthritis in cats.

Comparison of Prevalence of Osteoarthritis in the Hand: A Multicenter Retrospective Cohort Study

Introduction Several studies have previously been undertaken to investigate the prevalence of radiologic hand osteoarthritis (OA) in Caucasian, Japanese, Chinese, and Arabic populations. To date, there has been no direct international comparison study on the prevalence of radiologic hand OA between a Western and a Southeast Asian population. We hypothesize that there is difference in the pattern of joint involvement among individuals of both populations.Materials and Methods Consecutive hand radiographs from individuals aged 60 years and above were reviewed. Radiographic evidence of osteoarthritis in the various joints in the hands was graded using Kellgren–Lawrence (K-L) score. Chi-square test, Fisher's exact test, or Student's t-test was used as appropriate. Multiple logistic regression analysis was performed to evaluate the associations and relationships of radiographic hand OA between joints.Results A total of 194 patients exhibited radiographic OA. Singaporean patients were more likely to have radiographic OA of the thumb interphalangeal joint (IPJ) (65.1%) compared with the thumb carpometacarpal joint (CMCJ; 40.2%); British patients were more likely to have CMCJ (43.3%) OA than thumb IPJ (21.0%). The difference was statistically significant (p = 0.00026). In the Singapore population, it was more likely that a patient had concurrent OA of both thumb and finger joints, whereas in the British population, this was apparent in only the above-80-year-old group. The most commonly affected joint was the left thumb IPJ (joint specific prevalence of 35%) in the Singapore population, and the right index finger distal interphalangeal joint (DIPJ; joint specific prevalence of 41.5%) in the British population.Conclusion Our study, the first study to compare between Singaporean and British populations, showed statistically significant difference in the prevalence of OA in the hands. These findings suggest ethnic and cultural factors play a part in such a distribution trend.