Self-reported Knee Osteoarthritis Research Articles

A pilot randomized controlled trial evaluating outdoor community walking for knee osteoarthritis: walk

ObjectivesTo determine the feasibility of a randomized controlled trial (RCT) examining outdoor walking on knee osteoarthritis (KOA) clinical outcomes and magnetic resonance imaging (MRI) structural changes.MethodThis was a 24-week parallel two-arm pilot RCT in Tasmania, Australia. KOA participants were randomized to either a walking plus usual care group or a usual care control group. The walking group trained 3 days/week. The primary outcome was feasibility assessed by changes being required to the study design, recruitment, randomization, program adherence, safety, and retention. Exploratory outcomes were changes in symptoms, physical performance/activity, and MRI measures.ResultsForty participants (mean age 66 years (SD 1.4) and 60% female) were randomized to walking (n = 24) or usual care (n = 16). Simple randomization resulted in a difference in numbers randomized to the two groups. During the study, class sizes were reduced from 10 to 8 participants to improve supervision, and exclusion criteria were added to facilitate program adherence. In the walking group, total program adherence was 70.0% and retention 70.8% at 24 weeks. The walking group had a higher number of mild adverse events and experienced clinically important improvements in symptoms (e.g., visual analogue scale (VAS) knee pain change in the walking group: − 38.7 mm [95% CI − 47.1 to − 30.3] versus usual care group: 4.3 mm [− 4.9 to 13.4]).ConclusionsThis study supports the feasibility of a full-scale RCT given acceptable adherence, retention, randomization, and safety, and recruitment challenges have been identified. Large symptomatic benefits support the clinical usefulness of a subsequent trial.Trial registration number12618001097235.Key Points• This pilot study is the first to investigate the effects of an outdoor walking program on knee osteoarthritis clinical outcomes and MRI joint structure, and it indicates that a full-scale RCT is feasible.• The outdoor walking program (plus usual care) resulted in large improvements in self-reported knee osteoarthritis symptoms compared to usual care alone.• The study identified recruitment challenges, and the manuscript explores these in more details and provides recommendations for future studies.

Patient engagement in the design of an intervention to prevent muscle loss in individuals with knee osteoarthritis and a body mass index (BMI)≥35.

Interventions for knee osteoarthritis (OA) in adults with a large body size (defined as a body mass index [BMI]≥35kg/m2 ) often prioritise weight-loss, which may overshadow specific benefits for physical function, metabolic health, and body composition. As part of the development of a future clinical study, we gathered perspectives from individuals living with knee OA and a large body size to inform the proposed intervention design and delivery. Purposive and voluntary sampling was used to engage individuals ≥40years of age with self-reported knee OA and a BMI≥35kg/m2 . An anonymous electronic survey was distributed on social media between April 2020 and June 2020. Open-ended questions addressed a proposed 12-week multimodal intervention (involving targeted nutrition, resistance exercises, and self-management support). An optional semi-structured interview was offered upon completion, with interviews recorded and transcribed verbatim. Reflexive thematic analysis and interpretation guided by an acceptability framework was used to identify recommendations for the intervention design and delivery. Twenty individuals living across Canada completed the survey (100% female; 18 aged <65years and 2≥65years). Ten individuals completed the interview. From aggregate survey and interview data, three recommendations were generated: (1) the effectiveness of the intervention for health improvement (specifically mobility and pain) must be emphasised to avoid perceived weight-loss expectations; (2) extend support beyond 12-weeks and consider terminology free from weight-bias to enhance acceptance; (3) include optional customisation of intervention delivery to reduce acceptability-related burden. These female patient-derived recommendations may improve perceived intervention acceptability, and thereby may enhance participant enrolment and retention in clinical trials.

Association between hip and knee osteoarthritis with falls: A systematic review and meta-analysis.

To examine the association between hip and knee osteoarthritis (OA) and falls. Potentially relevant articles that examine the association between hip, knee, radiological, and self-reported OA and falls were retrieved from PubMed, EMBASE, Scopus, and Web of Science up until March of 2020. The pooled risk ratios (RRs) as well as their related 95% confidence intervals (CIs) were calculated. Statistic and subgroup analyses were performed. A total of 21 studies involving 146965 participants were included. No association was found between hip OA and falls. The pooled RRs value suggested a higher prevalence of falls in knee OA patients (RR=1.35, 95% CI: 1.20 to 1.51, P<.00001) and self-reported OA (RR=1.33, 95% CI: 1.23 to 1.45, P<.00001) than in non-OA subjects. The pooled RR value suggested no difference between prevalence of falls in radiological OA patients compared to non-OA subjects (RR=1.82, 95% CI: 0.89 to 3.73, P=.10). Both radiological and self-reported knee OA seem to be positively associated with falls, while no obvious association was found between hip OA and falls. Therefore, knee OA is a risk factor for falls which should be closely monitored.

"I've been to physical therapy before, but not for the knees." A qualitative study exploring barriers and facilitators to physical therapy utilization for knee osteoarthritis.

Physical therapy (PT) is recommended to reduce pain and improve function. However, only 10%-15% of adults with knee osteoarthritis (OA) use PT in the United States. The purpose of this study was to explore patient-reported barriers and facilitators to PT utilization for knee OA, to understand why PT is underutilized. Qualitative descriptive study using semi-structured interviews was conducted, that is, one-on-one phone interviews with adults from local community centers. Participants were eligible if they were fluent in English and self-reported knee OA (1) over 45 years of age, (2) have activity-related knee pain, and (3) have no morning stiffness or morning stiffness in the knee(s) for ≤30 min. Interviews were audio-recorded and transcribed. To identify barriers and facilitators to PT utilization for knee OA, a coding framework, thematic analysis, and a constant comparative approach were used. Of 22 participants with health insurance and who participated, 59% were considering PT, 23% refused PT, and 18% used PT for knee OA. Themes identified as either barriers or facilitators for participants were (1) previous experience with PT, (2) physician referral, (3) beliefs about treatment efficacy before and after knee replacement surgery, (4) insurance coverage, and (5) preference to avoid surgery. A previous positive encounter with PT and a physician referral may facilitate PT utilization for adults with knee OA. Knowledge about and access to PT services were not identified as barriers related to PT utilization. Further research is necessary to confirm findings in a broader group of adults with knee OA.

Association between meniscal tear patterns and self-reported knee osteoarthritis 5 years after meniscal surgery

Purpose: Patients with meniscal tears having knee arthroscopic surgery of the meniscus are at high risk of developing knee osteoarthritis (OA). Specific meniscal tear patterns such as horizontal and complex tears are typically observed in middle-aged and older patients and often in combination with OA. In contrast, younger patients more often have longitudinal-vertical tears in an otherwise healthy knee joint. Thus, patients with specific meniscal tear patterns may be at higher risk of developing knee OA than others.

Impact of Tart Cherry Juice on Joint Flexibility and Pain in Individuals with Self-Reported Knee Osteoarthritis (P01-030-19)

ObjectivesThe purpose of this study was to examine the daily consumption of tart cherry juice in comparison to a placebo juice on symptoms associated with knee osteoarthritis in both men and woman, age 45–79 years old, for a treatment period of 120 days. MethodsIn a randomized, double-blind control trial, a total of 66 adults with self-reported symptomatic knee OA, were randomized to either consume a 16 oz of tart cherry juice (TCJ) or a placebo juice daily for 4 months. Pain, mobility, plasma biomarkers of cartilage metabolism were evaluated at baseline, 2 months and 4 months. Pain, stiffness, and impact on quality of life were assessed using Self-administered Modified Short Form McGill Pain Questionnaire, while flexibility of the afflicted joint(s) was assessed via range of motion assessment (ROM). Plasma biomarkers related to cartilage metabolism such as glycoprotein 39 (YKL-40), hyaluronic acid, insulin-like growth factor(IGF)-1, and insulin-like growth factor binding protein (IGFBP-3) were determined. ResultsA total of 57 participants completed the study with an attrition rate of 9%. Pain and impact on quality of life decreased significantly at mid-point in the TCJ group, but these improvements were not maintained at the final time point. At midpoint, right knee ROM increased significantly in the TCJ at mid-point, but did not maintain significant at the end of the treatment period. Knee extension and knee flexion also improved significantly in the TCJ group from baseline to midpoint, while there was no significant change in the placebo group. The TCJ group had an overall significant decrease in plasma YKL-40, a marker of cartilage destruction, while no changes were observed in the placebo group. A significant decrease in the plasma IGF-1 and a non-significant up trend in IGFBP-3 were observed in the placebo group, while in the TCJ group no changes in IGF-1 and a non-significant decrease in IGFBP-3 was observed. There were no changes in the hyaluronic acid in the TCJ group during the study duration, but a non-significant up trending was noticed in the placebo group. ConclusionsThe findings of the study suggest that daily consumption of tart cherry juice results in improvement in mobility, relief of pain-related symptoms and quality of life, and selective markers of cartilage health. Funding SourcesCherry Marketing Institute.

Predictors of self-reported knee osteoarthritis in community-dwelling older women in Japan: A cross-sectional and longitudinal cohort study

PurposeThis study aimed to determine the predictors of knee osteoarthritis in community-dwelling elderly Japanese women. MethodsIn this prospective cohort study, The Tokyo Metropolitan Institute of Gerontology collected baseline data in 2008 and follow-up data in 2012 for participants from the Itabashi Ward of Tokyo, Japan. Participants were asked at each time point if they had been diagnosed with knee osteoarthritis. The baseline evaluation was conducted with 1289 community-dwelling women aged 75–85 years, of which 992 reported no history of knee osteoarthritis. The follow-up survey targeted these 992 participants; we obtained history of knee osteoarthritis from 867 of these participants. The baseline evaluation also included collection of anthropometric, fitness, hematologic, and lifestyle data. ResultsWe performed logistic regression analysis of the cross-sectional data at baseline. Participants who reported fewer light exercise sessions (≤2–4days/week) had lower odds ratios for history of self-reported knee osteoarthritis than those who reported more frequent exercise (≥5–6days/week). Logistic regression analysis of the longitudinal data revealed that slow walking speed (<65.22m/min), low serum albumin levels (<4.10g/dL), and low frequency of soy product consumption (≤1 time per 2days) at baseline resulted in higher odds ratios for incidence of self-reported knee osteoarthritis during the 4-year follow-up period. ConclusionsThe results suggest that slow walking speed, low serum albumin, and insufficient consumption of soy products are predictors for knee osteoarthritis in elderly Japanese women. These results could help in the design of knee osteoarthritis prevention programs for elderly women.

Predicting knee osteoarthritis risk in injured populations

BackgroundIndividuals who suffered a lower limb injury have an increased risk of developing knee osteoarthritis. Early diagnosis of osteoarthritis and the ability to track its progression is challenging. This study aimed to explore links between self-reported knee osteoarthritis outcome scores and biomechanical gait parameters, whether self-reported outcome scores could predict gait abnormalities characteristic of knee osteoarthritis in injured populations and, whether scores and biomechanical outcomes were related to osteoarthritis severity via Spearman's correlation coefficient. MethodsA cross-sectional study was conducted with asymptomatic participants, participants with lower-limb injury and those with medial knee osteoarthritis. Spearman rank determined relationships between knee injury and outcome scores and hip and knee kinetic/kinematic gait parameters. K-Nearest Neighbour algorithm was used to determine which of the evaluated parameters created the strongest classifier model. FindingsDifferences in outcome scores were evident between groups, with knee quality of life correlated to first and second peak external knee adduction moment (0.47, 0.55). Combining hip and knee kinetics with quality of life outcome produced the strongest classifier (1.00) with the least prediction error (0.02), enabling classification of injured subjects gait as characteristic of either asymptomatic or knee osteoarthritis subjects. When correlating outcome scores and biomechanical outcomes with osteoarthritis severity only maximum external hip and knee abduction moment (0.62, 0.62) in addition to first peak hip adduction moment (0.47) displayed significant correlations. InterpretationThe use of predictive models could enable clinicians to identify individuals at risk of knee osteoarthritis and be a cost-effective method for osteoarthritis screening.

Self-regulation in older Thai women with self-reported knee osteoarthritis: A path analysis

This study aimed at testing factors influencing coping behavior and health status among older women with knee osteoarthritis. A total of 274 participants completed questionnaires. Model testing revealed that self-efficacy was the most powerful predictor of coping behavior. Illness representation had a significant direct and indirect effect on health status and was a better predictor of health status than were the other variables. Understanding the complex relationships among study variables should help to tailor future interventions to better address the symptoms of osteoarthritis and to promote optimal health in older Thai women who report knee osteoarthritis.

Knee osteoarthritis negatively affects the recovery step following large forward-directed postural perturbations

The reasons for higher fall risk of people with osteoarthritis (OA) compared to people without OA are not known. It is possible that following a loss of balance OA may negatively affect the recovery stepping response. Stepping responses have not been reported for people with knee OA. Here, we compared recovery step kinematics following laboratory-induced trip and following a large treadmill-delivered perturbation simulating a trip between a group of women with and without self-reported knee OA. We hypothesized that knee OA would significantly impair recovery step kinematics compared to those of a control group. Following the laboratory-induced trip, step length and trunk flexion velocity at recovery step completion of women with OA were significantly impaired and more so for the women who fell. Following the treadmill-delivered perturbation, the recovery step kinematics of women with OA were not significantly impaired. For both perturbations, the women who fell had significantly impaired recovery step kinematics compared to those who did not fall, regardless of OA. The results are consistent with previous work on healthy middle aged and older women and suggest that the same biomechanical risk factors for trip-related falls are shared by middle age and older women regardless of the presence of knee OA. The results support the need to determine whether training protocols which have been shown to improve recovery step kinematics and reduce prospective falls by healthy older women can have similar outcomes for people with knee OA.

Prevalence of symptoms of self-reported knee osteoarthritis in Odo-Ogbe community, Ile-Ife

Background: Osteoarthritis, (OA) the most common of all the types of arthritis, is a significant public health problem which contributes greatly to disability in the elderly. Community-based prevalence studies of OA in South-Western Nigeria were scanty for referencing. Objective: This study investigated the prevalence of symptoms of self-reported knee OA (KOA) in a heterogeneous community of Odo-Ogbe in Ile-Ife, South-Western Nigeria. Methods: All houses in Odo-Ogbe community were numbered, and all odd numbered houses were selected for the study. Every adult individual of aged 35 years and above living in the selected houses were recruited for the study. The total number of participants was 119 individuals and all of them participated in the study by completing Western Ontario and McMaster Universities Osteoarthritis Index Questionnaire. Their anthropometric variables were also measured. Data were analyzed using descriptive and inferential statistics. Results: There were 99 females and 20 males respondents that participated in the study. Forty-seven (39.5%) had knee pain and other KOA symptoms. Among those with KOA symptoms, six of them were males while 41 (87.2%) of them were females. There was a significant negative relationship (P Conclusion: The prevalence of symptomatic KOA at Odo-Ogbe community is high, more female were affected, and many of those affected had family history of arthritis.

How well do radiographic, clinical and self-reported diagnoses of knee osteoarthritis agree? Findings from the Hertfordshire cohort study.

ObjectiveEpidemiological studies of knee osteoarthritis (OA) have often used a radiographic definition. However, the clinical syndrome of OA is influenced by a broad range of factors in addition to the structural changes required for radiographic OA. Hence more recently several studies have adopted a clinical or self-reported approach to OA diagnosis rather than a radiographic approach. The aim of this study was to investigate agreement between radiographic OA and the clinical and self-reported diagnoses of OA.DesignData were available for 199 men and 196 women in the Hertfordshire Cohort Study (HCS), UK. Participants completed a questionnaire detailing self-reported OA. Clinical OA was defined based on American College of Rheumatology (ACR) criteria. Knee radiographs were taken and graded for overall Kellgren and Lawrence (K&L) score.ResultsThe mean (standard deviation (SD)) age of study participants was 75.2 (2.6) years and almost identical proportions of men and women. The prevalence of knee OA differed depending on the method employed for diagnosis; 21% of the study participants self-reported knee OA, 18% of the participants had clinical knee OA and 42% of the participants had radiographic OA. Of those 72 study participants with a self-reported diagnosis of knee OA 52 (72%) had a radiographic diagnosis of knee OA, while 66% (39 out of 59) of study participants with clinical knee OA had a diagnosis of radiographic knee OA. However 58% of those participants diagnosed with radiographic OA did not have either self-reported knee OA or a diagnosis of clinical OA. Therefore in comparison with the radiographic definition of OA, both the clinical and self-report definitions had high specificity (91.5% & 91.5% respectively) and low sensitivity (24.5% and 32.7% respectively).ConclusionThere is modest agreement between the radiographic, clinical and self-report methods of diagnosis of knee OA.

A qualitative study of the consequences of knee symptoms: ‘It's like you're an athlete and you go to a couch potato’

ObjectivesTo explore the perceived consequences of knee symptoms on the lives of people aged 35–65 years who had diagnosed osteoarthritis (OA) or OA-like symptoms.DesignA qualitative study with six focus groups...

Freeze-Dried Grape Powder Reduces Joint Pain and Influences Serum Cartilage and Inflammatory Biomarkers in Older Adults with Self-Reported Knee Osteoarthritis

Freeze-Dried Grape Powder Reduces Joint Pain and Influences Serum Cartilage and Inflammatory Biomarkers in Older Adults with Self-Reported Knee Osteoarthritis

AB0976 Associations between ultrasonographic and radiographic features of osteoarthritis and pain – a within-person knee-matched case-control study

BackgroundAssociations between osteoarthritis (OA) features and pain are difficult to study due to varying pain report between persons. A study using a within-person knee-matched design showed strong associations between radiographic...

SAT0331 Identifying knee osteoarthritis phenotypes and comparing clinical outcomes - data from the must osteoarthritis cohort

BackgroundIt has been suggested that the heterogeneous population of persons with knee osteoarthritis (OA) consists of different phenotypes or subgroups, which may have important implications for clinical care and research....

Lower limb muscle strengthening does not change frontal plane moments in women with knee osteoarthritis: A randomized controlled trial

Background Osteoarthritis is a common musculo-skeletal problem accompanied with muscle weakness. Muscle weakness may be readily improved by resistance training. Greater muscle strength has been associated with a lower knee joint loading rate. Methods We conducted a single-blind randomized controlled trial of 54 female patients with osteoarthritis in at least one knee, according to the American College of Rheumatology clinical criteria. Patients were randomized into a 6-month high intensity progressive resistance training or a sham-exercise program. The primary outcomes were first peak knee and hip adduction moment measured using three-dimensional gait analysis at self-selected habitual and maximal speeds. Secondary outcomes were sagittal plane knee and hip moments, peak muscle strength, gait speed, and self-reported knee osteoarthritis symptoms measured by the Western Ontario and McMaster Osteoarthritis Index (WOMAC). Findings Six months of high intensity resistance training did not change the first peak knee or hip adduction moment at either habitual or maximum walking speeds ( P > 0.413) compared to the sham-exercise. However, the second peak hip adduction moment ( P = 0.025) and WOMAC pain score ( P < 0.001) were reduced significantly in both groups over time, but there was no group effect. The changes in the second peak hip adduction moment were inversely related to the changes in the WOMAC pain score ( r = − 0.394, P = 0.009). Interpretations Muscle strength training in women with osteoarthritis, while effective for reducing osteoarthritis symptoms, appeared to operate through mechanisms other than improved knee or hip joint loading, as paradoxically, improved symptoms were related to decreases of hip adduction moment in late stance.