Hip and knee osteoarthritis in an eighteenth century urban population
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Abstract:
A recent study of skeletons from Saxon and Medieval England has shown that in the past tibiofemoral osteoarthritis was far less prevalent than hip osteoarthritis, whereas at present this situation is reversed. This observation suggests that tibiofemoral osteoarthritis may be a ‘new’ disease. Obesity, which is to some extent linked to a modern life style, is thought to be a potential causative factor in this respect. A random sample of 250 skeletons buried between 1750 and 1830 in the Church of St Lawrence, Alkmaar (The Netherlands) offered the possibility to study the prevalence of osteoarthritis in the knee and hip joints in this particular period. We found tibiofemoral osteoarthritis to be less prevalent than osteoarthritis of the hip joint. Tibiofemoral osteoarthritis therefore can be seen as a truly modern phenomenon, which was at least not common until the early nineteenth century. © 1997 by John Wiley & Sons, Ltd.Obesity is one of the most significant, and potentially most preventable, risk factors for the development of osteoarthritis, and numerous studies have shown a strong association between body mass index and osteoarthritis of the hip, knee, foot and hand. However, the mechanism(s) by which obesity contributes to the onset and progression of osteoarthritis are not fully understood. The strong association between body mass index, altered limb alignment, and osteoarthritis of the knee--and the protective effects of weight loss--support the classic hypothesis that the effects of obesity on the joint are due to increased biomechanical loading and associated alterations in gait. However, obesity is now considered to be a low-grade systemic inflammatory disease, and recent studies suggest that metabolic factors associated with obesity alter systemic levels of pro-inflammatory cytokines that are also associated with osteoarthritis. Thus, the ultimate influence of obesity on osteoarthritis may involve a complex interaction of genetic, metabolic, and biomechanical factors. In this respect, mouse models of obesity can provide excellent systems in which to examine causal relationships among these factors. In recent years, there have been surprisingly few reports examining the effects of obesity on osteoarthritis using mouse models. In this paper, we review studies on mice and other animal models that provide both direct and indirect evidence on the role of obesity and altered diet in the development of osteoarthritis. We also examine the use of different body mass indices for characterizing "obesity" in mice by comparing these indices to typical adiposity levels observed in obese humans. Taken together, evidence from studies using mice suggest that a complex interaction of environmental and genetic factors associated with obesity contribute to the incidence and severity of osteoarthritis. The ability to control these factors, together with the development of methods to conduct more intricate measures of local biomechanical factors, make mouse models an excellent system to study obesity and osteoarthritis.
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We aimed to determine whether hand OA is characterized by systemic cartilage loss by assessing if radiographically normal joints had greater joint space width (JSW) loss over 4 years in hands with incident or prevalent OA elsewhere in the hand compared with hands without OA. We used semi-automated software to measure JSW in the distal and proximal IP joints of 3368 participants in the Osteoarthritis Initiative who had baseline and 48-month hand radiographs. A reader scored 16 hand joints (including the thumb base) for Kellgren-Lawrence (KL) grade. A joint had OA if scored as KL ≥2. We identified three groups based on longitudinal hand OA status: no hand OA (KL <2 in all 16 joints) at the baseline and 48-month visits, incident hand OA (KL <2 in all 16 joints at baseline and then one or more joints with KL ≥2 at 48 months) and prevalent hand OA (one or more joints with KL ≥2 at baseline and 48 months). We then assessed if JSW in radiographically normal joints (KL 0) differed across these three groups. We calculated unpooled effect sizes to help interpret the differences between groups. We observed small differences in JSW loss that are unlikely to be clinically important in radiographically normal joints between those without hand OA (n = 1054) and those with incident (n = 102) or prevalent hand OA (n = 2212) (effect size range -0.01-0.24). These findings were robust when examining JSW loss dichotomized based on meaningful change and in other secondary analyses. Hand OA is not a systemic disease of cartilage.
Interphalangeal Joint
Arthropathy
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Introduction: Osteoarthritis (OA) is a chronic inflammatory condition affecting the joint. Knee is the most commonly involved joint of body in osteoarthritis. Osteoarthritis may occur primarily in knee joint or it may be due to some underlying condition of knee joint in which case it’s called secondary osteoarthritis. We have conducted this study to know the mechanism causing osteoarthritis knee relying on preponderance of side of involvement.
Materials and Methods: This is a cross sectional study of 400 patients presented to OPD of Department of Orthopaedics, Civil Hospital Ahmedabad during 1st of May, 2016 to 31st of May, 2016. Only patients with primary osteoarthritis of knee were enrolled in our study.
Results: Out of 400 patients enrolled, 180 (45%) patients had involvement of left knee joint, 170(42%) patients had involvement of right knee joint whereas 50 (13%) patients had bilateral knee joint involvement. There is no preponderance noted for specific side of OA knee in our study. Furthermore there was no correlation found between occupation and development of OA knee in your study.
Conclusion: There is no preponderance for specific side for OA knee as per our study further strengthening the claim that OA knee is not due to the wear and tear mechanism as if it would have been so bilateral involvement would be more common and in unilateral involvement, dominant extremity would have been commonly involved which is not consistent with the findings of our study.
Keywords: Knee, Osteoarthritis, Side
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Background: Elderly patients have high prevalence of knee osteoarthritis which the severity of the disease can effect on their function and well-being. Health personnel can help promote and prevent this deterioration by educating the patient. Objective: This pre-experimental research aimed to study the effectiveness of the program to reduce knee pain in osteoarthritis elderly patients in Chang-sai health promotion hospital. Method: Thirty patient with osteoarthritis were participated in this study. Clinical outcomes which were knee pain and severity of osteoarthritis between pre-test and post-test groups to evaluate the effectiveness of the programme. Research instruments included 1) knee pain reducing program 2) brochures for knee exercise, and 3) health record form. Demographic data and health status were collected during 25th Jan – 22nd Feb 2019. Data were analyzed by frequencies, percentages, mean, standard deviation and dependent t-test . Result: Participant reported significantly reducing of pain score after the program, pre-test 5.16 to post-test 3.10 respectively (p-value<0.001). In moderate severity group of osteoarthritis, the severity was reducing from 23.30% to 6.70% after participated in the program. Conclusion: Knee pain reducing program could reduce pain score and severity of osteoarthritis in elderly patients. This program may benefit by alternatively applying in clinical practice to reduce the pain and the severity of knee osteoarthritis.
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Knee osteoarthritis is a common disease, with the clinical treatment of medicine and other ways. But most of the treatment are ineffective. In recent years, arthroscopic began to be applied to clinical treatment of osteoarthritis for knee joint, which obtained good results. This paper reviewed the progress of the treatment of knee joint clearance for knee osteoarthritis with the arthroscope.
Joint disease
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Purpose of review We discuss recent published epidemiologic data regarding risk factors for incident and progressive knee osteoarthritis and related knee pain to identify targets for primary and secondary prevention. We also discuss recently identified methodologic challenges to the study of knee osteoarthritis, particularly osteoarthritis progression. Recent findings Recent epidemiologic studies and systematic reviews of knee osteoarthritis have confirmed that being overweight and obese, and knee injuries increase the risk for incident knee osteoarthritis. Biomechanical risk factors such as leg-length inequalities and malalignment require further study. Obesity also appears to play a role in accelerating osteoarthritis worsening. However, with the exception of malalignment, no risk factors for knee osteoarthritis progression have been identified. Novel approaches to the study of knee pain have demonstrated a strong association between structural abnormalities and knee pain, contrary to the 'so-called' structure-symptom discordance, as well as between fluctuations of knee pain with changes in specific structural lesions. A number of methodologic issues, including conditioning on an intermediate stage of disease and depletion of susceptibles may explain, in part, the difficulty in identifying risk factors for knee osteoarthritis. Summary There is strong epidemiologic evidence that being overweight or obese and knee injury are associated with increased risk of developing knee osteoarthritis. Further study is required to confirm associations of leg-length inequality and malalignment with incident knee osteoarthritis. Few new risk factors for progression of knee osteoarthritis have been identified in the past few years. Without such knowledge, secondary prevention of osteoarthritis remains challenging.
Knee pain
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Objective To investigate the improvement of knee function by small needle knife in the patients with knee osteoarthritis and the difference among different TCM syndrome types,and to standardize the treatment of knee osteoarthritis with small needle knife. Method The patients with knee osteoarthritis were chosen,and their functional indexes were observed and compared according to TCM syndrome types before and after the treatment. Result Small needle knife had obvious effect of improvement on functional indexes of knee joint,and there was no difference among different TCM syndrome types. Conclusion Small needle knife can improve the function of knee joint to a certain extent in the patients with knee osteoarthritis.
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We investigated the clinical and radiographic disease course of hand osteoarthritis as well as determinants of poor clinical outcome and radiographic progression over a period of six years in 289 patients with hand osteoarthritis. Because these patients had osteoarthritis at multiple joints this enabled us to not only assess the association between progression of osteoarhtiritis in different hand joints groups but also between progression of hand osteoarthritis and osteoarthritis change at the knee. In addition, genetic factors in hand osteoarthritis progression were investigated as well as the influence of illness perceptions. The hand osteoarthritis subsets erosive osteoarthritis and thumb base osteoarthritis are further characterised. In the last part of the thesis the clinimetric properties of a pain score for osteoarthritis and radiographic outcome measures for hand osteoarthritis are evaluated.
Arthropathy
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GENERAL INFORMATION The Definition of Osteoarthritis Epidemiology of Osteoarthritis Pathology of Osteoarthritis Pathogenesis of Osteoarthritis DIAGNOSIS OF OSTEOARTHRITIS Clinical Features of Osteoarthritis Pitfalls in the Diagnosis of Osteoarthritis Synovial Fluid Analysis Radiography of Osteoarthritis Monitoring the Patient with Osteoarthritis THERAPY Nonmedicinal Therapy for Osteoarthritis Pain Systemic Pharmacologic Therapy Local Therapy for OA Pain A Rational Strategy for Selecting the Initial Pharmacologic Agent for the Management of Osteoarthritis Pain Disease-Modifying Drugs for Osteoarthritis (DMOADs) Tidal Irrigation of the Knee Surgical Intervention Index
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Objective
To evaluate the clinical effects of platelet-rich plasma (PRP) injections in patients with knee osteoarthritis.
Methods
In our hospital diagnosed with 58 cases of knee osteoarthritis patients as the research object, in all patients of knee joint cavity are PRP injection treatment, once a week, each injection of 5 ml, total injection three times. After treatment were followed up regularly, through international general Marius Holm (Lysholm) score system of knee joint function evaluation of knee joint function of patients after treatment were scored.
Results
Among 58 cases and 116 knee joins, the first injection provided 5 patients and 10 knee joints with symptom relief. The twice injection relieved the symptoms of 25 patients and 50 knee joints. After the third injection; the symptoms of 45 patients and 90 knee joints were relieved. At 6 months after the treatment, 55 patients and 110 knee joints received symptom relief. The effective rate of treatment was 94.8%. 3 patients and 6 knee joints were reported with no symptom relief.
Conclusion
Intra-articular PRP injection for knee osteoarthritis is a valid treatment option. PRP might relieve the symptom of osteoarthritis (OA) patients in a short time, and have good treatment outcomes, especially in patients with a less degree of knee degeneration and younger age.
Key words:
Osteoarthritis; Platelet-rich plasma
Clinical efficacy
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