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Brauer, Sandra. "Hip and knee osteoarthritis." Australian Journal of Physiotherapy 54, no. 4 (2008): 286. http://dx.doi.org/10.1016/s0004-9514(08)70013-8.
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Sims, Kevin. "Hip and knee osteoarthritis." Journal of Physiotherapy 56, no. 2 (2010): 139. http://dx.doi.org/10.1016/s1836-9553(10)70066-7.
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Nelson, Amanda E., Yvonne M. Golightly, Jordan B. Renner, Todd A. Schwartz, Felix Liu, John A. Lynch, Jenny S. Gregory, Richard M. Aspden, Nancy E. Lane, and Joanne M. Jordan. "Variations in Hip Shape Are Associated with Radiographic Knee Osteoarthritis: Cross-sectional and Longitudinal Analyses of the Johnston County Osteoarthritis Project." Journal of Rheumatology 43, no. 2 (December 15, 2015): 405–10. http://dx.doi.org/10.3899/jrheum.150559.
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Objective.Hip shape by statistical shape modeling (SSM) is associated with hip radiographic osteoarthritis (rOA). We examined associations between hip shape and knee rOA given the biomechanical interrelationships between these joints.Methods.Bilateral baseline hip shape assessments [for those with at least 1 hip with a Kellgren-Lawrence arthritis grading scale (KL) 0 or 1] from the Johnston County Osteoarthritis Project were available. Proximal femur shape was defined on baseline pelvis radiographs and evaluated by SSM, producing mean shape and continuous variables representing independent modes of variation (14 modes = 95% of shape variance). Outcomes included prevalent [baseline KL ≥ 2 or total knee replacement (TKR)], incident (baseline KL 0/1 with followup ≥ 2), and progressive knee rOA (KL increase of ≥ 1 or TKR). Limb-based logistic regression models for ipsilateral and contralateral comparisons were adjusted for age, sex, race, body mass index (BMI), and hip rOA, accounting for intraperson correlations.Results.We evaluated 681 hips and 682 knees from 342 individuals (61% women, 83% white, mean age 62 yrs, BMI 29 kg/m2). Ninety-nine knees (15%) had prevalent rOA (4 knees with TKR). Lower modes 2 and 3 scores were associated with ipsilateral prevalent knee rOA, and only lower mode 3 scores were associated with contralateral prevalent knee rOA. No statistically significant associations were seen for incident or progressive knee rOA.Conclusion.Variations in hip shape were associated with prevalent, but not incident or progressive, knee rOA in this cohort, and may reflect biomechanical differences between limbs, genetic influences, or common factors related to both hip shape and knee rOA.
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Barrios, Joaquin A., and Danielle E. Strotman. "A Sex Comparison of Ambulatory Mechanics Relevant to Osteoarthritis in Individuals With and Without Asymptomatic Varus Knee Alignment." Journal of Applied Biomechanics 30, no. 5 (October 2014): 632–36. http://dx.doi.org/10.1123/jab.2014-0039.
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The prevalence of medial knee osteoarthritis is greater in females and is associated with varus knee alignment. During gait, medial knee osteoarthritis has been linked to numerous alterations. Interestingly, there has been no research exploring sex differences during walking in healthy individuals with and without varus alignment. Therefore, the gait mechanics of 30 asymptomatic individuals with varus knees (15 females) and 30 normally-aligned controls (15 females) were recorded. Gait parameters associated with medial knee osteoarthritis were analyzed with two-factor analyses of variance. In result, varus males exhibited the greatest peak knee adduction moments, while normal females showed the greatest peak hip adduction angles and pelvic drop excursions. By sex, females exhibited greater peak hip adduction angles and moments and greater pelvic drop excursion, but lesser peak knee adduction angles. By alignment type, varus subjects exhibited greater peak knee adduction angles and moments, midstance knee flexion angles and excursion, and eversion angles and lateral ground reaction forces, but lesser peak hip adduction angles. In conclusion, females generally presented with proximal mechanics related to greater hip adduction, whereas males presented with more knee adduction. Varus subjects demonstrated a number of alterations associated with medial knee osteoarthritis. The differential sex effects were far less conclusive.
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Hálfdanardóttir, Freyja, Dan K. Ramsey, and Kristín Briem. "Timing of Frontal Plane Trunk Lean, Not Magnitude, Mediates Frontal Plane Knee Joint Loading in Patients with Moderate Medial Knee Osteoarthritis." Advances in Orthopedics 2018 (2018): 1–7. http://dx.doi.org/10.1155/2018/4526872.
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The purpose of this study was to examine the influence of trunk lean and contralateral hip abductor strength on the peak knee adduction moment (KAM) and rate of loading in persons with moderate medial knee osteoarthritis. Thirty-one males (17 with osteoarthritis, 14 controls) underwent 3-dimensional motion analysis, strength testing of hip abductors, and knee range of motion (ROM) measures, as well as completing the knee osteoarthritis outcome score (KOOS). No differences were found between groups or limbs for gait cycle duration, but the osteoarthritis group had longer double-limb support during weight acceptance (p<0.001) and delayed frontal plane trunk motion towards the stance limb (p<0.01). This was reflected by a lower rate of loading for the osteoarthritis group compared to controls (p<0.001), whereas no differences were found for peak KAM. Trunk angle, contralateral hip abductor strength, and BMI explained the rate of loading at the involved knee (p<0.001), an association not found for the contralateral knee or control knees. Prolonged trunk lean over the stance limb may help lower peak KAM values. Rate of frontal plane knee joint loading may partly be mediated by the contralateral limb’s abductor strength, accentuating the importance of bilateral lower limb strength for persons with knee osteoarthritis.
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Myszka, Anna, Janusz Piontek, Jacek Tomczyk, and Marta Zalewska. "Osteoarthritis – a problematic skeletal trait in past human populations. Osteoarthritic changes vs. entheseal changes in the late medieval and early modern population form Łekno." Anthropological Review 83, no. 2 (June 1, 2020): 143–61. http://dx.doi.org/10.2478/anre-2020-0011.
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AbstractAccording to medical knowledge, physical activity plays a role in osteoarthritic changes formation. The impact of occupation on osteoarthritic changes development in past human populations is not clear enough, causing problems with interpretation. The aim of the current study is to examine the relationship between osteoarthritis and entheseal changes. Skeletal material comes from the late medieval, early modern population from Łekno (Poland). The sample consists of 110 males and 56 females (adults only). Osteophytes, porosity and eburnation were analyzed in the shoulder, elbow, wrist, hip, knee, and ankle. Entheses on the humerus, radius, femur, and tibia were examined. Standard ranked categorical scoring systems were used for the osteoarthritic and entheseal changes examination.Males with more developed osteophytes in the shoulder have more “muscular” upper limbs (higher values of muscle markers). Males with more developed osteophytes in the hip and knee are predicted to have more “muscular” lower limbs. Males with more developed osteoarthritis in the shoulder, wrist, hip, and knee exhibit more developed entheseal changes. Males with more developed entheses tend to yield more developed osteophytes (all joints taken together) and general osteoarthritis (all changes and all joints taken together). Females with more developed entheses have more developed osteoarthritis in the elbow, wrist, and hip. Individuals with more developed entheses have much more developed osteophytes. When all the three types of changes are taken together, more “muscular” females exhibit more developed osteoarthritis. The lack of uniformity of the results, wild discussions on the usage of entheses in activity patterns reconstruction and other limitations do not allow to draw unambiguous conclusions about the impact of physical activity on the osteoarthritis in past populations and further studies are needed.
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Lao, Chunhuan, David Lees, Sandeep Patel, Douglas White, and Ross Lawrenson. "Length of Hospital Stay for Osteoarthritic Primary Hip and Knee Replacement Surgeries in New Zealand." International Journal of Environmental Research and Public Health 16, no. 23 (November 29, 2019): 4789. http://dx.doi.org/10.3390/ijerph16234789.
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This study aims to explore the length of stay (LOS) of publicly funded osteoarthritic primary hip and knee replacement surgeries in New Zealand. Patients with osteoarthritis who underwent publicly funded primary hip and knee replacement surgery in 2005–2017 were included. We have identified 53,439 osteoarthritic primary hip replacements and 50,072 osteoarthritic primary knee replacements. LOS has been reduced by almost 40% over the last 13 years. Logistic regression showed that women, Māori, Pacific and Asian patients, older patients, people with more comorbidities and those having opiates on discharge and patients in earlier years were more likely to have extended LOS following hip replacements and knee replacements. Regional differences were noted in LOS between the Waitemata District Health Board (DHB) compared to Tairāwhiti DHB where patients were the most likely to have a LOS of more than 5 days after hip and knee replacements. LOS after hip and knee replacements has been reduced dramatically. Women, Māori, Pacific and Asian patients, older patients and people with more comorbidities are more likely to have extended LOS. Patients dispensed opiates on discharge had a longer LOS. There are great geographical variations in LOS for primary hip and knee surgeries in New Zealand.
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Brauer, Sandra. "Hand, hip, and knee osteoarthritis." Journal of Physiotherapy 58, no. 3 (September 2012): 203. http://dx.doi.org/10.1016/s1836-9553(12)70117-0.
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Lohmander, L. S., M. Gerhardsson de Verdier, J. Rollof, P. M. Nilsson, and G. Engström. "Incidence of severe knee and hip osteoarthritis in relation to different measures of body mass: a population-based prospective cohort study." Annals of the Rheumatic Diseases 68, no. 4 (May 8, 2008): 490–96. http://dx.doi.org/10.1136/ard.2008.089748.
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Objective:To determine in a prospective population-based cohort study relationships between different measures of body mass and the incidence of severe knee and hip osteoarthritis defined as arthroplasty of knee or hip due to osteoarthritis.Materials and methods:Body mass index (BMI), waist circumference, waist–hip ratio (WHR), weight and percentage of body fat (BF%) were measured at baseline in 11 026 men and 16 934 women from the general population. The incidence of osteoarthritis over 11 years was monitored by linkage with the Swedish hospital discharge register.Results:471 individuals had knee osteoarthritis and 551 had hip osteoarthritis. After adjustment for age, sex, smoking and physical activity, the relative risks (RR) of knee osteoarthritis (fourth vs first quartile) were 8.1 (95% CI 5.3 to 12.4) for BMI, 6.7 (4.5 to 9.9) for waist circumference, 6.5 (4.6 to 9.43) for weight, 3.6 (2.6 to 5.0) for BF% and 2.2 (1.7 to 3.0) for WHR. Corresponding RR for hip osteoarthritis were 2.6 (2.0 to 3.4) for BMI, 3.0 (2.3 to 4.0) for weight, 2.5 (1.9 to 3.3) for waist, 1.3 (0.99 to 1.6) for WHR and 1.5 (1.2 to 2.0) for BF%.Conclusion:All measures of overweight were associated with the incidence of knee osteoarthritis, with the strongest relative risk gradient observed for BMI. The incidence of hip osteoarthritis showed smaller but significant differences between normal weight and obesity. Our results support a major link between overweight and biomechanics in increasing the risk of knee and hip osteoarthritis in men and women.
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Zeng, Chao, Kim Bennell, Zidan Yang, Uyen-Sa D. T. Nguyen, Na Lu, Jie Wei, Guanghua Lei, and Yuqing Zhang. "Risk of venous thromboembolism in knee, hip and hand osteoarthritis: a general population-based cohort study." Annals of the Rheumatic Diseases 79, no. 12 (September 16, 2020): 1616–24. http://dx.doi.org/10.1136/annrheumdis-2020-217782.
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ObjectivesOsteoarthritis is a leading cause of immobility and joint replacement, two strong risk factors for venous thromboembolism (VTE). We aimed to examine the relation of knee, hip and hand osteoarthritis to the risk of VTE and investigate joint replacement as a potential mediator.MethodsWe conducted three cohort studies using data from The Health Improvement Network. Up to five individuals without osteoarthritis were matched to each case of incident knee (n=20 696), hip (n=10 411) or hand (n=6329) osteoarthritis by age, sex, entry time and body mass index. We examined the relation of osteoarthritis to VTE (pulmonary embolism and deep vein thrombosis) using a multivariable Cox proportional hazard model.ResultsVTE developed in 327 individuals with knee osteoarthritis and 951 individuals without osteoarthritis (2.7 vs 2.0 per 1000 person-years), with multivariable-adjusted HR being 1.38 (95% CI 1.23 to 1.56). The indirect effect (HR) of knee osteoarthritis on VTE through knee replacement was 1.07 (95% CI 1.01 to 1.15), explaining 24.8% of its total effect on VTE. Risk of VTE was higher in hip osteoarthritis than non-osteoarthritis (3.3 vs 1.8 per 1000 person-years; multivariable-adjusted HR=1.83, 95% CI 1.56 to 2.13). The indirect effect through hip replacement yielded an HR of 1.14 (95% CI 1.04 to 1.25), explaining 28.1% of the total effect. No statistically significant difference in VTE risk was observed between hand osteoarthritis and non-osteoarthritis (1.5 vs 1.6 per 1000 person-years; multivariable-adjusted HR=0.88, 95% CI 0.67 to 1.16).ConclusionOur large population-based cohort study provides the first evidence that knee or hip osteoarthritis, but not hand osteoarthritis, was associated with an increased risk of VTE, and such an association was partially mediated through knee or hip replacement.
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Ghaznavi, Samina, Aneela Altaf Kidwai, Farhat Bashir, and Mahfooz Alam. "OSTEOARTHRITIS;." Professional Medical Journal 24, no. 10 (October 6, 2017): 1579–83. http://dx.doi.org/10.29309/tpmj/2017.24.10.713.
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Objectives: To determine the pattern of symptomatic and radiographicosteoarthritis in the urban population of Karachi. Data Source: Outpatient clinics. Design ofStudy: Cross sectional observational. Setting: Liaquat National Hospital, Karachi. Period:August 2015 till July 2016. Materials and Methods: Symptomatic patients belonging to bothgenders, aged ≥ 30 years, having clinical and radiographic osteoarthritis involving knee, hip,spine, hand, foot and shoulder were included. Diagnosis of knee osteoarthritis was based onAmerican College of Rheumatology criteria, whereas the diagnosis of other joint areas wasbased on clinical and radiographic features. Patients were categorized as having monofocal ormultifocal osteoarthritis. The results were interpreted as frequencies and percentages. Results:Of the total 215 patients, 137 (63.7%) were females and 78 (36.27%) were males with meanage of 52.2 ± 9.3 years. Monofocal and multifocal osteoarthritis was found in 151 (70.23%) and64 (31.2%) patients respectively. Knee osteoarthritis (92.7%) was the most frequent monofocalpresentation. Of 64 patients with multifocal osteoarthritis, knee and hip joint were involved in28 (43.75%) and knee and hand osteoarthritis was found in 13 (20.3%) patients. Seven patients(10.9%) had osteoarthritis of three or more joints. Overall bilateral knee osteoarthritis wasfound in 158 (77.45%) patients. Conclusion: Bilateral symptomatic and radiographic kneeosteoarthritis was the most common presentation. Comparatively less proportion of patientshad osteoarthritis of three or more joints.
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ALLEN, KELLI D., JIU-CHIUAN CHEN, LEIGH F. CALLAHAN, YVONNE M. GOLIGHTLY, CHARLES G. HELMICK, JORDAN B. RENNER, and JOANNE M. JORDAN. "Associations of Occupational Tasks with Knee and Hip Osteoarthritis: The Johnston County Osteoarthritis Project." Journal of Rheumatology 37, no. 4 (February 15, 2010): 842–50. http://dx.doi.org/10.3899/jrheum.090302.
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Objective.This cross-sectional study examined associations of occupational tasks with radiographic and symptomatic osteoarthritis (OA) in a community-based sample.Methods.Participants from the Johnston County Osteoarthritis Project (n = 2729) self-reported the frequency of performing 10 specific occupational tasks at the longest job ever held (never/seldom/sometimes vs often/always) and lifetime exposure to jobs that required spending > 50% of their time doing 5 specific tasks or lifting 22, 44, or 110 pounds 10 times weekly. Multivariable logistic regression models examined associations of each occupational task separately with radiographic and symptomatic knee and hip OA, controlling for age, race, gender, body mass index, prior knee or hip injury, and smoking.Results.Radiographic hip and knee OA were not significantly associated with any occupational tasks, but several occupational tasks were associated with increased odds of both symptomatic knee and hip OA: lifting > 10 pounds, crawling, and doing heavy work while standing (OR 1.4–2.1). More occupational walking and standing and less sitting were also associated with symptomatic knee OA, and more bending/twisting/reaching was associated with symptomatic hip OA. Exposure to a greater number of physically demanding occupational tasks at the longest job was associated with greater odds of both symptomatic knee and hip OA.Conclusion.Our results confirm an association of physically demanding occupational tasks with both symptomatic knee and hip OA, including several specific activities that increased the odds of OA in both joint groups. These tasks represent possibilities for identifying and targeting at-risk individuals with preventive interventions.
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Kang, Xin, Hongmou Zhao, Hua Lin, Hongliang Liu, and Tuanyun Zhao. "Shared susceptibilities between knee osteoarthritis and hip osteoarthritis." International Journal of Rheumatic Diseases 23, no. 5 (April 21, 2020): 705. http://dx.doi.org/10.1111/1756-185x.13838.
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Verlaan, Loek, Ramon J. Boekesteijn, Pieter W. Oomen, Wai-Yan Liu, Marloes J. M. Peters, M. Adhiambo Witlox, Pieter J. Emans, Lodewijk W. van Rhijn, and Kenneth Meijer. "Biomechanical Alterations during Sit-to-Stand Transfer Are Caused by a Synergy between Knee Osteoarthritis and Obesity." BioMed Research International 2018 (December 9, 2018): 1–7. http://dx.doi.org/10.1155/2018/3519498.
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Osteoarthritis is one of the major causes of immobility and its current prevalence in elderly (>60 years) is 18% in women and 9.6% in men. Patients with osteoarthritis display altered movement patterns to avoid pain and overcome movement limitations in activities of daily life, such as sit-to-stand transfers. Currently, there is a lack of evidence that distinguishes effects of knee osteoarthritis on sit-to-stand performance in patients with and without obesity. The purpose of this study was therefore to investigate differences in knee and hip kinetics during sit-to-stand movement between healthy controls and lean and obese knee osteoarthritis patients. Fifty-five subjects were included in this study, distributed over three groups: healthy controls (n=22), lean knee osteoarthritis (n=14), and obese knee OA patients (n=19). All subjects were instructed to perform sit-to-stand transfers at self-selected, comfortable speed. A three-dimensional movement analysis was performed to investigate compensatory mechanisms and knee and hip kinetics during sit-to-stand movement. No difference in sit-to-stand speed was found between lean knee OA patients and healthy controls. Obese knee osteoarthritis patients, however, have reduced hip and knee range of motion, which is associated with reduced peak hip and knee moments. Reduced vertical ground reaction force in terms of body weight and increased medial ground reaction forces indicates use of compensatory mechanisms to unload the affected knee in the obese knee osteoarthritis patients. We believe that an interplay between obesity and knee osteoarthritis leads to altered biomechanics during sit-to-stand movement, rather than knee osteoarthritis alone. From this perspective, obesity might be an important target to restore healthy sit-to-stand biomechanics in obese knee OA patients.
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Fachrizal, Achmad, and Komang Agung Irianto. "CLINICAL EVALUATION OF POST TOTAL HIP / KNEE REPLACEMENT IN HIP / KNEE SPINE SYNDROME." (JOINTS) Journal Orthopaedi and Traumatology Surabaya 6, no. 1 (April 30, 2017): 40. http://dx.doi.org/10.20473/joints.v6i1.2017.40-47.
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Insiden osteoarthritis pada hip joint, osteoarthritis pada knee joint, dan degenerative lumbar spondylosis semakin meningkat seiring dengan bertambahnya populasi penduduk usia tua. Kasus Hip/Knee Spine syndrome sendiri cukup sering ditemukan. Namun literatur yang mengevaluasi kondisi klinis, khususnya keluhan low back pain pada pasien dengan hip/knee spine syndrome post total hip/knee replacement masih sangat terbatas Tujuan dari penelitian ini adalah untuk mengevaluasi efek dari total hip/knee replacement pada pasien dengan hip/knee spine syndrome, berkaitan dengan keluhan low back pain.Penelitian ini adalah observasional retrospektif. Penelitian ini menggunakan 5 orang pasien post total hip/knee replacement yang juga didapatkan keluhan low back pain. Pasien yang terpilih akan dievaluasi klinis dengan menggunakan kuesioner LBP VAS Score, Oswestry Disability Index, Hip Harris Score untuk pasien post total hip replacement, dan Oxford Knee Score untuk pasien post total knee replacement. Dilakukan pengamatan pre dan post operasi pada seluruh pasien. Data pasien didapatkan dari Rumah Sakit Orthopaedi dan Traumatologi Surabaya mulai bulan Juni-November 2015.Berdasarkan test paired samples, didapatkan hasil sig 0,001 (< 0,05) pada skor VAS dan sig 0,033 (<0,05) pada skor ODI. Maka dapat disimpulkan bahwa terdapat perbedaan yang signifikan antara skor VAS LBP dan skor ODI sebelum dan setelah terapi Hip/Knee Replacement pada pasien dengan Hip/Knee Spine Syndrome.
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Lao, Chunhuan, David Lees, Sandeep Patel, Douglas White, and Ross Lawrenson. "Geographical and ethnic differences of osteoarthritis-associated hip and knee replacement surgeries in New Zealand: a population-based cross-sectional study." BMJ Open 9, no. 9 (September 2019): e032993. http://dx.doi.org/10.1136/bmjopen-2019-032993.
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ObjectivesTo (1) explore the regional and ethnic differences in rates of publicly funded osteoarthritis-associated hip and knee replacement surgeries and (2) investigate the mortality after surgery.DesignPopulation-based, retrospective, cross-sectional study.SettingGeneral population in New Zealand.ParticipantsPatients with osteoarthritis who underwent publicly funded primary hip and knee replacement surgeries in 2005–2017. Patients aged 14–99 years were included.Primary and secondary outcome measuresAge-standardised rate, standardised mortality ratio (SMR) and 30 days, 90 days and 1 year mortality.ResultsWe identified 53 439 primary hip replacements and 50 072 primary knee replacements with a diagnosis of osteoarthritis. The number and age-standardised rates of hip and knee replacements increased over time. Māori had the highest age-standardised rate of hip replacements, followed by European/others and Pacific, and Asian had the lowest rate. Pacific had the highest age-standardised rate of knee replacements, followed by Māori and European/others, and Asian had the lowest rate. The Northern Health Network had the lowest rate of hip surgeries, and the Southern Health Network had the lowest rate of knee surgeries. The SMRs of patients undergoing hip and knee replacements were lower than the general population: 0.92 (95% CI 0.89 to 0.95) for hip and 0.79 (95% CI 0.76 to 0.82) for knee. The SMRs were decreasing over time. The patterns of 30 days, 90 days and 1 year mortality were similar to the SMR.ConclusionsThe numbers of publicly funded osteoarthritis-associated primary hip and knee replacements are steadily increasing. Māori people had the highest age-standardised rate of hip replacements and Pacific people had the highest rate of knee replacements. The Northern Health Network had the lowest rate of hip surgeries, and the Southern Health Network had the lowest rate of knee surgeries. Compared with the general population, patients who had hip and knee replacements have a better life expectancy.
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Burgess, Louise C., Paul Taylor, Thomas W. Wainwright, and Ian D. Swain. "Lab-based feasibility and acceptability of neuromuscular electrical stimulation in hip osteoarthritis rehabilitation." Journal of Rehabilitation and Assistive Technologies Engineering 8 (January 2021): 205566832098061. http://dx.doi.org/10.1177/2055668320980613.
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Introduction Neuromuscular electrical stimulation (NMES) could provide an alternative or adjunct treatment modality to induce muscle hypertrophy in the hip osteoarthritis population. This preliminary study evaluates the feasibility and acceptability of NMES to evoke involuntary muscle contractions in adults with advanced hip osteoarthritis. Methods Thirteen adults with moderate-to-severe hip osteoarthritis and fifteen healthy, older adults were invited to a lab-based testing session. NMES was applied unilaterally to the knee extensors and hip abductors for one continuous, five-minute testing session. Data were collected on device acceptability, tolerability and muscle contractile force, and compared between groups. Results Electrical stimulation of the knee extensors elicited a visible muscular contraction in 11 participants (85%) with hip osteoarthritis and 15 controls (100%) at an intensity acceptable to the participant. Electrical stimulation of the hip abductors elicited a muscular contraction in eight participants (62%) with osteoarthritis, and ten controls (67%). Muscle contractile force, pain, discomfort and acceptability did not differ between groups, however NMES of the knee extensors was favoured across all measures of assessment when compared to the hip abductors. Conclusions Electrical stimulation of the knee extensors may be a feasible and acceptable treatment modality to address muscle atrophy in adults with advanced hip osteoarthritis.
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Nakafero, Georgina, Matthew Grainge, Ana Valdes, Nick Townsend, Christian Mallen, Weiya Zhang, Michael Doherty, Mamas A. Mamas, and Abhishek Abhishek. "Do β-adrenoreceptor blocking drugs associate with reduced risk of symptomatic osteoarthritis and total joint replacement in the general population? A primary care-based, prospective cohort study using the Clinical Practice Research Datalink." BMJ Open 9, no. 8 (August 2019): e032050. http://dx.doi.org/10.1136/bmjopen-2019-032050.
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IntroductionTo investigate if β-adrenoreceptor blocking drug (β-blocker) prescription reduces the risk of knee or hip osteoarthritis, total joint replacement and analgesic prescription.SettingPrimary care.Methods and analysisThis is a cohort study using data from the Clinical Practice Research Datalink. Two separate analyses will be performed. Study 1 will be on the association between β-blocker prescription and incident knee/hip osteoarthritis. Inclusion criteria will be age ≥40 years. Exposed participants will be those with ≥2 continuous β-blocker prescriptions, and the index date will be the date of the first prescription of β-blocker. Unexposed participants will include up to four controls matched for age, sex, general practice surgery and propensity score for β-blocker prescription. Exclusion criteria will include contraindications to β-blockers, consultations for osteoarthritis or potent analgesic prescription before the index date. Outcomes will be knee osteoarthritis (primary outcome), hip osteoarthritis, knee pain and hip pain. Study 2 will be on the association between β-blocker prescription and total joint replacement and analgesic prescription in people with osteoarthritis. Inclusion criteria will be age ≥40 years, knee or hip osteoarthritis, and index date will be as in study 1. Unexposed participants will be as in study 1, additionally matched for consultation for knee or hip osteoarthritis prior to the index date. Exclusion criteria will include contraindications to β-blockers and osteoarthritis in other joints prior to the index date. Outcomes will be total knee replacement (primary outcome), total hip replacement and new analgesic prescription.Statistical analysisKaplan-Meier curves will be plotted, and Cox proportional HRs and 95% CIs will be calculated. Stratified analysis will be performed by class of β-blocker, intrinsic sympathomimetic effect and indication(s) for prescription.Ethics and disseminationThis study was ethically approved by the Independent Scientific Advisory Committee of the Medicines and Healthcare Authority (Ref 18_227R). The results of this study will be published in peer-reviewed journals and presented at conferences.SummaryThis prospective cohort study will evaluate the analgesic potential of commonly used drugs for osteoarthritis pain.
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Wood, Alexander MacDonald, Timothy M. Brock, Kieran Heil, Rachel Holmes, and Axel Weusten. "A Review on the Management of Hip and Knee Osteoarthritis." International Journal of Chronic Diseases 2013 (2013): 1–10. http://dx.doi.org/10.1155/2013/845015.
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Arthritis is the most common chronic condition affecting patients over the age of 70. The prevalence of osteoarthritis increases with age, and with an aging population, the effect of this disease will represent an ever-increasing burden on health care. The knee is the most common joint affected in osteoarthritis, with up to 41% of limb arthritis being located in the knee, compared to 30% in hands and 19% in hips. We review the current concepts with regard to the disease process and risk factors for developing hip and knee osteoarthritis. We then explore the nonsurgical management of osteoarthritis as well as the operative management of hip and knee arthritis. We discuss the indications for surgical treatment of hip and knee arthritis, looking in particular at the controversies affecting young and obese patients in both hip and knee replacements. Patient and implant related outcomes along with survivorships are addressed as well as the experiences and controversies described in national joint registries.
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Nüesch, Corina, Petros Ismailidis, David Koch, Geert Pagenstert, Thomas Ilchmann, Anke Eckardt, Karl Stoffel, Christian Egloff, and Annegret Mündermann. "Assessing Site Specificity of Osteoarthritic Gait Kinematics with Wearable Sensors and Their Association with Patient Reported Outcome Measures (PROMs): Knee versus Hip Osteoarthritis." Sensors 21, no. 16 (August 10, 2021): 5363. http://dx.doi.org/10.3390/s21165363.
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There is a great need for quantitative outcomes reflecting the functional status in patients with knee or hip osteoarthritis (OA) to advance the development and investigation of interventions for OA. The purpose of this study was to determine if gait kinematics specific to the disease—i.e., knee versus hip OA—can be identified using wearable sensors and statistical parametric mapping (SPM) and whether disease-related gait deviations are associated with patient reported outcome measures. 113 participants (N = 29 unilateral knee OA; N = 30 unilateral hip OA; N = 54 age-matched asymptomatic persons) completed gait analysis with wearable sensors and the Knee/Hip Osteoarthritis Outcome Score (KOOS/HOOS). Data were analyzed using SPM. Knee and hip kinematics differed between patients with knee OA and patients with hip OA (up to 14°, p < 0.001 for knee and 8°, p = 0.003 for hip kinematics), and differences from controls were more pronounced in the affected than unaffected leg of patients. The observed deviations in ankle, knee and hip kinematic trajectories from controls were associated with KOOS/HOOS in both groups. Capturing gait kinematics using wearables has a large potential for application as outcome in clinical trials and for monitoring treatment success in patients with knee or hip OA and in large cohorts representing a major advancement in research on musculoskeletal diseases.
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SAYRE, ERIC C., JOANNE M. JORDAN, JOLANDA CIBERE, LOUISE MURPHY, TODD A. SCHWARTZ, CHARLES G. HELMICK, JORDAN B. RENNER, et al. "Quantifying the Association of Radiographic Osteoarthritis in Knee or Hip Joints with Other Knees or Hips: The Johnston County Osteoarthritis Project." Journal of Rheumatology 37, no. 6 (April 15, 2010): 1260–65. http://dx.doi.org/10.3899/jrheum.091154.
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Objective.To quantify the association of radiographic osteoarthritis (ROA) in one knee or hip joint with other knee or hip joints.Methods.We analyzed baseline data from the Johnston County Osteoarthritis Project (n = 3068). We fit 4 models for left/right knee/hip. The Kellgren-Lawrence (KL) radiographic grade severity scale was KL 0/1 (no/questionable ROA), 2 (mild ROA), or 3/4 (moderate/severe ROA). We estimated associations between KL grade in contralateral joints and other joint sites (e.g., worst hip in knee models), adjusting for sex, race/ethnicity (African American/white), age, and measured body mass index, using cumulative odds logistic regression models. Interactions were investigated: race/ethnicity by sex; race/ethnicity and sex by the 2 explanatory variables.Results.Contralateral joint KL grade was strongly associated with KL grade, with OR ranging from 9.2 (95% CI 7.1, 11.9) to 225.0 (95% CI 83.6, 605.7). In the left knee model, the contralateral joint association was stronger among African Americans than whites, but for the other models the associations by race/ethnicity were identical. Models examining other joint sites showed weaker but mostly statistically significant associations (OR 1.4 to 1.8).Conclusion.We found a strong multivariable-adjusted association between KL grades in contralateral knees and hips, and a modest association with the other joint site (e.g., knees vs hips). These results suggest that diagnosis of ROA in 1 large joint may be a marker for risk of multijoint ROA, and warrant interventions to reduce the incidence or severity of ROA at these other joints.
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Yilmaz, Serdar, Deniz Cankaya, Alper Deveci, Mahmut Ozdemir, and Murat Bozkurt. "An Unexpected Complication of Hip Arthroplasty: Knee Dislocation." Case Reports in Orthopedics 2015 (2015): 1–4. http://dx.doi.org/10.1155/2015/294187.
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An increasing number of patients with hip fracture have been seen with osteoporosis associated with osteoarthritis. Although knee dislocation is related to high-energy trauma, low-grade injuries can also lead to knee dislocation which is defined as “ultra-low velocity dislocation.” The case reported here is of an 82-year-old patient who presented with a left intertrochanteric hip fracture. Partial arthroplasty was planned because of osteoporosis. In the course of surgery, degenerative arthritic knee was dislocated during the hip reduction maneuver with the application of long traction. The neurovascular examination was intact, but the knee was grossly unstable and was dislocated even in a brace; thus a hinged knee prosthesis was applied nine days after surgery. The patient was mobilized with crutches after the knee prosthesis but exercise tolerance was diminished. In conclusion, it should be emphasized that overtraction must be avoided during the hip reduction maneuver in patients with advanced osteoarthritic knee.
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Lao, C., D. Lees, D. White, and R. Lawrenson. "FRI0514 USE OF OPIATE FOR HIP AND KNEE OSTEOARTHRITIS BEFORE AND AFTER JOINT REPLACEMENT SURGERY." Annals of the Rheumatic Diseases 79, Suppl 1 (June 2020): 856.1–856. http://dx.doi.org/10.1136/annrheumdis-2020-eular.1359.
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Background:Osteoarthritis of the hip and knee is one of the most common causes of reduced mobility. It also causes stiffness and pain. Opioids can offer pain relief but is usually used for severe acute pain caused by major trauma or surgery. The use of opioids for relief of chronic pain caused by arthritis has increased over the last few decades.[1]Objectives:This study aims to investigate the use of strong opiates for patients with hip and knee osteoarthritis before and after joint replacement surgery, over a 13 years period in New Zealand.Methods:This study included patients with osteoarthritis who underwent publicly funded primary hip and knee replacement surgeries in 2005-2017 in New Zealand. These records were identified from the National Minimum Dataset (NMD). They were cross referenced with the NZJR data to exclude the admissions not for primary hip or knee replacement surgeries. Patients without a diagnosis of osteoarthritis were excluded.The PHARMS dataset was linked to the NMD to identify the use of strong opiates before and after surgeries. The strong opiates available for community dispensing in New Zealand and included in this study are: dihydrocodeine, fentanyl, methadone, morphine, oxycodone and pethidine. Use of opiate within three months prior to surgery and within 12 months post-surgery were examined by gender, age group, ethnicity, Charlson Comorbidity Index score and year of surgery. Differences by subgroup was examined with Chi- square test. Logistic regression model was used to calculate the adjusted odds ratios of strong opiate use before and after surgery compared with no opiate use.Results:We identified 53,439 primary hip replacements and 50,072 primary knee replacements with a diagnosis of osteoarthritis. Of patients with hip osteoarthritis, 6,251 (11.7%) had strong opiate before hip replacement surgeries and 11,939 (22.3%) had opiate after surgeries. Of patients with knee osteoarthritis, 2,922 (5.8%) had strong opiate before knee replacement surgeries and 15,252 (30.5%) had opiate after surgeries.The probability of patients with hip and knee osteoarthritis having opiate decreased with age, increased with Charlson comorbidity index score, and increased over time both before and after surgeries. Male patients with hip and knee osteoarthritis were less likely to have opiate than female patients both before and after surgeries. New Zealand Europeans with hip and knee osteoarthritis were more likely to receive opiate than other ethnic groups prior to surgeries, but were less likely to have opiate than Asians post-surgeries.Patients who had opiate before surgeries were more likely to have opiate after surgeries than those who did not have opiate before surgeries. The odds ratio was 8.34 (95% confidence interval (CI): 7.87-8.84) for hip osteoarthritis and 11.94 (95% CI: 10.84-13.16) for knee osteoarthritis after adjustment for age, gender, ethnicity, year of surgery and Charlson comorbidity index score. Having opiate prior to surgeries also increased the probability of having opiate for 6 weeks or more after surgeries substantially. The adjusted odds ratio was 21.46 (95% CI: 19.74-23.31) for hip osteoarthritis and 27.22 (95% CI: 24.95-29.68) for knee osteoarthritis.Conclusion:Preoperative opiate holidays should be encouraged. Multiple strategies need to be used to develop analgesic plans that allow adequate rehabilitation, without precipitating a chronic opiate dependence. Clinicians would also benefit from clear guidelines for prescribing strong opiates.References:[1] Nguyen, L.C., D.C. Sing, and K.J. Bozic,Preoperative Reduction of Opioid Use Before Total Joint Arthroplasty.J Arthroplasty, 2016.31(9 Suppl): p. 282-7.Disclosure of Interests:None declared
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Raghava Neelapala, Y. V., Madhura Bhagat, and Purvi Shah. "Hip Muscle Strengthening for Knee Osteoarthritis." Journal of Geriatric Physical Therapy 43, no. 2 (2020): 89–98. http://dx.doi.org/10.1519/jpt.0000000000000214.
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Zachwieja, Erik C., Jose Perez, and Michaela Schneiderbauer. "Hip and Knee Arthroplasty in Osteoarthritis." Current Treatment Options in Rheumatology 3, no. 2 (April 12, 2017): 75–87. http://dx.doi.org/10.1007/s40674-017-0063-1.
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Phillips, Raymond E. "Review of Hip and Knee Osteoarthritis." JAMA 325, no. 24 (June 22, 2021): 2504. http://dx.doi.org/10.1001/jama.2021.6018.
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Bastick, Alex N., Jurgen Damen, Rintje Agricola, Reinoud W. Brouwer, Patrick JE Bindels, and Sita MA Bierma-Zeinstra. "Characteristics associated with joint replacement in early symptomatic knee or hip osteoarthritis: 6-year results from a nationwide prospective cohort study (CHECK)." British Journal of General Practice 67, no. 663 (July 31, 2017): e724-e731. http://dx.doi.org/10.3399/bjgp17x692165.
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BackgroundMany patients with osteoarthritis (OA) of the knee and/or hip undergo total joint replacement (TJR) because of severely progressed symptoms.AimTo determine patient and disease characteristics associated with undergoing TJR in participants with recent-onset knee and/or hip OA.Design and settingParticipants with hip or knee pain from the nationwide prospective Cohort Hip and Cohort Knee (CHECK) study were included.MethodThe outcome measure was total hip arthroplasty (THA) or total knee arthroplasty (TKA) during 6 years of follow-up. Joint-dependent characteristics were compared using generalised estimating equations (GEE). Multivariable models were built for both subgroups. Differences in symptomatic and radiographic progression were determined between baseline and 2-year follow-up (T2).ResultsThe knee subgroup included 751 participants (1502 knees), and there were 538 participants in the hip subgroup (1076 hips). Nineteen participants (22 knees) underwent TKA and 53 participants (62 hips) THA. Participants who underwent TKA had higher baseline body mass index, painful knee flexion, and higher Kellgren and Lawrence scores. Participants who underwent THA had painful internal hip rotation and showed more severe radiographic OA features. Participants who underwent TKA or THA showed more rapid symptomatic and radiographic OA progression at T2.ConclusionIn patients with recent-onset knee or hip pain, radiographic OA features already exist and a substantial number of patients fulfil existing criteria for knee and hip OA. A trend was observed in rapid progression of radiographic and symptomatic OA severity among patients with TKA and THA. Early detection of OA by the GP is important in managing knee and hip OA.
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Rego, I., M. Fernández-Moreno, C. Fernández-López, J. J. Gómez-Reino, A. González, J. Arenas, and F. J. Blanco. "Role of European mitochondrial DNA haplogroups in the prevalence of hip osteoarthritis in Galicia, Northern Spain." Annals of the Rheumatic Diseases 69, no. 01 (February 17, 2009): 210–13. http://dx.doi.org/10.1136/ard.2008.105254.
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Objective:To analyse the mitochondrial DNA (mtDNA) haplogroups of patients with hip osteoarthritis (OA) and those of healthy controls in a Spanish population.Methods:mtDNA haplogroups were assigned to 550 cases of hip OA and 505 clinically asymptomatic controls. Sets of controls with healthy knees and hips (n = 179) and patients with knee and/or hip OA (n = 977) were also analysed in a multivariate analysis after adjusting for sex, age and smoking.Results:Individuals carrying haplogroup J showed a significantly decreased risk of developing hip OA (OR 0.661; 95% CI 0.440 to 0.993; p = 0.045). In addition to haplogroup J, smoking protected against the development of hip OA (OR 0.543; 95% CI 0.311 to 0.946; p = 0.031). However, no relationship was found between rheumatoid arthritis and mtDNA haplogroups.Conclusion:The results of this study support the hypothesis that the mtDNA haplogroups have a role in the complex osteoarthritic process.
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Ro, Du Hyun, Joonhee Lee, Jangyun Lee, Jae-Young Park, Hyuk-Soo Han, and Myung Chul Lee. "Effects of Knee Osteoarthritis on Hip and Ankle Gait Mechanics." Advances in Orthopedics 2019 (March 24, 2019): 1–6. http://dx.doi.org/10.1155/2019/9757369.
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Introduction. Knee osteoarthritis (OA) can affect the hip and ankle joints, as these three joints operate as a kinetic/kinematic chain while walking. Purpose. This study was performed to compare (1) hip and ankle joint gait mechanics between knee OA and control groups and (2) to investigate the effects of knee gait mechanics on the ipsilateral hip and ankle joint. Methods. The study group included 89 patients with end-stage knee OA and 42 age- and sex-matched controls without knee pain or OA. Kinetic and kinematic parameters were evaluated using a commercial optoelectric gait analysis system. Range of motion (ROM) during gait, coronal motion arc, and peak joint moment of hip, knee, and ankle joints were investigated. Results. Ankle varus moment was 50% higher in the OA group (p=0.005) and was associated with higher knee adduction moment (p<0.001). The ROM of the hip and ankle joints were significantly smaller in the OA group and were associated with limited ROM of the knee joint (both p<0.001). The coronal motion arc of the hip was smaller in the OA group and was also associated with limited motion arc of the knee (p<0.001). Conclusions. Knee OA has a negative effect on the ROM, coronal motion arc, and joint moment of the ankle joint and hip joint. As knee OA is associated with increased moment of the ankle joint, attention should be paid to the ankle joint when treating patients with knee OA.
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Dahaghin, S., S. M. A. Bierma-Zeinstra, M. Reijman, H. A. P. Pols, J. M. W. Hazes, and B. W. Koes. "Does hand osteoarthritis predict future hip or knee osteoarthritis?" Arthritis & Rheumatism 52, no. 11 (2005): 3520–27. http://dx.doi.org/10.1002/art.21375.
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Araujo-Castillo, Roger V., Carlos Culquichicón, and Risof Solis Condor. "Burden of disease due to hip, knee, and unspecified osteoarthritis in the Peruvian social health insurance system (EsSalud), 2016." F1000Research 9 (April 3, 2020): 238. http://dx.doi.org/10.12688/f1000research.22767.1.
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Introduction: Since its introduction by the World Health Organization (WHO), the concept of burden of disease has been evolving. The current method uses life expectancy projected to 2050 and does not consider age-weighting and time-discounting. Our aim is to estimate the burden of disease due to hip, knee, and unspecified osteoarthritis using this new method in the Peruvian Social Health Insurance System (EsSalud) during 2016. Methods: We followed the original 1994 WHO study and the current 2015 Global Burden of Disease (GBD) methods to estimate disability adjusted life years (DALY) due to osteoarthritis, categorized by sex, age, osteoarthritis type, and geographical area. We used disability weights employed by the Peruvian Ministry of Health, and the last update issued by WHO. Results: Overall, EsSalud reported 17.9 new cases of osteoarthritis per 1000 patients per year. Annual incidence was 23.7/1000 among women, and 72.6/1000 in people above 60 years old. Incidence was 5.6/1000 for knee osteoarthritis and 1.1/1000 for hip. According to the 1994 WHO method, there were 399,884 DALYs or 36.6 DALYs/1000 patients per year due to osteoarthritis. 12.4 and 2.2 DALYs/1000 patients per-year were estimated for knee and hip osteoarthritis, respectively. Using the 2015 GBD method, there were 1,037,865 DALYs or 94.9 DALYs/1000 patients per year. 31.4 and 5.3 DALYs/1000 patients per year were calculated for knee and hip osteoarthritis, respectively. Conclusions: In the Peruvian social health insurance subsystem, hip, knee, and unspecified osteoarthritis produced a high burden of disease, especially among women and patients over 60. The 2015 GBD methodology yields values almost three times higher than the original recommendations.
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Araujo-Castillo, Roger V., Carlos Culquichicón, and Risof Solis Condor. "Burden of disease due to hip, knee, and unspecified osteoarthritis in the Peruvian social health insurance system (EsSalud), 2016." F1000Research 9 (August 17, 2020): 238. http://dx.doi.org/10.12688/f1000research.22767.2.
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Introduction: Since its introduction by the World Health Organization (WHO), the concept of burden of disease has been evolving. The current method uses life expectancy projected to 2050 and does not consider age-weighting and time-discounting. Our aim is to estimate the burden of disease due to hip, knee, and unspecified osteoarthritis using this new method in the Peruvian Social Health Insurance System (EsSalud) during 2016. Methods: We followed the original 1994 WHO study and the current 2015 Global Burden of Disease (GBD) methods to estimate disability adjusted life years (DALY) due to osteoarthritis, categorized by sex, age, osteoarthritis type, and geographical area. We used disability weights employed by the Peruvian Ministry of Health, and the last update issued by WHO. Results: Overall, EsSalud reported 17.9 new cases of osteoarthritis per 1000 patients per year. Annual incidence was 23.7/1000 among women, and 72.6/1000 in people above 60 years old. Incidence was 5.6/1000 for knee osteoarthritis and 1.1/1000 for hip. According to the 1994 WHO method, there were 399,884 DALYs or 36.6 DALYs/1000 patients per year due to osteoarthritis. 12.4 and 2.2 DALYs/1000 patients per-year were estimated for knee and hip osteoarthritis, respectively. Using the 2015 GBD method, there were 1,037,865 DALYs or 94.9 DALYs/1000 patients per year. 31.4 and 5.3 DALYs/1000 patients per year were calculated for knee and hip osteoarthritis, respectively. Conclusions: In the Peruvian social health insurance subsystem, hip, knee, and unspecified osteoarthritis produced a high burden of disease, especially among women and patients over 60. The 2015 GBD methodology yields values almost three times higher than the original recommendations.
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Butler, Robert J., Joaquin A. Barrios, Todd Royer, and Irene S. Davis. "Effect of Laterally Wedged Foot Orthoses on Rearfoot and Hip Mechanics in Patients with Medial Knee Osteoarthritis." Prosthetics and Orthotics International 33, no. 2 (January 2009): 107–16. http://dx.doi.org/10.1080/03093640802613237.
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The purpose of this study was to examine the effects of laterally wedged foot orthotic devices, used to treat knee osteoarthritis, on frontal plane mechanics at the rearfoot and hip during walking. Thirty individuals with diagnosed medial knee osteoarthritis were recruited for this study. Three dimensional kinematics and kinetics were recorded as the subjects walked in the laboratory at an intentional walking speed. Peak eversion, eversion excursion and peak eversion moment were increased while the peak knee adduction moment was reduced in the laterally wedged orthotic condition compared to the no wedge condition. In contrast, no changes were observed in the variables of interest at the hip. There was no significant relationship between the change in the peak frontal plane moment at the rearfoot and change in the peak frontal plane moment at the knee or hip as a result of the lateral wedge. Laterally wedged foot orthotic devices, used to treat knee osteoarthritis, do not influence hip mechanics. However, they do result in increased rearfoot eversion and inversion moment. Therefore, a full medical screen of the foot should occur before laterally wedged foot orthotic devices are prescribed as a treatment for knee osteoarthritis.
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Wallace, David, and Christa Barr. "The Effect of Hip Bracing on Gait in Patients with Medial Knee Osteoarthritis." Arthritis 2012 (July 25, 2012): 1–7. http://dx.doi.org/10.1155/2012/240376.
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Objective. Impaired hip motion has been associated with heightened medial knee joint loading in patients with knee osteoarthritis (OA). A hip external rotation strap designed to pull the femur into external rotation and abduction may serve as one protective mechanism. The primary aim of our study is to determine if the strap decreases medial knee joint loading during level walking in people with knee OA. Design. This study is a single-day repeated measures design. Methods. 15 volunteers with medial knee OA underwent motion analysis data collection during two randomly assigned walking conditions: (1) wearing the strap and (2) control (no strap). Primary outcome measures were peak pelvis, hip and knee joint motions, and torques. These outcomes were averaged across five trials for each condition. Results. Hip abduction (), trunk lean towards the stance limb () and pelvic tilt () significantly increased with the strap versus control trials. Knee adduction loading did not significantly change with the strap (). Conclusion. The use of the hip external rotation strap resulted in angular changes at the hip and pelvis which may be beneficial for patients with medial knee osteoarthritis.
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Mezghani, Neila, Delphine Billard, Youssef Ouakrim, Alexandre Fuentes, Nicola Hagemeister, and Jacques A. de Guise. "Biomechanical analysis to characterize the impact of knee osteoarthritis on hip, knee, and ankle kinematics." Journal of Biomedical Engineering and Informatics 3, no. 2 (May 9, 2017): 36. http://dx.doi.org/10.5430/jbei.v3n2p36.
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Background: Numerous studies use a biomechanical assessment to evaluate joint function in knee pathologies such as osteoarthritis. However, most of them focus only on the knee and the consequences of the pathology on other lower limb joints are poorly documented. The objective of this study is to analyze the impact of knee osteoarthritis on ipsilateral hip and ankle joint during gait.Methods: Three-dimension (3D) angular kinematic patterns of the three joints were analyzed on 32 patients diagnosed with knee osteoarthritis (OA) and a control group of 15 asymptomatic subjects (AS). Kinematic data was captured during treadmill gait trials at a self-selected comfortable speed. Analysis of covariance (ANCOVA) was performed on selected points of interest from 3D kinematic patterns of the hip, knee and ankle joints to compare both groups. The significance level was set at p = .05.Results: Gait 3D kinematic gait patterns of OA patients revealed significant differences with those of AS subjects at the three joints.Conclusions: Results suggest that patients with knee osteoarthritis also present alterations in hip and ankle kinematic during gait that should be considered when tailoring conservative treatments.
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Jandric, Slavica. "Differences in quality of life between patients with severe hip and knee osteoarthritis." Vojnosanitetski pregled 75, no. 1 (2018): 62–67. http://dx.doi.org/10.2298/vsp150502317j.
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Background/Aim. Osteoarthritis (OA) is the clinical manifestation of degenerative joint changes. The aim of this study was to investigate differences in quality of life (QoL) between patients with severe hip and knee OA. Methods. This is the cross-sectional study of 195 patients (average age 63.2 ? 11.1 yrs), with a diagnosis of OA of the hip and knee that were assigned to receive a total hip or knee replacement. The patients were divided into three groups in relation to localization of OA. The first group included patients with hip OA; the second group consisted of patients with knee OA and the third group with both hip and knee OA. Demographic and clinical data were collected for each patient. We measured health related quality of life (QoL) by Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) questionnaires. Statistical significance of differences was at the level of p < 0.05. Results. The best QoL was in the group of knee OA (42.7 ? 11.3) and the worst in the group with both hip and knee OA patients (35.8 ? 12.7). QoL assessed by WOMAC score and the domain of physical function were significantly different among three groups of patients with OA (F = 5.377, p < 0.01 and F = 5.273, p < 0.01) respectively). Results of three multiple linear regression models where WOMAC score was dependent variable and age, body mass index (BMI), social class, pain, stiffness, physical function, hypertension, cardiomyopathy, diabetes mellitus were independent variables, have shown that QoL was statistically significantly associated with pain and physical function in the hip and knee OA groups, whereas in the group with both hip and knee OA patients, QoL was associated with BMI, pain, physical function and diabetes mellitus. Conclusion. QoL of patients with severe hip and knee osteoarthritis in relation to localization was significantly different. QoL in severe hip and knee OA patients was significantly associated with pain and physical function, but in patients with both hip and knee OA QoL was also associated with BMI and diabetes mellitus.
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Yilmaz Tasdelen, Ozlem, Ali Utkan, Kubilay Ugurcan Ceritoglu, Funda Seher Ozalp Ates, and Hatice Bodur. "Responsiveness of the Turkish KOOS-PS and HOOS-PS in knee and hip joint arthroplasty patients." Journal of Back and Musculoskeletal Rehabilitation 33, no. 6 (November 11, 2020): 977–81. http://dx.doi.org/10.3233/bmr-181420.
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BACKGROUND: Adaptation to Turkish language and validation studies of Knee Injury and Osteoarthritis Outcome Score – Physical Function Short Form (KOOS-PS) and Hip Disability and Osteoarthritis Outcome Score – Physical Function Short Form (HOOS-PS) were done previously but responsiveness to changes of these questionnaires could not be tested in these studies. OBJECTIVE: The aim of this study was to assess the responsiveness of the Turkish versions of the KOOS-PS and HOOS-PS in a patient group who underwent knee or hip joint arthroplasty operation. METHODS: Sixty-three patients who underwent total knee arthroplasties and sixteen patients who underwent total hip arthroplasties for primary osteoarthritis were included in this study. The preoperative and 3-month postoperative KOOS-PS, HOOS-PS, and Western Ontario and McMaster Universities (WOMAC) Osteoarthritis Index hip and knee scores were collected from the hospital records, and the effect sizes (ESs) and standardized response means (SRMs) were calculated. RESULTS: The ESs and SRMs, respectively, were as follows: -1.954 and -2.156 for the KOOS-PS, -1.833 and -2.464 for the HOOS-PS, -4.848 and -4.210 for the WOMAC-knee, and -3.835 and -4.625 for the WOMAC-hip. CONCLUSIONS: The Turkish versions of the KOOS-PS and HOOS-PS exhibited strong responsiveness to change in the arthroplasty patients.
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Kontio, Tea, Markku Heliövaara, Eira Viikari-Juntura, and Svetlana Solovieva. "To what extent is severe osteoarthritis preventable? Occupational and non-occupational risk factors for knee and hip osteoarthritis." Rheumatology 59, no. 12 (June 13, 2020): 3869–77. http://dx.doi.org/10.1093/rheumatology/keaa238.
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Abstract Objectives To explore the relative contribution of cumulative physical workload, sociodemographic and lifestyle factors, as well as prior injury to hospitalization due to knee and hip OA. Methods We examined a nationally representative sample of persons aged 30–59 years, who participated in a comprehensive health examination (the Health 2000 Study). A total of 4642 participants were followed from mid-2000 to end-2015 for the first hospitalization due to knee or hip OA using the National Hospital Discharge Register. We examined the association of possible risk factors with the outcome using a competing risk regression model (death was treated as competing risk) and calculated population attributable fractions for statistically significant risk factors. Results Baseline age and BMI as well as injury were associated with the risk of first hospitalization due to knee and hip OA. Composite cumulative workload was associated with a dose–response pattern with hospitalizations due to knee OA and with hospitalizations due to hip OA at a younger age only. Altogether, prior injury, high BMI and intermediate to high composite cumulative workload accounted for 70% of hospitalizations due to knee OA. High BMI alone accounted for 61% and prior injury only for 6% of hospitalizations due to hip OA. Conclusion Our results suggest that overweight/obesity, prior injury and cumulative physical workload are the most important modifiable risk factors that need to be targeted in the prevention of knee OA leading to hospitalization. A substantial proportion of hospitalizations due to hip OA can be reduced by controlling excess body weight.
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Alageel, Musab, Abdullah Al Turki, Ali Alhandi, Rawa Alohali, Rakan Alsalem, and Sami Aleissa. "Cross-Cultural Adaptation and Validation of the Arabic Version of the Intermittent and Constant Osteoarthritis Pain Questionnaire." Sports Medicine International Open 4, no. 01 (February 17, 2020): E8—E12. http://dx.doi.org/10.1055/a-1031-0947.
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AbstractThis study aimed to translate and adapt the Intermittent and Constant Osteoarthritis Pain questionnaire into the Arabic language and evaluate the validity and reliability of this scale for participants with knee or hip osteoarthritis. This questionnaire was translated based on the Manufacturers Alliance for Productivity and Innovation protocol. The test-retest reliability was calculated using the Intraclass Correlation Coefficient. Then, Cronbach’s alpha was used to assess the internal consistency of Intermittent and Constant Osteoarthritis Pain questionnaire. After that, the criterion validity was evaluated against the Knee injury and Osteoarthritis Outcome Score. A total of 90 participants were included in this study, of which 29 participants were re-evaluated for reliability testing. The Intraclass Correlation Coefficient of the Knee Intermittent and Constant Osteoarthritis Pain questionnaire were 0.841, 0.923 and 0.911 for the total, constant, and intermittent knee pain, respectively. Cronbach’s alpha was 0.88, 0.93 and 0.94 for the total score, the intermittent knee pain and the constant knee pain, respectively. Eventually, criterion validity was r=0.24(P<0.05). Intermittent and Constant Osteoarthritis Pain in Arabic is a valid and reliable instrument to be used in Arabic-speaking patients with knee/hip osteoarthritis.
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Lee, J., Y. Eun, I. Y. Kim, S. Y. Kang, S. Lee, H. S. Cha, E. M. Koh, and H. Kim. "FRI0540 DIFFERENT ASSOCIATION BETWEEN BONE MINERAL DENSITY AND OSTEOARTHRITIS ACCORDING TO THE SITE OF OSTEOARTHRITIS." Annals of the Rheumatic Diseases 79, Suppl 1 (June 2020): 871.1–871. http://dx.doi.org/10.1136/annrheumdis-2020-eular.5170.
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Background:Osteoarthritis (OA) and osteoporosis (OP) are both high prevalence at old age, and there are various reports on the association between the two diseases. Some studies have shown that high bone mineral density (BMD) is a risk factor for OA incidence, while others have mentioned the possibility of OP contributing to onset of hip OA. Recent study described that higher BMD reduce the risk of hip OA and raise the risk of knee OA. So, the relationship between BMD and OA or the effects of BMD on different OA site are not clear yet.Objectives:In this study, we investigated the association between BMD and radiographic OA using representative sample data of Korean adults.Methods:The study included 6345 subjects aged 50 years or older who underwent BMD measurements using dual-energy X-ray absorptiometry and X-rays of at least one site of the spine, hip, and knee in the Korean National Health and Nutrition Examination Survey conducted in 2010-2011. OA was defined according to radiographic finding (KL grade ≥ 2). Weighted multivariable logistic regression was used to analyze the association between BMD and OA. Since gender differences are evident, men and women were analyzed separately.Results:Spine OA was about 60% in both men and women, and hip OA was about 35% in men but only 1% in women. Knee OA was 76% in women and 58% in men. In men, the risk of OA increased 1.24 times as BMD increased by 1 g/cm2. By site, knee and spine OA were statistically significant in relation to BMD, but hip OA was not statistically significant. In women, the association between BMD and knee and hip OA was insignificant. In spine OA, the risk of OA increased 1.2 times when BMD increased by 1 g/cm2.Conclusion:In conclusion, high BMD increased the risk of knee and spine OA in men, but did not affect hip OA. In women, high BMD increased the risk of spine OA. Differences in the mechanism of OA development by site are thought to be possible explanations for the differences in the association between BMD and OA.Disclosure of Interests:None declared
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Purcell, Sarah, Robert Thornberry, Sarah A. Elliott, Lynn Panton, Michael J. Ormsbee, Edgar R. Vieira, Jeong-Su Kim, and Carla M. Prado. "Body Composition, Strength, and Dietary Intake of Patients with Hip or Knee Osteoarthritis." Canadian Journal of Dietetic Practice and Research 77, no. 2 (June 2016): 98–102. http://dx.doi.org/10.3148/cjdpr-2015-037.
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Purpose: To describe body composition (fat mass (FM) and fat-free mass (FFM)), strength, and nutritional characteristics of patients with hip or knee osteoarthritis undergoing total joint arthroplasty. Methods: In this prospective pilot study, osteoarthritic patients underwent body composition assessment using bioelectrical impedance analysis, grip strength measurement, and completed a 24-h dietary recall during their pre-operative assessment. Results: Fifty-five patients were included (∼66% females, age 43–89 years). Mean ± SD body mass index (BMI) was 32.79 ± 6.48 kg/m2 and 62% were obese. Compared with hip osteoarthritis patients, knee osteoarthritis patients had a higher BMI (P = 0.018) and males with knee osteoarthritis had a lower grip strength (P = 0.028). There was a wide range in FM and FFM values across the BMI spectrum. Patients with a higher FM index (FMI, FM/height in m2) had higher levels of pain (P = 0.036) and females with higher FMI had a lower grip strength (P = 0.048). Dietary under-reporting was common and many patients did not meet recommendations for protein, vitamins C and E, or omega-3 fatty acids. Those who consumed less protein than the recommended dietary allowance were older (P = 0.018). Conclusions: A wide variability of body composition and dietary intake was observed which may impact strength and ultimately affect physical function. As such, patients with osteoarthritis may benefit from targeted nutrition and physical activity interventions before and after surgery.
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Bestwick-Stevenson, Thomas, Onosi S. Ifesemen, Richard G. Pearson, and Kimberley L. Edwards. "Association of Sports Participation With Osteoarthritis: A Systematic Review and Meta-Analysis." Orthopaedic Journal of Sports Medicine 9, no. 6 (June 1, 2021): 232596712110045. http://dx.doi.org/10.1177/23259671211004554.
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Background: The association between participating in sport and osteoarthritis is not fully understood. Purpose: To investigate the association between osteoarthritis and participating in sports not listed in previous reviews: American football, archery, baseball, bobsleigh, curling, handball, ice hockey, shooting, skeleton, speed skating, and wrestling. Study Design: Systematic review; Level of evidence, 3. Methods: We searched 4 electronic databases and hand searched recent/in-press editions of relevant journals. The criteria for study selection were case-control studies, cohort studies, nested case-control studies, and randomized trials with a control group that included adults to examine the effect of exposure to any of the included sports on the development of osteoarthritis. Results: The search returned 6197 articles after deduplication. Nine studies were included in the final review, covering hip, knee, and ankle osteoarthritis. There were no studies covering archery, baseball, skeleton, speed skating, or curling. The 6 sports included in the review were analyzed as a collective; the results of the meta-analysis indicated that participation in the sports analyzed was associated with an increased risk of developing osteoarthritis of the hip (relative risk [RR] = 1.67 [95% confidence interval (CI), 1.15-2.41]; P = .04), knee (RR = 1.60 [95% CI, 1.23-2.08]; P < .001), and ankle (RR = 7.08 [95% CI, 1.24-40.51]; P = .03) as compared with controls. Meta-analysis suggested a significantly increased likelihood of developing hip osteoarthritis through participating in wrestling (RR = 1.78 [95% CI, 1.20-2.64]; P = .004) and ice hockey (RR = 1.70 [95% CI, 1.27-2.29]; P < .001), while there was no significant difference through participating in handball (RR = 2.50 [95% CI, 0.85-7.36]; P = .10). Likelihood of developing knee osteoarthritis was significantly increased in wrestling (RR = 2.22 [95% CI, 1.59-3.11]) and ice hockey (RR = 1.52 [95% CI, 1.18-1.96]; both P < .002). According to the meta-analysis, shooting did not have a significant effect on the RR of knee osteoarthritis as compared with other sports (RR = 0.43 [95% CI, 0.06-2.99]; P = .39). Conclusion: The likelihood of developing hip and knee osteoarthritis was increased for ice hockey and wrestling athletes, and the risk of developing hip osteoarthritis was increased for handball athletes. The study also found that participation in the sports examined, as a collective, resulted in an increased risk of developing hip, knee, and ankle osteoarthritis.
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Magalhães, Claudio Marcos Bedran de, and Renata Noce Kirkwood. "Strategies to reduce joint load in the medial compartment of the knee during gait in individuals with osteoarthritis: a review of the literature." Fisioterapia em Movimento 29, no. 4 (December 2016): 831–42. http://dx.doi.org/10.1590/1980-5918.029.004.ao20.
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Abstract Introduction: Increased joint load on the medial compartment of the knee during gait is a mechanical factor responsible for pain and progression of medial knee osteoarthritis. The knee external adductor moment of force is a kinetic parameter that correlates with the joint load in the medial compartment. Objective: The aim of this study was to conduct a narrative review of the biomechanics strategies during gait of individuals with medial knee osteoarthritis that reduce external adductor moment of force of the knee. Methods: The review of the literature was conducted in the databases MEDLINE, PUBMED and PEDro and included articles published between 2000 and 2011. It was selected transversal, theoretical, correlational and longitudinal studies as well as controlled clinical trials. Results: Decreased gait velocity, increased external rotation of the foot, increased internal abductor moment force of the hip and lateral trunk inclination to the side of the support limb are compensatory strategies used to reduce the external adductor moment of force of the knee during gait of individuals with medial knee osteoarthritis. The lateral trunk inclination may be beneficial in a short term, however it decreases the activity of the abductors muscles of the hip during the support phase of the gait favoring compensation that could result in the progression of medial knee osteoarthritis. Conclusion: Strengthening of the abductors muscles of the hip reduces pain, improves the function and prevents compensations that in a long term could possibly accelerate the progression of the medial knee osteoarthritis.
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Bennell, K. "Exercise rehabilitation for hip and knee osteoarthritis." Journal of Science and Medicine in Sport 16 (December 2013): e39. http://dx.doi.org/10.1016/j.jsams.2013.10.093.
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Valdes, Ana M., and Tim D. Spector. "Genetic epidemiology of hip and knee osteoarthritis." Nature Reviews Rheumatology 7, no. 1 (November 16, 2010): 23–32. http://dx.doi.org/10.1038/nrrheum.2010.191.
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Ravaud, Philippe, Xavier Ayral, and Maxime Dougados. "Radiologic progression of hip and knee osteoarthritis." Osteoarthritis and Cartilage 7, no. 2 (March 1999): 222–29. http://dx.doi.org/10.1053/joca.1998.0155.
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Hinman, Rana. "Physiotherapy management of hip and knee osteoarthritis." Seminars in Arthritis and Rheumatism 41, no. 1 (August 2011): 93. http://dx.doi.org/10.1016/j.semarthrit.2011.06.017.
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Katz, Jeffrey N., Kaetlyn Arant, and Richard F. Loeser. "Review of Hip and Knee Osteoarthritis—Reply." JAMA 325, no. 24 (June 22, 2021): 2505. http://dx.doi.org/10.1001/jama.2021.6024.
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Singh, Jasvinder A., Ruili Luo, Glenn C. Landon, and Maria Suarez-Almazor. "Reliability and Clinically Important Improvement Thresholds for Osteoarthritis Pain and Function Scales: A Multicenter Study." Journal of Rheumatology 41, no. 3 (January 15, 2014): 509–15. http://dx.doi.org/10.3899/jrheum.130609.
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Objective.To assess the reliability and clinically meaningful thresholds of intermittent and constant osteoarthritis pain (ICOAP) score, the Knee injury and Osteoarthritis Outcome Score Physical function Short-form (KOOS-PS), the Hip disability and Osteoarthritis Outcome Score Physical function Short-form (HOOS-PS), and the Quality of life subscales of HOOS/KOOS (HOOS-QOL/KOOS-QOL) in patients with knee or hip arthritis.Methods.One hundred and ninety-five patients (141 knee, 54 hip) seen at 2 orthopedic outpatient clinics with a diagnosis of knee or hip OA completed patient-reported questionnaires (ICOAP pain scale, KOOS-PS, HOOS-PS, KOOS-QOL, HOOS-QOL) at baseline and 2-week followup. Reliability was assessed using intraclass correlation coefficients (ICC). We calculated minimum clinically important difference (MCID) and moderate improvement in the subgroup that reported change in the status of their affected joint.Results.The reliability as assessed by ICC was as follows: ICOAP pain scale, 0.63 (0.48, 0.74) in patients with knee arthritis, and 0.86 (0.73, 0.93) for hip arthritis; KOOS-PS, 0.66 (0.52, 0.77); HOOS-PS, 0.82 (0.66, 0.91); KOOS-QOL, 0.79 (0.69, 0.86); and HOOS-QOL, 0.67 (0.42, 0.83). MCID and moderate improvement estimates in patients with knee arthritis were ICOAP pain scale, 18.5 and 26.7; KOOS-PS, 2.2 and 15.0; and KOOS-QOL, 8.0 and 15.6. A smaller sample in patients with hip arthritis precluded MCID and moderate improvement estimates.Conclusion.We found that ICOAP pain and KOOS-PS/HOOS-PS scales were reasonably reliable in patients with hip OA. Reliability of these scales was much lower in patients with knee arthritis. Thresholds for clinically meaningful change in pain or function on these scales were estimated for patients with knee arthritis.
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Grieshaber-Bouyer, Kämmerer, Rosshirt, Nees, Koniezke, Tripel, Schiltenwolf, Kirsch, Hagmann, and Moradi. "Divergent Mononuclear Cell Participation and Cytokine Release Profiles Define Hip andKnee Osteoarthritis." Journal of Clinical Medicine 8, no. 10 (October 5, 2019): 1631. http://dx.doi.org/10.3390/jcm8101631.
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Osteoarthritis (OA) is a progressive joint disease driven by a blend of inflammatory and biomechanical processes. Studies using human samples to understand inflammatory mechanisms in OA frequently recruit OA patients with different affected joints, even though recent evidence indicates that OA is a heterogeneous disease which only culminates in a common end point. Differences in age of onset and the dynamics of disease progression suggest that different joints may represent different disease entities, thereby diluting the discovery potential in a combined analysis. We hypothesized that different OA joints may also differ in immunopathology within the synovium. To investigate this hypothesis, we profiled the immune cell contribution (flow cytometry) and cytokine release profiles (ELISA) in purified synovial membrane mononuclear cells from 50 patients undergoing either hip (n = 34) or knee (n = 16) replacement surgery. Unsupervised computational approaches were used for disease deconstruction. We found that hip and knee osteoarthritis are not identical in respect to the inflammatory processes that take place in the synovial membrane. Instead, we report that principally CD14+ macrophages are expanded fourfold in the synovial membrane of patients with knee OA compared to hip OA, with a trend to higher expression in CD8+ T cells, while CD4+ T cells, B cells, and NK cells were found at comparable quantities. Upon isolation and culture of cells from synovial membrane, isolates from hip OA released higher concentrations of Eotaxin (CCL11), G-CSF, GM-CSF, INF-γ, IP-10 (CXCL10), TNF-α, MIP-1α (CCL3), MIP-1β (CCL4), IL-4, IL-10, IL-17, and lower concentrations of stem cell factor (SCF), thereby highlighting the difference in the nature of hip and knee osteoarthritis. Taken together, this study establishes hip and knee OA as immunologically distinct types of OA, and creates a resource of the cytokine expression landscape and mononuclear cell infiltration pattern of patients with hip and knee osteoarthritis.