P129 Adolescent knee pain and risk of knee osteoarthritis 50 years later

Abstract Background Adolescent knee pain is a common complaint which may be due to patellar dislocation, meniscal tear, Osgood-Schlatter’s disease or patellofemoral maltracking. We studied the association of such pain with knee osteoarthritis (OA) 50 years later using a retrospective cohort design. Methods This study was based in the Hertfordshire Cohort Study, a cohort of men and women born in 1931 - 9. Participants completed a questionnaire detailing recall of adolescent knee pain, self-reported OA, demographics, lifestyle and The Western Ontario and McMaster Universities Arthritis Index (WOMAC). Clinical OA was defined based on the American College of Rheumatology (ACR) criteria and assessed at a clinical visit where knee radiographs were also taken and graded according to the methods of Kellgren and Lawrence. Results Completed data were available for 135 men and 139 women. The mean age was 78.8 (SD 2.6) years and the mean (SD) BMI was 26.3 (4.0). Two percent of men (n = 3) and 5% of women (n = 7) reported adolescent knee pain, of which 2 men and 3 women sought medical advice for their knee pain. 1 man and 2 women reported that their pain had been constant since teenage years while 2 men and 4 women reported that it was intermittent in nature. A report of adolescent knee pain was associated with an increased risk of clinical (odds ratio (OR) 5.45, p-value 0.015, 95% confidence interval (CI) 1.39 - 21.36); radiological (OR 2.33, p-value 0.228, 95% CI 0.60 - 9.24) and self-report (OR 2.71, p-value 0.134, 95% CI 0.74 - 10.0) of knee OA in later life. After adjustments for age, sex and BMI, adolescent knee pain was associated with an increased risk of clinical (OR 4.80, p-value 0.047, 95% CI 1.02 - 22.53); radiological (OR 1.85, p-value 0.404, 95% CI 0.44 - 7.78); self-report (OR 3.23, p-value 0.10, 95% CI 0.80 - 12.94) although relationships were only significant for clinical knee OA. Conclusion Recalled adolescent knee pain was associated with a clinical diagnosis of knee OA in later life. The lack of association with self-report of OA suggests that this is not simply a consequence of recall bias and exploration in other data sets is now indicated. Disclosures M.A. Clynes: None. F. Laskou: None. M.H. Edwards: None. C. Cooper: None. A. Taylor: None. M. Stokes: None. E.M. Dennison: None.

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Evolution of pain at 3 months by oral resveratrol in knee osteoarthritis (ARTHROL): protocol for a multicentre randomised double-blind placebo-controlled trial

BMJ Open ◽

10.1136/bmjopen-2017-017652 ◽

2017 ◽

Vol 7 (9) ◽

pp. e017652 ◽

Cited By ~ 4

Author(s):

Christelle Nguyen ◽

Isabelle Boutron ◽

Gabriel Baron ◽

Emmanuel Coudeyre ◽

Francis Berenbaum ◽

...

Keyword(s):

Knee Osteoarthritis ◽

Knee Pain ◽

Rating Scale ◽

Controlled Trial ◽

Tertiary Care ◽

Double Blind ◽

Double Blind Placebo ◽

Knee Oa ◽

The Mean ◽

Anti Inflammatory

IntroductionOsteoarthritis (OA) pathophysiology is driven in part by joint inflammation. Resveratrol has in vitro anti-inflammatory properties. We aim to assess the efficacy of oral resveratrol for knee pain at 3 months in people with knee OA.Methods and analysisWe will conduct a randomised double-blind placebo-controlled trial. Overall, 164 individuals with knee OA fulfilling 1986 American College of Rheumatology criteria will be recruited in three tertiary care centres in France and randomised to receive oral resveratrol, 40 mg (two caplets) two times per day for 1 week, then 20 mg (one caplet) two times per day or a matching placebo for a total of 6 months. Randomisation will be centralised and stratified by centre. The allocation ratio of assignments will be 1:1. The primary outcome will be the mean change from baseline in knee pain on a self-administered 11-point pain Numeric Rating Scale at 3 months. Secondary outcomes will be the mean change in knee pain at 6 months, the function subscore of the Western Ontario and McMaster Universities Arthritis Index score, patient global assessment, proportion of responders according to the Osteoarthritis Research Society International–Outcome Measures in Rheumatology criteria at 3 and 6 months, and self-reported number of intra-articular injections of corticosteroids or hyaluronic acid and consumption of analgesics and non-steroidal anti-inflammatory drugs since the last contact. Other interventions will be allowed and self-reported. Adherence will be monitored by capsule counts and a booklet and adverse events recorded at 3 and 6 months. Statisticians, treating physicians and participants will be blinded to the allocated treatment.Ethics and disseminationThe oral resveratrol in knee osteoarthritis (ARTHROL) trial has been authorised by theAgenceNationale de Sécurité du Médicament et des Produits de Santéand ethics were approved by theComité deProtection des Personnes Île-de-FranceIII. The findings of the study will be published in a peer-reviewed journal and disseminated at conferences. The design of ARTHROL will warrant the translation of its findings into clinical practice.Trial registration numberClinicalTrials.gov identifier:NCT02905799. Pre-results. First received: 14 September 2016. Last updated: 16 September 2016. Status: not yet recruiting.

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The Effect of Patellar height by using Insall Salvati Index on Pain, Function, Muscle Strength and Postural Stability in Patients with Primary Knee Osteoarthritis

Current Medical Imaging Formerly Current Medical Imaging Reviews ◽

10.2174/1573405616999200817172649 ◽

2020 ◽

Vol 16 ◽

Author(s):

Pinar Doruk Analan ◽

Hulya Ozdemir

Keyword(s):

Muscle Strength ◽

Knee Osteoarthritis ◽

Physical Function ◽

Fall Risk ◽

Postural Stability ◽

Patellar Height ◽

Knee Oa ◽

American College Of Rheumatology ◽

Isokinetic Muscle Strength ◽

The Mean

Purpose: The Insall-Salvati Index (ISI) is the ratio of the patellar tendon length to the length of the patella. This ratio is the most commonly used method for evaluating patellar placement and patellofemoral imbalance. The position of the patella is important for the knee joint function and also biomechanics. The abnormal position of the patella may lead to patellofemoral malalignment and instability. Herein, we aimed to analyze the relationship between the ISI and pain, physical function, muscle strength, fall risk and postural stability in patients with primary knee osteoarthritis (OA). Methods: 62 sympthomatic knees of 45 patients (aged between 40 -75 years) who were suffering from the primary knee OA according to the American College of Rheumatology criteria were included retrospectively in the study. Patients with stages II and III osteoarthritis according to the Kellgren-Lawrence (K/L) radiological grading system were included. The ISI was measured on the lateral knee radiograph in a 30° flexed posture. Visual Analogue scale (VAS), Western Ontario and McMaster Universities Osteoarthritis (WOMAC) and Lequesne indexes were recorded for evaluating pain and function. Tetrax Interactive Balance System was used to assess fall risk and postural stability. Isokinetic muscle strength measurements of quadriceps and hamstrings were recorded at the constant angular velocities of 60 and 180°/sec. Results: The mean age of the study population was 58.52 ±8.01 years. Th The frequency of the patellar situation types were as follows; patella alta; 15 (24.2%), patella baja; n=2(3.2%), normal patellar height; n=45(72.6%). The mean ISI was found 1.19 ±0.17 on the right side and 1.18±0.16 on the left side. There was not any significant correlation between the ISI and VAS, WOMAC and Lequesne indexes, postural stability scores and isokinetic measurements (r<0.3, p>0.05). Conclusions: In primary knee OA, the ISI may not have an effect on pain, physical function, fall risk, postural stability, and isokinetic muscle strength.

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Lifetime socioeconomic circumstances and chronic pain in later adulthood: findings from a British birth cohort study

BMJ Open ◽

10.1136/bmjopen-2018-024250 ◽

2019 ◽

Vol 9 (3) ◽

pp. e024250 ◽

Cited By ~ 3

Author(s):

Matthew A Jay ◽

Rebecca Bendayan ◽

Rachel Cooper ◽

Stella G Muthuri

Keyword(s):

Birth Cohort ◽

Later Life ◽

Financial Hardship ◽

Self Report ◽

Relative Risk Ratio ◽

Birth Cohort Study ◽

Adjusted Relative Risk ◽

Occupational Class ◽

American College Of Rheumatology ◽

Increased Risk

ObjectivesTo investigate associations between a range of different indicators of socioeconomic position (SEP: occupational class, education, household overcrowding and tenure, and experience of financial hardship) across life and chronic widespread and regional pain (CWP and CRP) at age 68.DesignProspective birth cohort; the Medical Research Council National Survey of Health and Development.SettingEngland, Scotland and Wales.ParticipantsUp to 2378 men and women who have been followed-up since birth in 1946 to age 68.Primary outcome measuresOn the basis of their self-report of pain at age 68, participants were classified as: CWP (American College of Rheumatology criteria), CRP (pain of at least 3 months’ duration but that does not meet the definition of CWP), other pain (<3 months in duration) or no pain.ResultsAt age 68, the prevalence of CWP was 13.3% and 7.8% in women and men, respectively, and that of CRP was 32.3% and 28.7% in women and men, respectively. There was no clear evidence that indicators of SEP in childhood or later adulthood were associated with pain. Having experienced (vs not) financial hardship and being a tenant (vs owner-occupier) in earlier adulthood were both associated with an increased risk of CWP; for example, moderate hardship adjusted relative risk ratio (RRRadj) 2.32 (95% CI: 1.19 to 4.52) and most hardship RRRadj 4.44 (95% CI: 2.02 to 9.77). Accumulation of financial hardship across earlier and later adulthood was also associated with an increased risk of CWP.ConclusionsConsideration of socioeconomic factors in earlier adulthood may be important when identifying targets for intervention to prevent CWP in later life.

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Comparison of NSAIDS Versus NSAIDS Plus Duloxetine in Knee Osteoarthritis Patients

10.53350/pjmhs2115102865 ◽

2021 ◽

Vol 15 (10) ◽

pp. 2865-2868

Author(s):

Muhammad Muddasser Khan Panezai ◽

Shahzad Gul ◽

Zia Ehsan Kakar ◽

Uzma Rasheed ◽

Shazia Zammurad ◽

...

Keyword(s):

Knee Osteoarthritis ◽

Knee Pain ◽

Womac Score ◽

P Value ◽

Reduction Of Pain ◽

Group A ◽

Keywords Chronic Pain ◽

The Mean ◽

Group B ◽

Study Setting

Objective: To compare the efficacy of Duloxetine with NSAIDS versus NSAIDS alone for the treatment of knee pain secondary to osteoarthritis. Study Design: Randomized clinical trial study. Setting and Duration: Department of Rheumatology, PIMS Hospital, Islamabad, from April to August 2021. Methodology: One hundred and twenty eight patients with knee osteoarthritis were included in the study and were divided in two equal groups; one group was subjected to Duloxetine plus NSAIDs and other to just NSAIDs. The response was assessed at end of 3 months. Reduction in pain more than or equal to 50% from the baseline was considered as efficacy. Results: The mean VAS score was 3.56±1.15 in group A (Duloexetine plus NSAIDS) A while in group B (NSAID alone), 4.45±1.22 and significantly (p-value > 0.05). Similarly, the comparison of WOMAC score for pain showed that the mean WOMAC score was significantly (P-value > 0.05) less 5.68±1.56 in group A in contrast to 6.39 ± 1.69 in group B. Comparison of efficacy between two groups showed that the rate of efficacy was significantly (P-value >0.05) higher in group A 48.4% as compared to 31.3% in group B. Conclusion: Addition of Duloxetine to NSAIDs resulted in more reduction of pain in terms of VAS and WOMAC score with acceptable adverse effects. Keywords: Chronic pain, Duloxetine, Knee pain, NSAIDs, Osteoarthritis

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A study on knee osteoarthritis in physical medicine and rehabilitation department, Rangpur Medical College

KYAMC Journal ◽

10.3329/kyamcj.v8i2.35698 ◽

2018 ◽

Vol 8 (2) ◽

pp. 18-23

Author(s):

Mohammad Moniruzzaman ◽

Muhammad Alamgir Mandal ◽

Md Ariful Islam ◽

Md Ashraful Haque ◽

Md Ahsan Ullah ◽

...

Keyword(s):

Knee Joint ◽

Knee Osteoarthritis ◽

P Value ◽

Physical Medicine ◽

Knee Oa ◽

Demographic Study ◽

Study Population ◽

Radiological Changes ◽

The Mean ◽

Clinical Grading

Background: Physical Medicine & Rehabilitation (PMR) Department has also been trying to provide services with specialized outdoor (referred patient only) set up for twenty million people of Rangpur division.Objectives: Study is to know the demographic study, clinical grading, examination findings and radiological changes of Knee osteoarthritis.Materials & Methods: It was an observational study. This study was done on referred patients of Knee osteoarthritis in PMR specialized outdoor of RpMCH from 20th September, 2012 to 20th October; 2012. The objective of this study is to know the demographic study, clinical grading, examination findings and radiological changes of knee osteoarthritis (OA). Consecutive sampling technique was adopted and total 34 samples were taken.Results: Among 30 study population, 4 (13.3%) were male, 26 (86.7%) were female and male: female ratio was 0.15 (Table I). The mean age was 52.20±9.572 (standard deviation) and P value was 0.000. Regarding Occupation, 18 (60%) were housewife, 10 (33.3%) were sedentary worker and 2 (6.7%) were businessmen (P value 0.002) (Table IV). Among the study population, 18 (60.0%) had both knee joint OA, 8 (26.7%) had right knee joint OA and 4 (13.3%) had left knee OA. The mean duration of knee joint pain was 25.33 ± 37.570 (standard deviation) month (P value 0.001) (Table VII). Among the study population, 4 (13.3%) had diabetes mellitus, 6 (20.0%) had hypertension, 2 (6.7%) had hypertension with ischemic heart disease and 2 (6.7%) had diabetes mellitus with hypertension with bronchial asthma and 16 (53.3%) were normotensive and nondiabetic (Figure 1). According to clinical grading of knee OA, 2 (6.7%) were in grade-1a, 6 (20%) were in grade-1b, 2 (6.7%) were in grade-2a, 4 (13.3%) were in grade-2b, 8 (26.7%) were in grade-3b, 8 (26.7%) were in grade-4 (P value 0.180 ) (Figure 2).Conclusion: This study reveals that clinically more advanced OA patients actually carrying early radiological changes.KYAMC Journal Vol. 8, No.-2, Jan 2018, Page 18-23

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The efficacy of transcatheter arterial embolization for knee pain on patients with knee osteoarthritis: A case series

Journal of Back and Musculoskeletal Rehabilitation ◽

10.3233/bmr-210043 ◽

2021 ◽

pp. 1-6

Author(s):

Kun Yung Kim ◽

Gi-Wook Kim

Keyword(s):

Conservative Treatment ◽

Knee Osteoarthritis ◽

Knee Pain ◽

Transcatheter Arterial Embolization ◽

Rating Scale ◽

Case Series ◽

Arterial Embolization ◽

Numeric Rating Scale ◽

Knee Oa ◽

Before And After

BACKGROUND: Knee osteoarthritis (OA) is accompanied by inflammation and angiogenesis. Modifying angiogenesis through transcatheter arterial embolization (TAE) can be a potential treatment for knee OA. OBJECTIVE: We subjected five OA knees in three patients to TAE and report the results of our post-treatment observations. CASE DESCRIPTION: Three patients that had experienced knee pain for a minimum of one year prior to the study, and whose pain had persisted despite conservative treatment, were included in this study. Patients more often chose conservative treatment over surgical treatment. Pain and functional scales were evaluated before, immediately, and 1 month after TAE using the Numeric Rating Scale (NRS) and Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC). TAE was performed by an experienced interventional radiologist. The average values of NRS evaluated before and after 5 TAEs were 5.2 before TAE, 3 immediately after TAE, and 3.6 after 1 month of TAE, and the average values of WOMAC were 52, 38.4, and 36.4, respectively. There were no major adverse effects. CONCLUSION: The examined cases support the conclusion that TAE is an effective treatment for patients with knee OA. Substantial pain relief and WOMAC improvement were observed both immediately and one month after TAE.

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EFFICACY OF LATERAL WEDGING IN FOOTWEAR IN MEDIAL COMPARTMENT OSTEOARTHRITIS KNEE

10.36106/paripex/8300399 ◽

2019 ◽

pp. 1-3

Author(s):

Suman Badhal ◽

U. Singh ◽

S. L Yadav ◽

Gita Handa

Keyword(s):

Intervention Group ◽

Cost Effective ◽

Mean Difference ◽

Medial Compartment ◽

Treatment Modalities ◽

Rank Test ◽

P Value ◽

Knee Oa ◽

The Mean ◽

Group B

INTRODUCTION: In Knee osteoarthritis (OA) Shoe modifications, such as lateral-wedge insoles or shock absorbing shoes with insoles, have been recommended for conservative therapy of mild knee OA but with little objective data on Indian patients. OBJECTIVE : this prospective study was done to study the effect of lateral heel sole wedging (insole) in the patients of OA of knee (medial compartment) and its relation to function,pain and stiffness parameters status on VAS and WOMAC scale and to see the requirement of the number of Aceclofenac tablets. METHODS: 60 patients fulfilling the inclusion criteria were enrolled and divided into intervention group A (30) and nonintervention Group B (30) with random allocation.Paired t-test,Wilcoxon sign rank test and Man Whitney U test were applied at significant p-value of <0.05%. RESULTS: the reduction of mean difference in pain on VAS and WOMAC scale, improvement in Mean difference in function parameters the mean reduction of pain in standing/ walking,bending and ascending/descending at WOMAC scale was significantly higher in intervention group. Also the mean reduction in the need for aceclofenac was significantly lower in intervention group evident from fourth week onward to fifth and sixth week.Conclusion:The lateral wedging in shoes in medial joint osteoarthritis is beneficial and it can be cost-effective conservative treatment modalities in early osteoarthritis patients, particularly in developing countries as it can reduces the requirement of NSAIDS and improve functional level of patients by reducing pain in various activities.

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Associations of Metabolic Syndrome and Its Components with the Risk of Incident Knee Osteoarthritis Leading to Hospitalization: A 32-Year Follow-up Study

Cartilage ◽

10.1177/1947603519894731 ◽

2019 ◽

pp. 194760351989473

Author(s):

Sanna Konstari ◽

Katri Sääksjärvi ◽

Markku Heliövaara ◽

Harri Rissanen ◽

Paul Knekt ◽

...

Keyword(s):

Metabolic Syndrome ◽

Confidence Interval ◽

Knee Osteoarthritis ◽

Fasting Glucose ◽

Full Model ◽

Knee Oa ◽

Increased Risk ◽

Metabolic Syndrome Components ◽

Reduced Risk

Objectives To examine whether metabolic syndrome or its individual components predict the risk of incident knee osteoarthritis (OA) in a prospective cohort study during a 32-year follow-up period. Design The cohort consisted of 6274 participants of the Mini-Finland Health Survey, who were free from knee OA and insulin-treated diabetes at baseline. Information on the baseline characteristics, including metabolic syndrome components, hypertension, elevated fasting glucose, elevated triglycerides, reduced high-density lipoprotein, and central obesity were collected during a health examination. We drew information on the incidence of clinical knee OA from the national Care Register for Health Care. Of the participants, 459 developed incident knee OA. In our full model, age, gender, body mass index, history of physical workload, smoking history, knee complaint, and previous injury of the knee were entered as potential confounding factors. Results Having metabolic syndrome at baseline was not associated with an increased risk of incident knee OA. In the full model, the hazard ratio for incident knee OA for those with metabolic syndrome was 0.76 (95% confidence interval [0.56, 1.01]). The number of metabolic syndrome components or any individual component did not predict an increased risk of knee OA. Of the components, elevated plasma fasting glucose was associated with a reduced risk of incident knee OA (hazard ratio 0.71, 95% confidence interval [0.55, 0.91]). Conclusions Our findings do not support the hypothesis that metabolic syndrome or its components increase the risk of incident knee OA. In fact, elevated fasting glucose levels seemed to predict a reduced risk.

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Stress in Caregivers and Children with a Developmental Disorder Who Receive Rehabilitation

Children ◽

10.3390/children7090136 ◽

2020 ◽

Vol 7 (9) ◽

pp. 136

Author(s):

Sung Hyun Kim ◽

In Young Sung ◽

Eun Jae Ko ◽

Jieun Park ◽

Nayoung Heo

Keyword(s):

Externalizing Problems ◽

Child Behavior Checklist ◽

Developmental Disorders ◽

Developmental Disorder ◽

Early Rehabilitation ◽

Self Report ◽

P Value ◽

Psychological Burden ◽

Stress Levels ◽

The Mean

This study aimed to evaluate the stress levels of caregivers and children with developmental disorders who were receiving rehabilitation treatment. The relationships between stress levels and factors such as early rehabilitation and home rehabilitation were quantified. Methods: This study was conducted in children with development disorders, aged from 1.5 years to 18 years, who were undergoing rehabilitation. The Korean version of the Child Behavior Checklist (K-CBCL) and the Adult Self-Report (K-ASR) were used to evaluate stress levels in children and caregivers, respectively. Results: Questionnaires were provided to 150 caregivers who agreed to participate. However, only 76 copies of the K-CBCL and 75 copies of the K-ASR were collected. The mean K-CBCL and K-ASR t scores were in the normal range. The K-CBCL score correlated positively with the K-ASR score (p value < 0.5). K-CBCL externalizing problems score correlated positively with the age at the start of rehabilitation, and the K-CBCL and K-ASR externalizing problems scores correlated negatively with home treatment delivered by caregivers. Conclusions: Stress levels of children and caregivers were closely related. Home rehabilitation provided by caregivers reduced stress in both caregivers and children. Early rehabilitation did not impart additional psychological burden on caregivers or children.

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What Is the Price and Claimed Efficacy of Platelet-Rich Plasma Injections for the Treatment of Knee Osteoarthritis in the United States?

The Journal of Knee Surgery ◽

10.1055/s-0038-1669953 ◽

2018 ◽

Vol 32 (09) ◽

pp. 879-885 ◽

Cited By ~ 8

Author(s):

Nicolas S. Piuzzi ◽

Mitchell Ng ◽

Ariel Kantor ◽

Kenneth Ng ◽

Stephanie Kha ◽

...

Keyword(s):

United States ◽

Standard Deviation ◽

Knee Osteoarthritis ◽

Clinical Efficacy ◽

Health Care Providers ◽

Platelet Rich Plasma ◽

The United States ◽

Care Providers ◽

Knee Oa ◽

The Mean

AbstractPlatelet-rich plasma (PRP) injections are often used for the treatment of knee osteoarthritis (OA), despite clinical value and cost-effectiveness not being definitely established. PRP injections are considered as a potential means of reducing pain and improving function in patients with knee OA, in the hope of delaying or avoiding the need for surgical intervention. Centers that offer PRP injections usually charge patients out of pocket and directly market services. Therefore, the purpose of this study was to quantify the current (1) prices and (2) marketed clinical efficacy of autologous PRP injections for knee OA. A prospective cross-sectional study was performed based on 286 centers identified in the United States offering PRP injections for knee OA. A total of 179 (73.4%) centers were successfully contacted via e-mail or phone, using a simulated 52-year-old male patient with knee OA. Scripted questions were asked by the simulated patient to determine the current marketed prices and clinical efficacy, either reported as “good results” or “symptomatic improvement,” claimed by each treating center. The mean price for a single unilateral knee same-day PRP injection was $714 with a standard deviation of $144 (95% confidence interval [CI]: $691–737, n = 153). The mean claim of clinical efficacy was 76% with a standard deviation of 11% (95% CI: 73.5–78.3%, n = 84). Out of the 84 clinics, 10 claimed “90 to 100% efficacy,” 27 claimed “80 to 90%,” 29 claimed “70 to 80%,” 9 claimed “60 to 70%,” 8 claimed “50 to 60%,” and 1 claimed “40 to 60%.” These findings provide a unique perspective on the PRP market for the treatment of knee OA that is valuable to physicians and health care providers in providing better education to patients on the associated costs and purported clinical benefits of PRP injections.

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