scholarly journals Association between disease progression and depression onset in persons with radiographic knee osteoarthritis

Rheumatology ◽  
2020 ◽  
Vol 59 (11) ◽  
pp. 3390-3399
Author(s):  
Alan M Rathbun ◽  
Michelle D Shardell ◽  
Alice S Ryan ◽  
Michelle S Yau ◽  
Joseph J Gallo ◽  
...  
Keyword(s):  
Disease Progression ◽  
Disease Severity ◽  
Gait Speed ◽  
Joint Space Width ◽  
Joint Space ◽  
Knee Oa ◽  
Increased Risk ◽  
Pain Subscale ◽  
Space Width

Abstract Objectives Osteoarthritis (OA) disease progression may lead to deteriorating psychosocial function, but it is unclear what aspects of disease severity are related to the onset of depression. This study assessed which components of OA disease progression cumulatively contribute to depression onset in persons with radiographic knee OA. Methods Osteoarthritis Initiative participants (n = 1651) with radiographic disease (Kellgren-Lawrence grade ≥2) in one or both knees and below the screening threshold for probable depression [Center for Epidemiological Studies Depression (CES-D) scale <16] at baseline were included. Disease severity was measured from baseline to the third annual follow-up visit using joint space width, 20-meter gait speed, and the Western Ontario and McMaster Universities Osteoarthritis Index pain subscale, each categorized into quintiles. Depression onset (CES-D ≥ 16) was assessed annually at four follow-up visits. Marginal structural models that account for time-dependent confounding and attrition evaluated the association between each time-varying disease severity measure and depression onset. Results Each disease severity measure exhibited a non-linear relationship concerning the probability of depression onset, with the higher quintiles generally being associated with a larger risk. The highest quintile (relative to the lowest) of joint space width and gait speed were both significantly associated with depression onset. By contrast, none of the higher pain quintiles compared with the lowest were significantly associated with the onset of depression. Conclusion Faster disease progression as measured by either worsening structural severity or decreasing physical performance corresponds to an increased risk of depression among individuals with radiographic knee OA.

scholarly journals Association between current medication use and progression of radiographic knee osteoarthritis: data from the osteoarthritis initiative

Rheumatology ◽  
2021 ◽  
Author(s):  
Thomas A Perry ◽  
Xia Wang ◽  
Michael Nevitt ◽  
Christina Abdelshaheed ◽  
Nigel Arden ◽  
...  
Keyword(s):  
Reference Group ◽  
Medication Use ◽  
Joint Space Width ◽  
Joint Space ◽  
Knee Oa ◽  
Current Medication ◽  
History Of ◽  
Osteoarthritis Initiative ◽  
Space Width

Abstract Objective Use of specific medications may accelerate the progression of radiographic knee OA (RKOA). Our aim was to examine the effect of medication use on the progression of RKOA. Methods We used longitudinal data from the Osteoarthritis Initiative (OAI), an observational study of risk factors for knee OA. At baseline, we selected participants with RKOA (Kellgren–Lawrence grade ≥2) and excluded those with a history of knee-related injury/surgery and other musculoskeletal disorders. Current medication use (use/non-use in the previous 30 days) and radiographic medial minimum joint space width (mJSW) data were available at baseline and annually up to 96 months follow-up. We used random effects, panel regression to assess the association between current medication use (non-users as reference group) and change in mJSW. Results Of 2054 eligible participants, 2003 participants with baseline mJSW data were included [55.7% female, mean age 63.3 (s.d. 8.98) years]. Of seven medication classes, at baseline NSAIDs were the most frequently used analgesia (14.7%), anti-histamine (10.4%) use was frequent and the following comorbidity medications were used most frequently: statins (27.4%), anti-hypertensives (up to 15.0%), anti-depressant/anxiolytics/psychotropics (14.0%), osteoporosis-related medication (10.9%) and diabetes-related medication (6.9%). Compared with current non-users, current use of NSAIDs was associated with a loss of mJSW (b = −0.042, 95% CI −0.08, −0.0004). No other associations were observed. Conclusions In current users of NSAIDs, mJSW loss was increased compared with current non-users in participants with RKOA. Clinical trials are required to assess the potential disease-modifying effects of these medications.

scholarly journals Changes in Knee Joint Space Width in Treatment with a New Hyaluronic-Based Hydrogel

2017 ◽  
Vol 63 (3) ◽  
pp. 125-128
Author(s):  
Octav Marius Russu ◽  
Andrei Marian Feier ◽  
Tudor Sorin Pop ◽  
Marcela Todoran ◽  
István Gergely
Keyword(s):  
Hyaluronic Acid ◽  
Knee Joint ◽  
Knee Osteoarthritis ◽  
Joint Space Narrowing ◽  
Joint Space Width ◽  
Joint Space ◽  
One Year ◽  
A Minor ◽  
Space Width

AbstractObjective: Our purpose was to assess the effect of a new hyaluronic acid-based (Hymovis®) injections on joint space width narrowing in patients diagnosed with knee osteoarthritis.Methods: A prospective clinical trial was conducted in the Department of Orthopedics and Traumatology II from the Clinical County Hospital, Tîrgu Mureș, Romania. Thirty-five patients diagnosed with idiopathic knee osteoarthritis received two intraarticular injections with hyaluronic acid-based hydrogel (24 mg of hyaluronic acid/3 ml) at one-week interval. Anteroposterior radiographs were obtained before the injections, at six and twelve months after. Minimum joint space width was measured by two senior orthopaedics surgeons at each follow up. Each radiograph was measured again by the same evaluators two weeks apart.Results: Thirty-one patients were present at the final follow-up. A minor reduction in mean weight was noticed (from 82.2 kg ± 16.2 kg to 80.9 kg ± 16.0, p > 0.398) without any correlation with joint space width narrowing. There were no major changes at the first follow up (6 months) regarding joint space narrowing. A reduction in joint space width was observed however at 12 months varying from 4.4 mm (SD ± 1.64, range 1.8-7.1) at the first assessment to 4.3 mm (SD ± 1.26, range 0.0-6.8) at the final follow-up but with no statistical difference (p=0.237).Conclusion: No significant modification in joint space width at the final follow-up secondarily proved that two injections of Hymovis® may slow down narrowing in the knee joint space over a one-year period.

scholarly journals Sensitivity-to-change and validity of semi-automatic joint space width measurements in hand osteoarthritis: a follow-up study

2016 ◽  
Vol 24 (7) ◽  
pp. 1172-1179 ◽  
Author(s):  
W. Damman ◽  
M.C. Kortekaas ◽  
B.C. Stoel ◽  
R. van 't Klooster ◽  
R. Wolterbeek ◽  
...  
Keyword(s):  
Joint Space Width ◽  
Joint Space ◽  
Hand Osteoarthritis ◽  
Sensitivity To Change ◽  
Follow Up Study ◽  
Width Measurements ◽  
Space Width

scholarly journals Knee Osteoarthritis Revisited; But Only After KL Grading Is Tested: A Retrospective Analysis

2019 ◽  
pp. 9-13
Author(s):  
Victoria David Kuttan ◽  
Deepak Anap ◽  
Sushil Kachevar
Keyword(s):  
Knee Joint ◽  
Disease Progression ◽  
Joint Space Width ◽  
Lateral Compartment ◽  
Exercise Programme ◽  
Joint Space ◽  
Osteoarthritis Of The Knee ◽  
Tibiofemoral Joint ◽  
Keywords Osteoarthritis ◽  
Space Width

Background: Osteoarthritis (OA) of the knee is one of the major causes in musculoskeletal condition leading to functional loss in patients. Determining the progression of the disease is a useful tool which will help in the planning of the exercise programme to slow or halt the disease progression. Measuring the joint space width of the tibiofemoral joint is one of the best options for knowing the disease progression and helps in designing an exercise programme. Aim: Retrospective measurement of joint space width in patients with bilateral tibiofemoral osteoarthritis of the knee joint. Methodology: Data was retrieved from the picture archiving and communication system (PACS) from 1st of February to 22nd of June 2018. Radiographs that were showing OA knee features by using Kellegren Lawrence (KL) grading system were considered and the joint space between the tibial and femoral compartment was measured. Result: The joint space width showed more reduction in the medial compartment of the joint as compared to the lateral compartment. Conclusion: In the rural population of Maharashtra the medial joint space is markedly decreased as compared to the lateral compartment of the tibiofemoral joint and as the KL grade increases the joint space width decreased. Keywords: Osteoarthritis; Knee; Joint space width; Rural Maharashtra.

scholarly journals Strategies for increasing gait speed in patients with hip osteoarthritis: their clinical significance and effects on hip loading

2020 ◽  
Author(s):  
Hiroshige Tateuchi ◽  
Haruhiko Akiyama ◽  
Koji Goto ◽  
Kazutaka So ◽  
Yutaka Kuroda ◽  
...  
Keyword(s):  
Physical Function ◽  
Gait Speed ◽  
Stride Length ◽  
Joint Space Width ◽  
Hip Osteoarthritis ◽  
Joint Space ◽  
Hip Pain ◽  
Rate Of Increase ◽  
Type C ◽  
Space Width

Abstract Background: Changes in gait speed are required in various situations and can be achieved by changing stride length, cadence, or both. Differences in strategies for increasing gait speed may have different effects on hip joint and physical function. The purpose of this study was to determine the effects of strategies for increasing gait speed on hip pain, physical function, and changes in hip loading during gait in patients with hip osteoarthritis (OA). We hypothesized that patients who increase gait speed mainly by increasing cadence would have lesser hip pain, a higher physical function, and a lower rate of increase in hip moments with increasing gait speed.Methods: Forty-seven patients with secondary hip OA (age, 48.3 ± 11.0 years) were included. Gait speed, stride length, cadence, and peak and impulse of the hip moments were measured during gait at self-selected normal and fast gait speeds. The patients were classified as types S (with mainly increasing stride length, n = 11 [23.4%]), C (with mainly increasing cadence, n = 23 [48.9%]), and SC (with increasing stride length and cadence, n = 13 [27.7%]) according to whether they used changes in stride length and/or cadence to transition from normal to fast gait. Hip pain, physical function, and hip moments changes during gait were compared between types.Results: The physical function was higher in types C (38.0 ± 8.8, P = 0.018) and SC (40.6 ± 8.5, P = 0.015) than in type S (28.2 ± 7.8), even after adjustment for age and minimum joint space width. Hip pain was not significantly different between types. The robustness of these results was confirmed with sensitivity analysis. The rates of increases in peak external hip adduction (P = 0.003) and internal rotation moments (P = 0.009) were lower in type C than in type SC.Conclusions: Type C tended to suppress the increase in hip moments during fast gait. Types C and SC, which included increased cadence, maintained higher physical function levels than type S. Encouraging the use of cadence-increasing strategy may be useful for reducing hip loading and maintaining physical function in patients with hip OA.

Identifying Phenotypes of Knee Osteoarthritis by Separate Quantitative Radiographic Features May Improve Patient Selection for More Targeted Treatment

2013 ◽  
Vol 40 (6) ◽  
pp. 891-902 ◽  
Author(s):  
Margot B. Kinds ◽  
Anne C.A. Marijnissen ◽  
Max A. Viergever ◽  
Pieter J. Emans ◽  
Floris P.J.G. Lafeber ◽  
...  
Keyword(s):  
Bone Density ◽  
Clinical Characteristics ◽  
Joint Space Width ◽  
Specific Treatment ◽  
Joint Space ◽  
Radiographic Features ◽  
Knee Oa ◽  
Improve Patient Selection ◽  
Space Width ◽  
Varus Angle

Objective.Expression of osteoarthritis (OA) varies significantly between individuals, and over time, suggesting the existence of different phenotypes, possibly with specific etiology and targets for treatment. Our objective was to identify phenotypes of progression of radiographic knee OA using separate quantitative features.Methods.Separate radiographic features of OA were measured by Knee Images Digital Analysis (KIDA) in individuals with early knee OA (the CHECK cohort: Cohort Hip & Cohort Knee), at baseline and at 2-year and 5-year followup. Hierarchical clustering was performed to identify phenotypes of radiographic knee OA progression. The phenotypes identified were compared for changes in joint space width (JSW), varus angle, osteophyte area, eminence height, bone density, for Kellgren-Lawrence (K-L) grade, and for clinical characteristics. Logistic regression analysis evaluated whether baseline radiographic features and demographic/clinical characteristics were associated with each of the specific phenotypes.Results.The 5 clusters identified were interpreted as “Severe” or “No,” “Early” or “Late” progression of the radiographic features, or specific involvement of “Bone density.” Medial JSW, varus angle, osteophyte area, eminence height, and bone density at baseline were associated with the Severe and Bone density phenotypes. Lesser eminence height and bone density were associated with Early and Late progression. Larger varus angle and smaller osteophyte area were associated with No progression.Conclusion.Five phenotypes of radiographic progression of early knee OA were identified using separate quantitative features, which were associated with baseline radiographic features. Such phenotypes might require specific treatment and represent relevant subgroups for clinical trials.

scholarly journals OP0185 KNEE JOINT DISTRACTION IS MORE EFFICIENT IN RESTORING CARTILAGE THICKNESS THAN HIGH TIBIAL OSTEOTOMY IN PATIENTS WITH SEVERE KNEE OSTEOARTHRITIS

2020 ◽  
Vol 79 (Suppl 1) ◽  
pp. 114.2-115
Author(s):  
M. Jansen ◽  
S. Maschek ◽  
R. Van Heerwaarden ◽  
S. Mastbergen ◽  
W. Wirth ◽  
...  
Keyword(s):  
Stock Options ◽  
Joint Space Width ◽  
Joint Space ◽  
Cartilage Thickness ◽  
Tibial Osteotomy ◽  
Knee Oa ◽  
Leg Axis ◽  
Cartilage Restoration ◽  
Joint Distraction ◽  
Space Width

Background:Both high tibial osteotomy (HTO) and knee joint distraction (KJD) are joint preserving surgical techniques unloading the affected femorotibial compartment in patients with knee osteoarthritis (OA). While HTO permanently unloads the more affected compartment (MAC) by overcorrecting the leg axis, KJD temporarily unloads the whole joint by separating the tibia and femur for 5 mm for 6 weeks. In a previous randomized controlled trial (RCT), comparable clinical benefit and radiographic joint space width (JSW) increase over 2 years follow-up were demonstrated for both treatments1. Yet, comparison of JSW before and after HTO may be unreliable, as pseudo-widening of the unloaded compartment may occur due to the induced leg axis change. Therefore, direct cartilage thickness measurements need to be compared between KJD and HTO, to accurately evaluate the efficacy of both treatment options on cartilage structure.Objectives:To compare two-year cartilage thickness changes after treatment with KJDvsHTO and identify factors predicting cartilage thickness restoration.Methods:Patients indicated for HTO were randomized to KJD (KJDHTO) or HTO treatment. Patients indicated for total knee arthroplasty received KJD (KJDTKA). Standardized semi-flexed weight-bearing radiographs and 3T MRIs with 3D spoiled gradient recalled imaging sequence with fat suppression (SPGR-fs) were acquired before and two years after surgical treatment. Cartilage thickness in the knee was measured using Chondrometrics Works 3.0 software. On the radiographs the mean JSW in the MAC were measured with KIDA software. Readers were blinded to the type of intervention and acquisition order. The primary and secondary outcomes were the mean MAC cartilage thickness (ThCtAB) and percentage of denuded bone area (dABp) change before and two years after treatment (MRI), with radiographic joint space width (JSW) used as a reference.Results:No statistically significant differences in the baseline characteristics were seen between KJDHTO(n=18) and HTO (n=33). The KJDTKAgroup (n=18) had a higher age and Kellgren-Lawrence grade (KLG) than the HTO and KJDHTOgroups.KJDHTOpatients did not show significant changes in MAC cartilage thickness, dABp, or JSW over time (all p>0.10; figure 1). HTO patients displayed a decrease in MAC cartilage thickness and an increase in dABp (both p<0.03), but an increase in JSW (p=0.006). KJDTKAshowed a significant increase in MAC cartilage thickness and JSW and decrease in dABp (all p<0.01). Baseline OA severity was the strongest predictor of cartilage restoration. KJD patients with severe OA (KJDsevere; KLG ≥3) showed significant restoration (all p<0.01; figure 2); mild OA patients (KJDmild; KLG ≤2) showed a slight deterioration. KJDsevereshowed a significantly greater cartilage restoration response in the MAC than HTOseverefor cartilage thickness (p=0.005) and dABp (p=0.003), but not JSW change (p=0.521). The changes in all three parameters did not differ significantly between KJDmildand HTOmild(all p>0.08).Conclusion:In patients with severe knee OA, KJD is more efficient in restoring cartilage thickness than HTO is. In these patients, KJD causes significant cartilage restoration while HTO, despite shifting the leg axis and demonstrating radiographic joint space widening, shows loss of cartilage as measured on MRI. In patients with mild knee OA, neither HTO nor KJD treatment results in significant cartilage restoration and both treatments show a slight deterioration that is likely the result of natural OA progression. As such, this research promotes the choice KJD as joint-preserving surgery in case of knee OA patients with more severe structural damage.References:[1]MP Jansenet al, Cartilage 2019.Disclosure of Interests:Mylène Jansen: None declared, Susanne Maschek Shareholder of: Stock/stock options at Condrometrics GmbH, Employee of: Employment at Condrometrics GmbH, Ronald Van Heerwaarden: None declared, Simon Mastbergen: None declared, Wolfgang Wirth Shareholder of: Stock/stock options at Condrometrics GmbH, Consultant of: Consultancy to Galapagos NV, Employee of: Employment at Condrometrics GmbH, Floris Lafeber Shareholder of: Co-founder and shareholder of ArthroSave BV, Felix Eckstein Shareholder of: Stock/stock options at Condrometrics GmbH, Consultant of: Consultancy at Merck KGaA, Samumed, Bioclinica, Galapagos, Servier, Novartis, Employee of: Employment at Condrometrics GmbH, Speakers bureau: Development of educational presentations for Medtronic

scholarly journals Strategies for increasing gait speed in patients with hip osteoarthritis: their clinical significance and effects on hip loading

2021 ◽  
Vol 23 (1) ◽  
Author(s):  
Hiroshige Tateuchi ◽  
Haruhiko Akiyama ◽  
Koji Goto ◽  
Kazutaka So ◽  
Yutaka Kuroda ◽  
...  
Keyword(s):  
Physical Function ◽  
Gait Speed ◽  
Stride Length ◽  
Joint Space Width ◽  
Hip Osteoarthritis ◽  
Joint Space ◽  
Hip Pain ◽  
Rate Of Increase ◽  
Type C ◽  
Space Width

Abstract Background Changes in gait speed are required in various situations and can be achieved by changing stride length, cadence, or both. Differences in strategies for increasing gait speed may have different effects on hip joint and physical function. The purpose of this study was to determine the effects of strategies for increasing gait speed on hip pain, physical function, and changes in hip loading during gait in patients with hip osteoarthritis (OA). We hypothesized that patients who increase gait speed mainly by increasing cadence would have lesser hip pain, a higher physical function, and a lower rate of increase in hip moments with increasing gait speed. Methods Forty-seven patients with secondary hip OA (age, 48.3 ± 11.0 years) were included. Gait speed, stride length, cadence, and peak and impulse of the hip moments were measured during gait at self-selected normal and fast gait speeds. The patients were classified as types S (with mainly increasing stride length, n = 11 [23.4%]), C (with mainly increasing cadence, n = 23 [48.9%]), and SC (with increasing stride length and cadence, n = 13 [27.7%]) according to whether they used changes in stride length and/or cadence to transition from normal to fast gait. Hip pain, physical function, and hip moment changes during gait were compared between types. Results The physical function was higher in types C (38.0 ± 8.8, P = 0.018) and SC (40.6 ± 8.5, P = 0.015) than in type S (28.2 ± 7.8), even after adjustment for age and minimum joint space width. Hip pain was not significantly different between types. The robustness of these results was confirmed with sensitivity analysis. The rates of increases in peak external hip adduction (P = 0.003) and internal rotation moments (P = 0.009) were lower in type C than in type SC. Conclusions Type C tended to suppress the increase in hip moments during fast gait. Types C and SC, which included increased cadence, maintained higher physical function levels than type S. Encouraging the use of cadence-increasing strategy may be useful for reducing hip loading and maintaining physical function in patients with hip OA.

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