The Long-Term Impact of Osteoarthritis Following Knee Surgery in Former College Athletes

2019 ◽  
Vol 28 (1) ◽  
pp. 33-38 ◽  
Author(s):  
Janet E. Simon ◽  
Dustin R. Grooms ◽  
Carrie L. Docherty
Keyword(s):  
Knee Injury ◽  
College Athletes ◽  
Short Form ◽  
Knee Surgery ◽  
Mean Difference ◽  
Short Form 36 ◽  
Knee Oa ◽  
Quality Of Life Scale ◽  
History Of

Context: Individuals who sustain a knee surgery have been shown to have an increased likelihood to develop osteoarthritis (OA). Objective: Identify the consequences of knee surgery in a cohort of former college athletes. Design: Cross-sectional. Setting: Research laboratory. Participants: A group of 100 former Division I college athletes aged 40–65 years (60 males and 40 females) participated in the study. Interventions: All individuals self-reported whether they sustained a knee injury during college requiring surgery and if they have been diagnosed with knee OA by a medical physician post knee injury. Individuals were categorized into 3 groups: no history of knee injury requiring surgery (33 males and 24 females; 54.53 [5.95] y), history of knee surgery in college with no diagnosis of OA later in life (4 males and 6 females; 51.26 [7.29] y), and history of knee surgery in college with physician diagnosed OA later in life (23 males and 10 females; 54.21 [7.64] y). All individuals completed the knee injury and osteoarthritis outcome score (KOOS) and short form-36 version 2. Main Outcome Measures: Scores on the KOOS and short form-36 version 2. Results: A majority (76.7%) of individuals who had a knee surgery in college did develop OA. The largest mean differences were between the healthy knee and surgical knee/OA groups on the KOOS-quality of life scale (mean difference: 49.76; χ2(3) = 44.65; P < .001) and KOOS-sports scale (mean difference: 43.69; χ2(3) = 28.69; P < .001), with the surgical knee/OA group scoring worse. Conclusions: Later in life functional limitations were observed in individuals who sustained a knee injury requiring surgery and developed OA. These findings support increased efforts toward prevention of knee injuries and consideration of the long-term implication when making treatment and return to activity decisions.

Knee Surgery Is Associated With Greater Odds of Knee Osteoarthritis Diagnosis

2019 ◽  
Vol 28 (7) ◽  
pp. 716-723
Author(s):  
Abbey C. Thomas ◽  
Janet E. Simon ◽  
Rachel Evans ◽  
Michael J. Turner ◽  
Luzita I. Vela ◽  
...  
Keyword(s):  
Knee Osteoarthritis ◽  
Knee Injury ◽  
Online Survey ◽  
Disease Onset ◽  
Knee Surgery ◽  
Lower Extremity Injury ◽  
Odds Ratios ◽  
Cross Sectional Survey ◽  
Knee Oa ◽  
History Of

Context: Knee osteoarthritis (OA) frequently develops following knee injury/surgery. It is accepted that knee injury/surgery precipitates OA with previous studies examining this link in terms of years after injury/surgery. However, postinjury OA prevalence has not been examined by decade of life; thereby, limiting our understanding of the age at which patients are diagnosed with posttraumatic knee OA. Objective: Evaluate the association between the knee injury and/or surgical history, present age, and history of receiving a diagnosis of knee OA. Design: Cross-sectional survey. Setting: Online survey. Participants: A total of 3660 adults were recruited through ResearchMatch©. Of these, 1723 (47.1%) were included for analysis due to history of (1) knee surgery (SURG: n = 276; age = 53.8 [15.3] y; and body mass index [BMI] = 29.9 [8.0] kg/m2), (2) nonsurgical knee injury (INJ: n = 449; age = 46.0 [15.6] y; and BMI = 27.5 [6.9] kg/m2), or (3) no knee injury (CTRL: n = 998; age = 44.0 [25.2] y; and BMI = 26.9 [6.6] kg/m2). Respondents were subdivided by decade of life (20–29 through 70+). Intervention: An electronic survey regarding knee injury history, treatment, and diagnosis of knee OA. Main Outcome Measures: Binary logistic regression determined the association between knee surgical status and OA by decade of life. Participants with no histories of OA or lower-extremity injury were the referent categories. BMI was a covariate in all analyses. Results: SURG respondents were more likely to report having knee OA than CTRL for all age groups (odds ratios: 11.43–53.03; P < .001). INJ respondents aged 30 years and older were more likely to have OA than CTRL (odds ratios: 2.99–14.22; P < .04). BMI influenced associations for respondents in their 50s (P = .001) and 60s (P < .001) only. Conclusions: INJ increased the odds of reporting a physician diagnosis of knee OA in adults as young as 30 to 39 years. Importantly, SURG yielded 3 to 4 times greater odds of being diagnosed with knee OA compared with INJ in adults as young as 20 to 29 years. Delaying disease onset in these young adults is imperative to optimize the quality of life long term after surgery.

The prediction of long-term outcome after subarachnoid hemorrhage as measured by the Short Form-36 Health Survey

2009 ◽  
Vol 16 (11) ◽  
pp. 1409-1413 ◽  
Author(s):  
Wolfram Scharbrodt ◽  
Marco Stein ◽  
Vanessa Schreiber ◽  
Dieter-Karsten Böker ◽  
Matthias F. Oertel
Keyword(s):  
Subarachnoid Hemorrhage ◽  
Health Survey ◽  
Short Form ◽  
Term Outcome ◽  
Long Term Outcome ◽  
Short Form 36

scholarly journals AB0879 DOES BODY WEIGHT INFLUENCE THE KNEE INJURY AND OSTEOARTHRITIS OUTCOME SCORE IN PERSONS WITH SYMPTOMATIC KNEE OSTEOARTHRITIS?

2020 ◽  
Vol 79 (Suppl 1) ◽  
pp. 1745.2-1745
Author(s):  
A. Ben Tekaya ◽  
L. Rouached ◽  
A. Slimi ◽  
J. Galalou ◽  
E. Bahlouli ◽  
...  
Keyword(s):  
Knee Osteoarthritis ◽  
Functional Impairment ◽  
Knee Injury ◽  
Short Form ◽  
Normal Weight ◽  
Knee Oa ◽  
Outcome Score ◽  
Symptomatic Knee Osteoarthritis ◽  
Symptomatic Knee ◽  
Grade Iii

Background:Overweight is a major risk factor for the development and progression of knee osteoarthritis (OA). Weight loss for patients with knee OA has been associated with improvement in self-reported pain and function and is recommended by EULAR as part of the therapeutic management.Objectives:The aim of the study was to evaluate the relation between overweight and functional impairment in adults with knee OA.Methods:It was a prospective study conducted in a rheumatologic department over a 4 months period. Patients with symptomatic knee OA based on the ACR criteria, were included. A screening of body mass index (BMI) was carried out for all patients. It was categorized following the WHO classification into: normal (<25 kg/m2), overweight (25 to <30), obese (up to 30).Pain level was evaluated using the Visual Analogue Scale (VAS). Function was assessed by the short form of the Knee injury and Osteoarthritis Outcome Score (KOOS-PS) (KOOS-PS scores to 0 representing no difficulty and 100 representing extreme difficulty). The patients’ knee radiographies were graded according to Kellgren Lawrence criteria (KL). The patients were allocated in two groups; as grade I-II KL (Group 1) and grade III-IV KL (Group 2).Results:We included 143 patients with a mean age of 65.17± 10.7 years and 88.1% of women. Patients were from low socio-economic class in 30.8% of cases. Mean disease duration of the KOA was 5.4 years [3months-20 years] and mean BMI was 31.8±5.6kg/m2. Patients were with normal weight in 16.1%, overweight in 19.6% and obese in 64.3%.Knee OA was bilateral in 85.3% and other OA sites were associated in 37.8% of patients. Mean VAS pain of knee OA was 6.6±1.5 and KOOS-PS was 48.8±16.5/100. Concerning the radiographic damage; we found grade I-II (KL) in 22.6% and grade III-IV (KL) in 77.4%.High BMI (BMI≥25 kg/m2was not significantly associated with worse KOOS score (p=0.9), more pain (p=0.5) or an increasing severity of radiological knee osteoarthritis (p=0.14). Moreover, the level BMI was not associated with the presence of other OA sites (p=0.9) or a bilateral KOA (p=0.07).Conclusion:These data, from a subset of participants with symptomatic radiographic knee OA, demonstrate no correlation between obesity and pain, functional impairment and radiographic severity.Acknowledgments:noneDisclosure of Interests:None declared

Intramuscular interferon beta-1a therapy in patients with relapsing-remitting multiple sclerosis: a 15-year follow-up study

2010 ◽  
Vol 16 (5) ◽  
pp. 588-596 ◽  
Author(s):  
RA Bermel ◽  
B. Weinstock-Guttman ◽  
D. Bourdette ◽  
P. Foulds ◽  
X. You ◽  
...  
Keyword(s):  
Multiple Sclerosis ◽  
Interferon Beta ◽  
Short Form ◽  
Expanded Disability Status Scale ◽  
Short Form 36 ◽  
Disability Status ◽  
Scale Scores ◽  
Term Tolerability

Disease-modifying drugs are initiated early and continued for years in patients with multiple sclerosis. Long-term tolerability and impact are not known. The objective of this study was to evaluate long-term tolerability of intramuscular interferon beta-1a and effects on disability and quality of life. Patients were evaluated an average of 15 years after randomization into a placebo-controlled, double-blind trial of intramuscular interferon beta-1a for relapsing multiple sclerosis. Patient-reported Expanded Disability Status Scale, the Short Form-36, a visual analog scale of self-care independence, and a living situation questionnaire were administered. Status was ascertained in 79% (136/172) of eligible patients. Analysis focused on 122 living patients. Despite open-label, non-standardized treatment after the 2-year clinical trial, 46% ( n= 56) of the patients remained on intramuscular interferon beta-1a. Expanded Disability Status Scale scores were correlated highly with Short Form-36 subcategories and visual analog scale scores. Patients currently using intramuscular interferon beta-1a had a significantly lower mean Expanded Disability Status Scale score ( p= 0.011), less progression to Expanded Disability Status Scale milestones, significantly better scores on the physical component of the Short Form-36 ( p< 0.0001), and reported better general health and greater independence. We conclude that patients continuing to use intramuscular interferon beta-1a had less disability and better quality of life compared with patients not currently using intramuscular interferon beta-1a 15 years after randomization into a clinical trial.

scholarly journals Attention deficit hyperactivity disorder increases anxiety and depression in concussed college athletes

Neurology ◽  
2018 ◽  
Vol 91 (23 Supplement 1) ◽  
pp. S27.3-S28
Author(s):  
Gunn Brett Steven ◽  
Michael Kay Jacob James ◽  
Torres-McGehee Toni ◽  
Moore Davis
Keyword(s):  
South Carolina ◽  
State Anxiety ◽  
College Athletes ◽  
Depression Scale ◽  
Collegiate Athletes ◽  
Cumulative Effect ◽  
Management Program ◽  
Mean Difference ◽  
Anxiety And Depression ◽  
History Of

The purpose of this study was to compare symptom profiles of anxiety and depression in athletes with ADHD, a history of concussion, a history of concussion and ADHD, and controls. We hypothesized collegiate athletes with ADHD who experienced a concussion would report higher levels of anxiety and depression than other athletes. Nine hundred seventy nine NCAA Division-I college athletes at the University of South Carolina (USC) were surveyed as part of a larger performance health and wellness management program at USC. We acquired ADHD diagnoses, history of concussion, physician diagnosed concussions, State-Trait Anxiety Inventory (STA-I), and Center of Epidemiologic Studies Depression Scale (CES-D). Athletes were divided into 4 groups (1) ADHD with Concussion, (2) ADHD no concussion, (3) ADHD no concussion, and (4) No ADHD no concussion for comparison. State Anxiety scores were significantly higher in the ADHD with concussion group (42.1 ± 14.2) compared to all other groups (33.4 ± 8.9). Depression scores were also significantly higher for ADHD with concussion group (25.5 ± 10.2) than all other groups (16.3 ± 5.7). Tukey post hoc revealed both the anxiety mean difference of 8.4 (95% CI [0.68–6.2]) and depression mean difference of 9.7 (95% CI [4.2–15.1]) were statistically significant (p < 0.05). These findings suggest ADHD may have a cumulative effect on state anxiety and depression beyond that of either ADHD or concussion alone. Therefore, athletes with ADHD should receive extra care and management as they will likely experience more severe symptoms following injury.

scholarly journals Certified Athletic Trainers' Knowledge and Perceptions of Posttraumatic Osteoarthritis After Knee Injury

2017 ◽  
Vol 52 (6) ◽  
pp. 541-559 ◽  
Author(s):  
Brian Pietrosimone ◽  
J. Troy Blackburn ◽  
Yvonne M. Golightly ◽  
Matthew S. Harkey ◽  
Brittney A. Luc ◽  
...  
Keyword(s):  
Knee Injury ◽  
Athletic Trainers ◽  
Acl Injury ◽  
Acute Injury ◽  
Lower Percentage ◽  
Meniscal Injury ◽  
Posttraumatic Osteoarthritis ◽  
Knee Oa ◽  
Definition Of

Context:  Posttraumatic osteoarthritis (PTOA) is a specific phenotype of osteoarthritis (OA) that commonly develops after acute knee injury, such as anterior cruciate ligament (ACL) or meniscal injury (or both). Athletic trainers (ATs) are well positioned to educate patients and begin PTOA management during rehabilitation of the acute injury, yet it remains unknown if ATs currently prioritize long-term outcomes in patients with knee injury. Objective:  To investigate ATs' knowledge and perceptions of OA and its treatment after ACL injury, ACL reconstruction, or meniscal injury or surgery. Design:  Cross-sectional study. Patients or Other Participants:  An online survey was administered to 2000 randomly sampled certified ATs. We assessed participants' perceptions of knee OA, the risk of PTOA after ACL or meniscal injury or surgery, and therapeutic management of knee OA. Results:  Of the 437 ATs who responded (21.9%), the majority (84.7%) correctly identified the definition of OA, and 60.3% indicated that they were aware of PTOA. A high percentage of ATs selected full meniscectomy (98.9%), meniscal tear (95.4%), ACL injury (90.2%), and partial meniscectomy (90.1%) as injuries that would increase the risk of developing OA. Athletic trainers rated undertaking strategies to prevent OA development in patients after ACL injury or reconstruction (73.8%) or meniscal injury or surgery (74.7%) as extremely or somewhat important. Explaining the risk of OA to patients with an ACL or meniscal injury was considered appropriate by 98.8% and 96.8% of respondents, respectively; yet a lower percentage reported that they actually explained these risks to patients after an ACL (70.8%) or meniscal injury (80.6%). Conclusions:  Although 84.7% of ATs correctly identified the definition of OA, a lower percentage (60.3%) indicated awareness of PTOA. These results may reflect the need to guide ATs on how to educate patients regarding the long-term risks of ACL and meniscal injuries and how to implement strategies that may prevent PTOA.

Motion Preservation and Clinical Outcome of Porous Coated Motion Cervical Disk Arthroplasty

Neurosurgery ◽  
2012 ◽  
Vol 71 (1) ◽  
pp. 30-37 ◽  
Author(s):  
David Choi ◽  
Vladimir Petrik ◽  
Sally Fox ◽  
Joy Parkinson ◽  
Jake Timothy ◽  
...  
Keyword(s):  
Clinical Outcome ◽  
Neck Pain ◽  
Short Form ◽  
Neck Disability Index ◽  
Long Term Results ◽  
Short Form 36 ◽  
Neck Disability ◽  
Artificial Cervical Disk ◽  
Cervical Disk

Abstract BACKGROUND: Artificial cervical disk replacements are commonly used to treat radiculomyelopathy caused by degenerative disk disease. However, long-term disk mobility and an effect on adjacent segment disease have yet to be demonstrated. We report improvements in clinical outcome after disk replacement but also demonstrate potential limitations. OBJECTIVE: To review clinical and radiological outcomes after diskectomy and disk replacement with the Porous Coated Motion (PCM) artificial cervical disk. METHODS: A retrospective review was done of consecutive patients who underwent 1- or 2-level PCM disk replacements. The following criteria were studied: arm pain, neck pain, Neck Disability Index and Short Form-36 questionnaires, and flexion-extension radiographs up to 2 years after surgery. RESULTS: Eighty PCM artificial disks were implanted in 53 patients. Only 17 disks (21%) maintained physiological movement, and complete fusion was seen in 18.8%. One disk replacement was revised because of anterior displacement. There were no complications of infection, cerebrospinal fluid leak, dysphagia, or hoarse voice. Arm and neck pain improved significantly after diskectomy, but Neck Disability Index questionnaires demonstrated a slight improvement that was not sustained by 2 years. Short Form-36 scores demonstrated a trend toward better outcome with time, but it was significant only for the mental domain. CONCLUSION: Clinical improvement was seen after PCM disk replacement, but adequate range of movement was sustained in only 21% of disk replacements over time. Unclear long-term results of this and other disk replacements suggest caution in adopting these new devices as the gold standard.

Knee Osteoarthritis

2005 ◽  
Vol 10 (2) ◽  
pp. 1-3, 7, 12
Author(s):  
Christopher R. Brigham ◽  
Charles N. Brooks ◽  
James B. Talmage
Keyword(s):  
Knee Injury ◽  
Joint Space ◽  
Joint Surface ◽  
Knee Oa ◽  
Radiographic Measurements ◽  
Rate Of Progression ◽  
Potential Risk Factors ◽  
Data History ◽  
Physical Findings

Abstract More than 20 million Americans have osteoarthritis (OA), which affects the knee more often than any other joint and is the most common cause of long-term disability in persons older than 65 years. Knee OA is common, particularly in older patients and especially the obese. Knee injury, depending on the severity and type, can increase the risk of developing and the rate of progression of OA. In assessing impairment for knee OA, the evaluator must obtain a thorough history and physical examination and identify all potential risk factors. To opine that an injury caused OA, the evaluator should demonstrate that the traumatized knee shows significant arthritis but that the contralateral uninjured knee is radiographically normal; for an evaluator to suggest that pre-existing arthritis was aggravated, the involved knee should show significantly more advanced OA than the contralateral joint. Joint space widths (cartilage intervals) of both knees must be measured carefully on anteroposterior films obtained standing with a film-to-camera distance of 90 cm (36 in) and the beam at the level of and parallel to the joint surface. Taking into account all of the data (history, physical findings, and radiographic measurements from both the involved and contralateral joint), the rating physician can assess causation, estimate impairment, and apportion the latter to one or more etiologies.

scholarly journals Knee Osteoarthritis Is Associated With Previous Meniscus and Anterior Cruciate Ligament Surgery Among Elite College American Football Athletes

2016 ◽  
Vol 9 (3) ◽  
pp. 247-251 ◽  
Author(s):  
Matthew V. Smith ◽  
Jeffrey J. Nepple ◽  
Rick W. Wright ◽  
Matthew J. Matava ◽  
Robert H. Brophy
Keyword(s):  
Magnetic Resonance Imaging ◽  
Acl Reconstruction ◽  
Cruciate Ligament ◽  
Knee Injuries ◽  
Knee Surgery ◽  
Football Players ◽  
Resonance Imaging ◽  
Knee Oa ◽  
History Of ◽  
Anterior Cruciate

Background: Football puts athletes at risk for knee injuries such meniscus and anterior cruciate ligament (ACL) tears, which are associated with the development of osteoarthritis (OA). Previous knee surgery, player position, and body mass index (BMI) may be associated with knee OA. Hypothesis: In elite football players undergoing knee magnetic resonance imaging at the National Football League’s Invitational Combine, the prevalence of knee OA is associated with previous knee surgery and BMI. Study Design: Retrospective cohort. Level of Evidence: Level 4. Methods: A retrospective review was performed of all participants of the National Football League Combine from 2005 to 2009 who underwent magnetic resonance imaging of the knee because of prior knee injury, surgery, or knee-related symptoms or concerning examination findings. Imaging studies were reviewed for evidence of OA. History of previous knee surgery—including ACL reconstruction, meniscal procedures, and articular cartilage surgery—and position were recorded for each athlete. BMI was calculated based on height and weight. Results: There was a higher prevalence of OA in knees with a history of previous knee surgery (23% vs 4.0%, P < 0.001). The prevalence of knee OA was 4.0% in those without previous knee surgery, 11% in those with a history of meniscus repair, 24% of those with a history of ACL reconstruction, and 27% of those with a history of partial meniscectomy. Among knees with a previous ACL reconstruction, the rate of OA doubled in tibiofemoral compartments in which meniscal surgery was performed. BMI >30 kg/m2 was also associated with a higher risk of OA ( P = 0.007) but player position was not associated with knee OA. Conclusions: Previous knee surgery, particularly ACL reconstruction and partial meniscectomy, and elevated BMI are associated with knee OA in elite football players. Future research should investigate ways to minimize the risk of OA after knee surgery in these athletes. Clinical Relevance: Treatment of knee injuries in football athletes should consider chondroprotection, including meniscal preservation and cartilage repair, when possible.

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