Serum level of Adrenomedullin in patients with primary knee osteoarthritis; relation to disease severity

Abstract Background Adrenomedullin (AM) is a peptide which was suggested to be involved in the pathogenesis of osteoarthritis through its anti-inflammatory and anti-apoptotic effect. AM was found to be elevated in some inflammatory rheumatic diseases as rheumatoid arthritis and ankylosing spondylitis. The current study was performed to measure serum Adrenomodullin (AM) concentrations in patients with primary knee osteoarthritis (KOA) and to assess association with severity of the disease. The study was performed on 50 patients with primary KOA diagnosed according to American College of Rheumatology (ACR) Revised Criteria for Early Diagnosis of Knee Osteoarthritis and 20 age- and sex-matched controls with no clinical features of KOA. The Kellgren and Lawrence (KL) classification was used to evaluate the disease severity of knee OA. Disease activity was assessed by The Western Ontario and McMaster Universities Arthritis Index (WOMAC). Blood samples had been collected from patients with OA and controls for assessing Adrenomodullin in patients’ sera by ELISA. Results There were a significant increase in serum Adrenomedullin concentrations in KOA patients compared to controls (10.64 ±19.2 ng/ml vs. 1.39 ±1.6 ng/ml in cases and controls respectively) (p value = 0.036). There was positive significant correlation of serum Adrenomedullin levels with KL grades (r=0.608, p value <0.001). OA patients with VAS score >6 have significantly higher serum Adrenomedullin levels than OA patients with VAS Score <6. No detected significant correlation between any of (patients’ age, BMI, disease duration, tenderness score, and WOMAC score) with serum Adrenomedullin levels among studied OA cases (p values >0.05). Conclusion This study concluded that serum Adrenomedullin (AM) level is elevated in patients with KOA and is positively correlated with the severity of disease.

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The Effectiveness of Intra-Articular Injection of Hypertonic Saline in Pain Control and Function of Patients with Knee Osteoarthritis

Journal of Orthopedic and Spine Trauma ◽

10.18502/jost.v5i1.3320 ◽

2020 ◽

Author(s):

Behrouz Tavana ◽

Sirous Azizi ◽

Sharif Najafi ◽

Ensie Taftian ◽

Nastaran Maghbouli

Keyword(s):

Quality Of Life ◽

Knee Osteoarthritis ◽

Hypertonic Saline ◽

Pain Reduction ◽

Functional Improvement ◽

Obese Patients ◽

Knee Oa ◽

Vas Score ◽

American College Of Rheumatology

Background: The aim of this study was to report the effectiveness of intra-articular injection of hypertonic saline in pain reduction and functional improvement in patients with knee osteoarthritis (OA). Methods: Patients with knee pain and dysfunction who fulfilled the American College of Rheumatology criteria and whose illness was sub-acute or chronic were enrolled. We performed a single intra-articular injection of 5 cc of hypertonic (5%) saline solution. Measured outcomes were Visual Analogue Scale (VAS) score and Knee Injury and Osteoarthritis Outcome Score (KOOS) evaluated before and 1 month after intervention. Results: A total of 28 patients with mean age of 66.3 years were surveyed. Overall, study participants reported clinically and statistically significant reduction in VAS and KOOS subscales for symptoms, pain, function, daily living, sports, recreational activities, and quality of life in one month of follow-up with respect to the patients’ mean baseline scores (by 24.47%, 42.74%, 54.96%, 43.78%, and 63.63%, respectively). Although obese patients [body mass index (BMI) ≥ 30 kg/m2] showed less improvement in terms of pain, sports, and quality of life subscales of KOOS, compared with non-obese patients (BMI < 30 kg/m2); VAS score difference was not significant. Conclusion: Intra-articular injection of hypertonic saline yields a statistically and clinically significant short-term pain reduction and functional improvement of patients with knee OA.

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Effects of Glucosamine-Chondroitin Sulfate, Glucosamine-Chondroitin Sulfate-Methylsulfonylmethane, or Placebo in Patients with First and Second Grade of Knee Osteoarthritis

Orthopaedic Journal of Sports Medicine ◽

10.1177/2325967114s00216 ◽

2014 ◽

Vol 2 (11_suppl3) ◽

pp. 2325967114S0021

Author(s):

Erick Wonggokusuma ◽

Bambang Setyohadi ◽

Carles Siagian ◽

Andri M.T. Lubis

Keyword(s):

Placebo Group ◽

Knee Osteoarthritis ◽

Chondroitin Sulfate ◽

Womac Score ◽

Mean Difference ◽

Second Grade ◽

Controlled Clinical Trial ◽

Knee Oa ◽

Vas Score ◽

Significant Difference

Objectives: Combination of glucosamine-chondroitin sulfate is often prescribed for patients with first and second grade Kellgren-Lawrence osteoarthritis (OA). Numerous studies have reported significant efficacy of this supplement and also their combinations with methylsulfonylmethane (MSM) for the treatment of OA. However, controversies emerged regarding the effectiveness of these supplements. This current study evaluated the efficacy of glucosamine-chondroitin sulfate and glucosamine-chondroitin sulfate-MSM on improvement of patients with first and second grade knee OA. Methods: This study was a double blind, randomized controlled clinical trial on 147 patients with first and second grade (Kellgren-Lawrence) of knee OA. Subjects were allocated by permuted block randomization to three groups, either glucosamine-chondroitin sulfate (GC) (n=49), or glucosamine-chondroitin sulfate-MSM (GCM) (n=48), or placebo (n=50). The GC group received 1500 mg glucosamine + 1200 mg chondroitin sulfate + 500 mg saccharum lactis; GCM group received 1500 mg glucosamine + 1200 mg chondroitin sulfate + 500 mg MSM; while placebo group received three matching capsules of saccharum lactis. These drugs were administered once a day for three consecutive months. VAS and WOMAC score were measured at the baseline, then at 12th week after treatment. Data was analysed by using t-independent test. Results: At week 12, WOMAC score in placebo group was significantly higher than that in GCM group (mean difference 7.15, CI 12.06-2.23, p=0.005), and it was also higher in GC group compared to GCM group (mean difference 8.17, CI 13.49-2.84, p=0.003). Whereas VAS score at week 12 in placebo group was significantly higher compared to that in GC group (mean difference 0.18, CI 1.18-0.19, p=0.007) and to that in GCM group (mean difference 0.86, CI 1.37-0.35, p=0.001). However, there was no significant difference of WOMAC score at week 12 between placebo and GC groups (p=0.681), and of VAS score between GC and GCM groups (p=0.497). Conclusion: Combinations of glucosamine-chondroitin sulfate and glucosamine-chondroitin sulfate-MSM did not improve WOMAC and VAS scores in patients with grade I and II of knee osteoarthritis, when compared with placebo.

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AB0861 СURRENT PHARMACOTHERAPY FOR KNEE OSTEOARTHRITIS: SPECIFIC FEATURES OF SYMPTOMATIC AND DISEASE MODIFYING EFFECTS

Annals of the Rheumatic Diseases ◽

10.1136/annrheumdis-2020-eular.1160 ◽

2020 ◽

Vol 79 (Suppl 1) ◽

pp. 1738.1-1738

Author(s):

L. Denisov ◽

E. Tsvetkova ◽

N. Ionichenok ◽

A. Lila

Keyword(s):

Knee Osteoarthritis ◽

Symptomatic Improvement ◽

Visual Analogue Scale Pain ◽

Open Label ◽

Knee Oa ◽

American College Of Rheumatology ◽

Parallel Group ◽

Analogue Scale Pain ◽

Womac Questionnaire ◽

Kellgren And Lawrence

Objectives:to study the specific features of the symptomatic effect and tolerability of paracetamol (P), glucosamine sulfate (GS), chondroitin sulfate (CS), and meloxicam (M) in patients with knee osteoarthritis (OA).Methods:An 18-month open-label randomized prospective parallel-group trial enrolled 80 patients with knee OA who fulfilled the American College of Rheumatology criteria and signed the informed consent. They had Kellgren and Lawrence grades I-III OA with visual analogue scale pain intensity of > 40mm in the target knee, a body mass index of < 35 rg/m2, and no clinical dysfunctions of vital organs and systems. The patients were randomized into 4 groups: 1) P 2g daily; 2) a standard GS regimen; 3) a standard CS regimen; 4) M 15mg daily. The patients were followed up for 18 months, The effectiveness was evaluated by the WOMAC questionnaire, Lequesne index, and OMERACT-OARSI (D scenario) during 8 visits. Laboratory and clinical examination as well as electrocardiography were performed. Adverse events were recorded during each visit.Results:After 4 weeks of treatment, symptomatic improvement was noted in all groups; however, the best effect was achieved by the use of M and continued to the end of the study. The percentage of patients reacting to the therapy by the OMERACT-OARSI criteria was highest in M group (100%), reached 90% in GS, 85% in CS groups and 75% in P group. In the groups of P, GS and CS failed to respond to treatment 25, 10, and 15% correspondingly. However, medium narrowing of articular space (NAS) was measured at the end of the study and was significantly lower in GS group (-0.07; p=0,0002), CS (-0.1; p=0.004) and M (-0.06; p=0.006). Besides, the quota of patients without heavy NAS (> 0.5 mm in medial KJ) was the lowest in GS group as compared with three other groups.Conclusion:The results of this trial suggest that it is expedient to use GS, CS and M long, support the recent guidelines of the European Society for Clinical and Economic aspects of Osteoporosis and OA (ESCEO), and can give proofs of the efficiency and safety of GS, CS, and M used in the treatment of knee OA.Disclosure of Interests:None declared

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

Rheumatology ◽

10.1093/rheumatology/keaa111.124 ◽

2020 ◽

Vol 59 (Supplement_2) ◽

Author(s):

Michael A Clynes ◽

Faidra Laskou ◽

Mark H Edwards ◽

Cyrus Cooper ◽

Angela Taylor ◽

...

Keyword(s):

Knee Osteoarthritis ◽

Knee Pain ◽

Meniscal Tear ◽

Later Life ◽

Self Report ◽

P Value ◽

Knee Oa ◽

American College Of Rheumatology ◽

Increased Risk ◽

The Mean

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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Association between meniscal volume and development of knee osteoarthritis

Rheumatology ◽

10.1093/rheumatology/keaa522 ◽

2020 ◽

Author(s):

Dawei Xu ◽

Jan van der Voet ◽

Nils M Hansson ◽

Stefan Klein ◽

Edwin H G Oei ◽

...

Keyword(s):

Knee Osteoarthritis ◽

Primary Outcome ◽

Joint Space Narrowing ◽

Joint Space ◽

Primary Outcome Measure ◽

Obese Women ◽

Knee Oa ◽

Kellgren And Lawrence ◽

Over Time

Abstract Objective To assess the association between meniscal volume, its change over time and the development of knee OA after 30 months in overweight/obese women. Methods Data from the PRevention of knee Osteoarthritis in Overweight Females study were used. This cohort included 407 women with a BMI ≥ 27 kg/m2, free of OA-related symptoms. The primary outcome measure was incident OA after 30 months, defined by one out of the following criteria: medial or lateral joint space narrowing (JSN) ≥ 1.0 mm, incident radiographic OA [Kellgren and Lawrence (K&L) ≥ 2], or incident clinical OA. The secondary outcomes were either of these items separately. Menisci at both baseline and follow-up were automatically segmented to obtain meniscal volume and delta-volumes. Generalized estimating equations were used to evaluate associations between the volume measures and the outcomes. Results Medial and lateral baseline and delta-volumes were not significantly associated to the primary outcome. Lateral meniscal baseline volume was significantly associated to lateral JSN [odds ratio (OR) = 0.87; 95% CI: 0.75, 0.99], while other measures were not. Medial and lateral baseline volume were positively associated to K&L incidence (OR = 1.32 and 1.22; 95% CI: 1.15, 1.50 and 1.03, 1.45, respectively), while medial and lateral delta-volume were negatively associated to K&L incidence (OR = 0.998 and 0.997; 95% CI: 0.997, 1.000 and 0.996, 0.999, respectively). None of the meniscal measures were significantly associated to incident clinical OA. Conclusion Larger baseline meniscal volume and the decrease of meniscal volume over time were associated to the development of structural OA after 30 months in overweight and obese women.

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Status gizi berhubungan positif dengan derajat nyeri sendi penderita osteoartritis lutut

Jurnal Gizi Klinik Indonesia ◽

10.22146/ijcn.18210 ◽

2012 ◽

Vol 8 (3) ◽

pp. 144 ◽

Cited By ~ 1

Author(s):

Nyoman Kertia

Keyword(s):

Risk Factors ◽

Body Mass Index ◽

Knee Osteoarthritis ◽

Body Mass ◽

Joint Pain ◽

Cross Sectional Study ◽

Cross Sectional ◽

Knee Oa ◽

Vas Score ◽

Bivariate Correlation

Background: Knee osteoarthritis (OA) is a common disorder that is associated with significant morbidity, disability, and medical costs, particularly in its advanced stages. While the cause of knee OA remains unclear, it has been associated with various risk factors, such as age, sex, genetic predisposition, biomechanical, and obesity. Pain in osteoarthritis occurs due to combination of various factors. Pain significantly increases the medical and non medical cost in OA. Data showed that obesity will increase the mechanical stress and pain of knee OA. However, uncertainty remains regarding potential relationship between body mass index (BMI) and pain in osteoarthritis. Moreover, since obesity is one of modifiable and preventable risk factors for the onset and progression of the disease, it is important to know the correlation between BMI and severity of pain in knee OA.Objectives: To investigate the relationship between body mass index and severity of joint pain in knee osteoarthritis.Methods: A cross sectional study was conducted and subjects were osteoarthritis patients in rheumatology clinic of Sardjito general hospital. Body mass index and visual analogue scale (VAS) score were measured. Correlation between BMI and VAS score were analyzed by bivariate correlation test.Results: There were 80 patients with osteoarthritis who participated in the study. Mean BMI was 26.36 +4.23 kg/m2 and VAS score was 52.40+24.53 mm. The correlation test showed that there was a positive but non significant correlation between BMI and VAS scores (r = 0,11; p = 0,33).Conclusion: There was a positive but non significant correlation between body mass index and the severity of joint pain in knee osteoarthritis.

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T2 mapping evaluation of changes in cartilage matrix after PRP and HA injection therapy in knee osteoarthritis: a prospective, randomized, double blind, placebo controlled study

10.21203/rs.3.rs-36493/v1 ◽

2020 ◽

Author(s):

Matjaz Vogrin ◽

Jakob Naranda ◽

Mario Gorenjak ◽

Tomaz Bajec ◽

Domen Mongus ◽

...

Keyword(s):

Placebo Group ◽

Knee Osteoarthritis ◽

Pain Score ◽

T2 Mapping ◽

Womac Score ◽

Controlled Study ◽

Womac Pain ◽

Womac Pain Score ◽

Knee Oa

Abstract BackgroundIn this study we focused on evaluating the effect of intra-articular platelet-rich plasma (PRP) and hyaluronic acid (HA) on the qualitative and quantitative properties of the articular cartilage in patients with knee osteoarthritis (OA).MethodsWe evaluated 264 patients undergoing treatment of moderate knee OA. Patients aged between 40 and 70 years were included with articular K-L stage ≤ 2. Patients were randomized into three groups and treated with three doses of intra-articular PRP, HA, or placebo injection. Patients were evaluated clinically and by using T2 mapping.ResultsBoth PRP (619.05 ± 243 ms; p = 2.7 × 10− 5) and HA (637.12 ± 273 ms; p = 1.×10− 4) group showed statistically significant lower post-application T2 relaxation times in comparison to the placebo group (859.80 ± 406 ms).Cartilage thickness increased significantly after PRP (2.41±0.87 vs. 2.58±0.97 mm, p=0.033) and HA (2.28±0.81 vs. 2.80±1.00 mm, p=1.8×10) applications. There was a significant decrease in WOMAC pain score by 30% (p=0,001) and the overall WOMAC score by 27 p=1.9×10-4%) in PRP group. The decrease in WOMAC pain score and the overall WOMAC score in the placebo group was similar to the results observed in the PRP group. In the HA group a significant decrease in WOMAC pain score by 14% (p=0,005) was observed only at the first follow-up, whereas no difference was observed at the second follow-up. ConclusionsT2 mapping of cartilage tissue may aid to monitor its properties after the intra-articular therapies in knee OA. However, there is a discrepancy between clinical findings and the results of T2 mapping, suggesting questionable grounds for applying intra-articular therapy.

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Intra-Articular Hybrid Hyaluronic Acid Injection Treatment in Overweight Patients with Knee Osteoarthritis: A Single-Center, Open-Label, Prospective Study

Applied Sciences ◽

10.3390/app11188711 ◽

2021 ◽

Vol 11 (18) ◽

pp. 8711

Author(s):

Dalila Scaturro ◽

Fabio Vitagliani ◽

Pietro Terrana ◽

Daniele Cuntrera ◽

Vincenzo Falco ◽

...

Keyword(s):

Quality Of Life ◽

Hyaluronic Acid ◽

Knee Osteoarthritis ◽

Disease Severity ◽

Prospective Trial ◽

Open Label ◽

Knee Oa ◽

Symptomatic Knee ◽

Significant Difference

Background: A BMI > 25 is the most decisive, albeit modifiable, risk factor for knee osteoarthritis (KOA). This study aimed at assessing the efficacy of intra-articular injections of hybrid hyaluronic acid (HA) complexes (Sinovial® H-L) for the treatment of KOA in overweight patients in terms of disease severity, cardiocirculatory capacity, and quality of life. Materials: In this single-site, open-label, prospective trial, 37 patients with symptomatic knee OA were assessed at baseline and 3 months after ultrasound-guided intra-articular injection of hybrid HA complexes (Sinovial® H-L). Results: Primary variables displaying a statistically significant improvement after treatment were pain (VAS), disease severity (WOMAC), and cardiopulmonary capacity (6 min walk test). Among secondary variables, quality of life (SF-12) improved significantly, as did analgesic intake for pain control. No statistically significant difference was observed in body fat and muscle mass percentage measured by bioelectrical impedance analysis. Conclusions: Intra-articular hybrid HA injections are significantly effective in improving OA-related disease severity, cardiopulmonary function, and analgesic intake. This supports the role of hybrid HA viscosupplementation as a nonpharmacological treatment to relieve pain, reduce disability, improve quality of life, and limit the risk of polypharmacy in overweight patients with knee OA.

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HIERARCHICAL ANALYSIS AND CLASSIFICATION OF ASYMPTOMATIC AND KNEE OSTEOARTHRITIS GAIT PATTERNS USING A WAVELET REPRESENTATION OF KINETIC DATA AND THE NEAREST NEIGHBOR CLASSIFIER

Journal of Mechanics in Medicine and Biology ◽

10.1142/s0219519408002474 ◽

2008 ◽

Vol 08 (01) ◽

pp. 45-54 ◽

Cited By ~ 5

Author(s):

NEILA MEZGHANI ◽

KARINE BOIVIN ◽

KATIA TURCOT ◽

RACHID AISSAOUI ◽

NICOLA HAGMEISTER ◽

...

Keyword(s):

Knee Osteoarthritis ◽

Nearest Neighbor ◽

Reaction Force ◽

Hierarchical Classification ◽

Gait Patterns ◽

Knee Oa ◽

Nearest Neighbor Rule ◽

Kellgren And Lawrence ◽

Using Data

The purpose of this study is twofold: (1) to develop a classification method to distinguish between asymptomatic (AS) and knee osteoarthritis (OA) gait patterns using ground reaction force (GRF) measurements, and (2) to investigate OA severity within OA gait patterns. Features were first extracted from the GRF vectors to be used for classification. We investigated a two-level hierarchical classification and analysis method using the nearest neighbor rule. At the first level, the GRF data were classified into two classes: AS and OA. At the second level, the GRF data of OA patients were classified according to the pathology severity. The OA patients were grouped into two OA severity categories according to the Kellgren and Lawrence (KL) scale: KL 1 and KL 2 for one category, and KL 3 and KL 4 for the other. Experiments were conducted using data of 42 cases, 16 AS and 26 pathological. The method discriminated between AS and OA subjects with an accuracy of 38 of 42 cases, and assessed the severity correctly with an accuracy of 20 of 26 cases. These results demonstrated the validity of both, the feature and the classifier, for automatic classification of AS and knee OA gait patterns and for analysis of OA severity.

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Differences in quality of life between patients with severe hip and knee osteoarthritis

Vojnosanitetski pregled ◽

10.2298/vsp150502317j ◽

2018 ◽

Vol 75 (1) ◽

pp. 62-67

Author(s):

Slavica Jandric

Keyword(s):

Quality Of Life ◽

Diabetes Mellitus ◽

Knee Osteoarthritis ◽

Physical Function ◽

Statistical Significance ◽

Womac Score ◽

Linear Regression Models ◽

Cross Sectional ◽

Knee Oa

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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