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1.
Bone Joint J ; 102-B(3): 345-351, 2020 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-32114814

RESUMEN

AIMS: Tibiotalocalcaneal (TTC) fusion is used to treat a variety of conditions affecting the ankle and subtalar joint, including osteoarthritis (OA), Charcot arthropathy, avascular necrosis (AVN) of the talus, failed total ankle arthroplasty, and severe deformity. The prevalence of postoperative complications remains high due to the complexity of hindfoot disease seen in these patients. The aim of this study was to analyze the relationship between preoperative conditions and postoperative complications in order to predict the outcome following primary TTC fusion. METHODS: We retrospectively reviewed the medical records of 101 patients who underwent TTC fusion at the same institution between 2011 and 2019. Risk ratios (RRs) associated with age, sex, diabetes, cardiovascular disease, smoking, preoperative ankle deformity, and the use of bone graft during surgery were related to the postoperative complications. We determined from these data which pre- and perioperative factors significantly affected the outcome. RESULTS: Out of the 101 patients included in the study, 29 (28.7%) had nonunion, five (4.9%) required below-knee amputation (BKA), 40 (39.6%) returned to the operating theatre, 16 (15.8%) had hardware failure, and 22 (21.8%) had a postoperative infection. Patients with a preoperative diagnosis of Charcot arthropathy and non-traumatic OA had significantly higher nonunion rates of 44.4% (12 patients) and 39.1% (18 patients) (p = 0.016) and infection rates of 29.6% (eight patients) and 37% (17 patients) compared to patients with traumatic arthritis, respectively (p = 0.002). There was a significantly increased rate of nonunion in diabetic patients (RR 2.22; p = 0.010). Patients with chronic kidney disease were 2.37-times more likely to have a nonunion (p = 0.006). Patients aged over 60 years had more than a three-fold increase in the rate of postoperative infection (RR 3.60; p = 0.006). The use of bone graft appeared to be significantly protective against postoperative infection (p = 0.019). CONCLUSION: We were able to confirm, in the largest series of TTC ankle fusions currently in the literature, that there remains a high rate of complications following this procedure. We found that patients with a Charcot or non-traumatic arthropathy had an increased risk of nonunion and postoperative infection compared to individuals with traumatic arthritis. Those with diabetes, chronic kidney disease, or aged over 60 years had an increased risk of nonunion. These findings help to confirm those of previous studies. Additionally, our study adds to the literature by showing that autologous bone graft may help in decreasing infection rates. These data can be useful to surgeons and patients when considering, discussing and planning TTC fusion. It helps surgeons further understand which patients are at a higher risk for postoperative complications when undergoing TTC fusion. Cite this article: Bone Joint J. 2020;102-B(3):345-351.


Asunto(s)
Articulación del Tobillo/cirugía , Artrodesis/métodos , Osteoartritis/cirugía , Articulación Talocalcánea/cirugía , Tibia/cirugía , Articulación del Tobillo/diagnóstico por imagen , Femenino , Estudios de Seguimiento , Humanos , Incidencia , Masculino , Persona de Mediana Edad , Osteoartritis/diagnóstico , Complicaciones Posoperatorias/epidemiología , Radiografía , Estudios Retrospectivos , Factores de Riesgo , Articulación Talocalcánea/diagnóstico por imagen , Tibia/diagnóstico por imagen , Resultado del Tratamiento , Estados Unidos/epidemiología
2.
Bone Joint J ; 102-B(3): 365-370, 2020 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-32114820

RESUMEN

AIMS: Patient-specific instrumentation has been shown to increase a surgeon's precision and accuracy in placing the glenoid component in shoulder arthroplasty. There is, however, little available information about the use of patient-specific planning (PSP) tools for this operation. It is not known how these tools alter the decision-making patterns of shoulder surgeons. The aim of this study was to investigate whether PSP, when compared with the use of plain radiographs or select static CT images, influences the understanding of glenoid pathology and surgical planning. METHODS: A case-based survey presented surgeons with a patient's history, physical examination, and, sequentially, radiographs, select static CT images, and PSP with a 3D imaging program. For each imaging modality, the surgeons were asked to identify the Walch classification of the glenoid and to propose the surgical treatment. The participating surgeons were grouped according to the annual volume of shoulder arthroplasties that they undertook, and responses were compared with the recommendations of two experts. RESULTS: A total of 59 surgeons completed the survey. For all surgeons, the use of the PSP significantly increased agreement with the experts in glenoid classification (x2 = 8.54; p = 0.014) and surgical planning (x2 = 37.91; p < 0.001). The additional information provided by the PSP also showed a significantly higher impact on surgical decision-making for surgeons who undertake fewer than ten shoulder arthroplasties annually (p = 0.017). CONCLUSIONS: The information provided by PSP has the greatest impact on the surgical decision-making of low volume surgeons (those who perform fewer than ten shoulder arthroplasties annually), and PSP brings all surgeons in to closer agreement with the recommendations of experts for glenoid classification and surgical planning. Cite this article: Bone Joint J 2020;102-B(3):365-370.


Asunto(s)
Artroplastía de Reemplazo de Hombro/métodos , Toma de Decisiones , Imagen Tridimensional , Osteoartritis/cirugía , Articulación del Hombro/cirugía , Cirugía Asistida por Computador/métodos , Tomografía Computarizada por Rayos X/métodos , Adulto , Femenino , Humanos , Masculino , Persona de Mediana Edad , Osteoartritis/diagnóstico , Articulación del Hombro/diagnóstico por imagen
3.
Med Clin North Am ; 104(2): 293-311, 2020 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-32035570

RESUMEN

Osteoarthritis (OA) is a worldwide endemic and debilitating disease. Previously thought to simply be damaged from "wear and tear," OA is now understood to be a complex interaction of local and systemic factors. This article reviews the pathology, symptoms, diagnosis, and various conservative, surgical, and novel treatments of OA.


Asunto(s)
Osteoartritis , Manejo de Atención al Paciente/métodos , Humanos , Osteoartritis/diagnóstico , Osteoartritis/fisiopatología , Osteoartritis/terapia
4.
Arthritis Care Res (Hoboken) ; 72(2): 193-200, 2020 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-31479193

RESUMEN

OBJECTIVE: Osteoarthritis (OA) is a major reason for chronic pain, stiffness, and functional limitation. This study was undertaken to analyze factors associated with the burden of OA, taking the pattern of joint involvement into account. METHODS: From a random sample of 8,995 patients with OA (International Statistical Classification of Diseases and Related Health Problems, Tenth Revision, German Modification codes M15 [polyarticular], M16 [hip], or M17 [knee]) from a German statutory health insurance database, 3,564 patients completed a survey including the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC). Patients with knee, hip, concomitant hip and knee, or polyarticular manifestation were compared concerning pain, stiffness, function, and impact on work and personal life. Data were linked to dispensation records. The association of age, sex, body mass index (BMI), symptom duration, and the World Health Organization-5 Well-Being Index (WHO-5) with WOMAC results was assessed in multiple linear regression models. RESULTS: Patients with knee (n = 1,448), hip (n = 959), hip and knee (n = 399), or polyarthritic (n = 758) OA were included. Concomitant hip and knee OA was accompanied by the highest WOMAC values (mean 44), frequent impairment of personal life (75%), and the highest use of analgesics (52% nonsteroidal antiinflammatory drugs, 22% opioids, and 37% others). In the regression analyses, BMI per 5 units and WHO-5 per 10% worsening were associated with an increase in WOMAC values of 4-5 points, irrespective of the joint manifestations. CONCLUSION: Disease burden is high in patients with concomitant hip and knee OA and is connected with frequent prescription of analgesics. Involvement of several joints, BMI, and depressive symptoms need to be considered when using the WOMAC as an outcome instrument.


Asunto(s)
Costo de Enfermedad , Bases de Datos Factuales/tendencias , Revisión de Utilización de Seguros/tendencias , Osteoartritis/diagnóstico , Osteoartritis/epidemiología , Adulto , Anciano , Estudios Transversales , Femenino , Alemania/epidemiología , Humanos , Masculino , Persona de Mediana Edad , Distribución Aleatoria
5.
Equine Vet J ; 52(1): 46-51, 2020 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-30900769

RESUMEN

BACKGROUND: Reliable and validated biomarkers for osteoarthritis (OA) are currently lacking. OBJECTIVES: To develop an accurate and minimally invasive method to assess OA-affected horses and provide potential spectral markers indicative of disease. STUDY DESIGN: Observational, cross-sectional study. METHODS: Our cohort consisted of 15 horses with OA and 48 without clinical signs of the disease, which were used as controls. Attenuated total reflection Fourier-transform infrared (ATR-FTIR) spectroscopy was used to investigate serum samples (50 µL) collected from these horses. Spectral processing and multivariate analysis revealed differences and similarities, allowing for detection of spectral biomarkers that discriminated between the two cohorts. A supervised classification algorithm, namely principal component analysis coupled with quadratic discriminant analysis (PCA-QDA), was applied to evaluate the diagnostic accuracy. RESULTS: Segregation between the two different cohorts, OA-affected and controls, was achieved with 100% sensitivity and specificity. The six most discriminatory peaks were attributed to proteins and lipids. Four of the spectral peaks were elevated in OA horses, which could be potentially due to an increase in lipids, protein expression levels and collagen, all of which have been previously reported in OA. Two peaks were found decreased and were tentatively assigned to the reduction of proteoglycan content that is observed during OA. MAIN LIMITATIONS: The control group had a wide range of ages and breeds. Presymptomatic OA cases were not included. Therefore, it remains unknown whether this test could also be used as an early diagnostic tool. CONCLUSIONS: This spectrochemical approach could provide an accurate and cost-effective blood test, facilitating point-of-care diagnosis of equine OA.


Asunto(s)
Enfermedades de los Caballos/diagnóstico , Osteoartritis/veterinaria , Espectroscopía Infrarroja por Transformada de Fourier/veterinaria , Animales , Estudios Transversales , Enfermedades de los Caballos/sangre , Caballos , Osteoartritis/sangre , Osteoartritis/diagnóstico , Espectroscopía Infrarroja por Transformada de Fourier/métodos
6.
Medicine (Baltimore) ; 98(50): e18318, 2019 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-31852118

RESUMEN

BACKGROUND: Osteoarthritis (OA) is a major degenerative disease that affects the elderly. The global prevalence of OA is increasing annually. However, current treatments are unable to halt the progress of OA. At present, pharmacological treatments such as non-steroidal anti-inflammatory drugs (NSAIDs) and cyclooxygenase-2 (COX-2) inhibitors control the pain; however, there may be side effects to these medications. We hypothesized that Cortex Eucommiae (CE; Eucommia ulmoides Oliver) extract, which is used as a dietary supplement, may slow down or prevent OA. METHODS: This is a protocol for a 12-week, multicenter, randomized, double-blind, placebo-controlled, parallel-group study to evaluate the efficacy and safety of CE extract in subjects with mild OA. One-hundred subjects with mild OA will be recruited and randomly divided in a 1:1 ratio into 2 groups. One group will receive CE extract for 12 weeks and the other group will receive placebo for 12 weeks. Outcomes will be evaluated by using the visual analog scale (VAS), Korean-Western Ontario and McMaster Universities index (K-WOMAC), Korean-Short Form health survey-36 score (KSF-36), and laboratory test results. DISCUSSION: This clinical trial is expected to provide evidence of the efficacy and safety of CE extract as a treatment for mild OA. TRIAL REGISTRATION: Clinical Trials.gov NCT03744611, registered on November 12, 2018, at https://clinicaltrials.gov/ct2/show/NCT03744611.


Asunto(s)
Eucommiaceae , Articulaciones/diagnóstico por imagen , Osteoartritis/tratamiento farmacológico , Extractos Vegetales/uso terapéutico , Rango del Movimiento Articular/fisiología , Adulto , Anciano , Método Doble Ciego , Femenino , Estudios de Seguimiento , Humanos , Articulaciones/fisiopatología , Masculino , Persona de Mediana Edad , Osteoartritis/diagnóstico , Osteoartritis/fisiopatología , Radiografía , Índice de Severidad de la Enfermedad , Factores de Tiempo , Resultado del Tratamiento
7.
Pediatrics ; 144(6)2019 12.
Artículo en Inglés | MEDLINE | ID: mdl-31722963

RESUMEN

OBJECTIVES: In this study, we aimed to contrast the bacteriologic epidemiology of osteoarticular infections (OAIs) between 2 patient groups in successive 10-year periods, before and after the extensive use of nucleic acid amplification assays in the diagnostic process. METHODS: Epidemiologic data and bacteriologic etiologies of all children presenting with OAIs on admission to our institution over 20 years (1997-2016) were assessed retrospectively. The population was divided into 2 cohorts, using the standardized use of polymerase chain reaction as the cutoff point (2007). The conventional cohort included children with OAIs mainly investigated by using classic cultures, whereas the molecular cohort referred to patients also investigated by using molecular assays. RESULTS: Kingella kingae was the most frequently isolated pathogen, responsible for 51% of OAIs, whereas other classic pathogens were responsible for 39.7% of cases in the molecular cohort. A statistically significant increase in the mean incidence of OAIs was observed, as was a decrease in the mean age at diagnosis after 2007. After 2007, the pathogen remained unidentified in 21.6% of OAIs in our pediatric population. CONCLUSIONS: Extensive use of nucleic acid amplification assays improved the detection of fastidious pathogens and has increased the observed incidence of OAI, especially in children aged between 6 and 48 months. We propose the incorporation of polymerase chain reaction assays into modern diagnostic algorithms for OAIs to better identify the bacteriologic etiology of OAIs.


Asunto(s)
Artritis Infecciosa/diagnóstico , Kingella kingae/aislamiento & purificación , Infecciones por Neisseriaceae/diagnóstico , Osteoartritis/diagnóstico , Osteomielitis/diagnóstico , Adolescente , Artritis Infecciosa/genética , Niño , Preescolar , Estudios de Cohortes , Femenino , Humanos , Lactante , Recién Nacido , Kingella kingae/genética , Masculino , Infecciones por Neisseriaceae/genética , Osteoartritis/genética , Osteomielitis/genética , Reacción en Cadena en Tiempo Real de la Polimerasa/métodos , Estudios Retrospectivos
8.
Acta Clin Croat ; 58(Suppl 1): 82-89, 2019 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-31741564

RESUMEN

The concept of diagnostics and therapy of musculoskeletal and neuropathic diseases of the stomatognathic system, which are the subject of this paper, has been developing for decades. It can be said that in order to avoid misunderstanding, the orofacial pain as a clinical problem, in the narrower sense, involves non-odontogenic and non-malignant causes of orofacial region. In this study, the results of clinical diagnosis of the population of 557 consecutive patients with orofacial pain based on multidisciplinary diagnostics were evaluated. 15.6% of patients have given up on the participation in the study. It has been shown that the patients who dropped out of the study were significantly older (p=0.0411) than those who agreed to participate, but there was no difference in gender ratio (p=0.185) since the proportion of female patients prevailed. In an analysis of 84.4% of patients participating in the study, the elevated anxiety values were established (mean value on STAI 1 was 39.2 and STAI 2 was 41.1) and statistical significance was found in correlation between elevated anxiety and intensity of pain as shown on visual analogue scale on open mouth (p<0.0001). Compared to the age, the statistical significance was for STAI 1 (p=0.0097) but not for STAI 2 (p=0.5599). The most common form of therapy is Michigan stabilization splint: for disc displacement of temporomandibular joint (TMJ) in 38.9% of patients and in combination with physiotherapy in 18.7% of patients; for osteoarthritis of TMJ in 28.4% and in combination with physiotherapy in 26.4% of patients. The treatment with anticonvulsant drugs for trigeminal neuralgia predominates in 54.3% of patients, which is combined with acupuncture in 25.7% of patients and only acupuncture in 17.1% of patients. In this study, a multidisciplinary co-operation in initial diagnostics and differential was designed to develop subspecialist knowledge on orofacial pain.


Asunto(s)
Dolor Facial/terapia , Osteoartritis/cirugía , Trastornos de la Articulación Temporomandibular/cirugía , Neuralgia del Trigémino/terapia , Terapia por Acupuntura , Adolescente , Adulto , Anciano , Anciano de 80 o más Años , Ansiedad/etiología , Niño , Dolor Facial/etiología , Dolor Facial/psicología , Femenino , Humanos , Masculino , Persona de Mediana Edad , Osteoartritis/complicaciones , Osteoartritis/diagnóstico , Dimensión del Dolor , Modalidades de Fisioterapia , Articulación Temporomandibular , Trastornos de la Articulación Temporomandibular/complicaciones , Trastornos de la Articulación Temporomandibular/diagnóstico , Neuralgia del Trigémino/complicaciones , Neuralgia del Trigémino/diagnóstico , Adulto Joven
9.
Clin Exp Rheumatol ; 37 Suppl 120(5): 18-23, 2019.
Artículo en Inglés | MEDLINE | ID: mdl-31621564

RESUMEN

Modern medical care is based largely on a paradigm known as a "biomedical model," in which "objective," high-technology biomarkers guide clinical care, and most health outcomes are determined by health professionals rather than individuals, using drugs as the primary therapy. The biomedical model is spectacularly effective in the acute care inpatient hospital, the setting for 95% of medical education and training, and to guide management of many chronic diseases, such as hypertension and diabetes, for which a "gold standard" biomarker is a major determinant of clinical decisions. This model also has contributed importantly to knowledge of biomarkers, biochemical and structural abnormalities in osteoarthritis (OA) and other rheumatic diseases. However, a biomedical model has many limitations in understanding the long-term course of OA and many chronic diseases in outpatient medicine, the setting of 95% of activities that determine long-term health outcomes. Patient self-report questionnaires provide the most informative data concerning OA patient status and changes in status, and more significant data in the prognosis of outcomes such as mortality than laboratory or radiographic measures. Furthermore, the incidence, prevalence, morbidity, and mortality of OA is considerably greater in individuals of low versus high socioeconomic status. These associations are not unique to OA, and are seen in many diseases, including comorbid conditions which are the acute causes of death in OA. Associations of low socioeconomic and poor health are explained only in small part by limited access to medical services, the conventional explanation. Strong evidence suggests that socioeconomic status is a surrogate marker for patient self-management, actions and environment, in addition to actions of health professionals, in the pathogenesis, course and outcomes of chronic diseases. These observations suggest the value of a complementary "biopsychosocial model" to better understand pathogenesis, principles of treatments, and outcomes in OA and other chronic diseases. Inclusion of clinical information from patient questionnaires and socioeconomic status variables in clinical and research settings could add new understanding of biomarkers and pain in OA for both basic and clinical investigators. Furthermore, the data indicate that poor physical function assessed on a self-report questionnaire might be regarded as an important reversible risk factor in public health and research agendas, for which the OA community might be strong advocates.


Asunto(s)
Osteoartritis , Enfermedad Crónica , Comorbilidad , Humanos , Modelos Teóricos , Osteoartritis/diagnóstico , Osteoartritis/epidemiología , Factores de Riesgo , Autoinforme , Clase Social , Encuestas y Cuestionarios
10.
Rev Prat ; 69(5): 502-504, 2019 May.
Artículo en Francés | MEDLINE | ID: mdl-31626451

RESUMEN

Osteoarthritis (OA), the most common osteoarticular disease, is a all joint disease. It affects several joint (spine, knee, hip, hands) that are subject to different degrees of mechanical stress. As well, the clinical forms of OA could differ significantly from one subject to another: some could have mono or polyarticular, erosive hand OA or recurrent effusion while we do not know what governs these different clinical presentations. We now consider the pathophysiology of OA according to the patient's risk factors because we know that they involve different pathogenic mechanisms. Thus, four major clinical phenotypes are defined based on risk factors which are age, trauma, obesity/ metabolic syndrome, and family history. Osteoarthritis is therefore a much more complex disease than it has been thought for a long time. The lack of efficient therapeutic may be due in part to the lack of knowledge of these different phenotypes that are always all grouped together in studies. It is therefore necessary to better characterize the different OA to meet the growing needs of care.


Asunto(s)
Obesidad/complicaciones , Osteoartritis/clasificación , Osteoartritis/diagnóstico , Diagnóstico Diferencial , Articulaciones de la Mano/patología , Humanos , Articulación de la Rodilla/patología , Osteoartritis de la Cadera , Osteoartritis de la Rodilla , Factores de Riesgo
12.
J Craniofac Surg ; 30(7): 2082-2084, 2019 Oct.
Artículo en Inglés | MEDLINE | ID: mdl-31574782

RESUMEN

BACKGROUND: To evaluate whether genetic polymorphisms in FGF3, FGF10, and FGF13 are associated with temporomandibular disorders (TMD) in patients that presented dentofacial deformities requiring orthognathic surgery. MATERIAL AND METHODS: The sample comprised a total of 113 patients of both sexes. The diagnosis of TMD was performed before orthognathic surgery between Research Diagnostic Criteria for Temporomandibular Disorders (RDC-TMD). According to the TMD assessment, the patients were divided into 3 major groups: myofascial pain, articular disc displacements and other TMD conditions (arthralgia, arthritis, and arthrosis). Genomic DNA was collected from saliva samples and genetic polymorphisms in FGF3 (rs1893047 and rs7932320), FGF10 (rs900379) and FGF13 (rs5931572 and rs5974804) were analyzed by real-time polymerase chain reactions. The association between the TMD conditions and the genetic polymorphisms assessed were analyzed by Poisson Regression. The model was calculated on bivariate and adjusted by sex. The established alpha was 5%. Data were analyzed by using SPSS software (IBM, Armonk, NY). RESULTS: The genetic polymorphisms rs7932320 in FGF3 (P < 0.001) and rs900379 in FGF10 (P < 0.05) were associated with the presence of muscle disorder. The genetic polymorphisms rs1893047 in FGF3, rs900379 in FGF10, and rs5974804 and rs5931572 in FGF13, were associated with the presence of disk displacement (P < 0.05). The genetic polymorphisms rs1893047 and rs7932320 in FGF3, rs900379 in FGF10, and rs900379 in FGF10 were associated with other TMD conditions (P < 0.05). CONCLUSION: Genetic polymorphisms in FGF3, FGF10, and FGF13 genes were associated with temporomandibular disorders in a population with dentofacial deformities.


Asunto(s)
Factor 10 de Crecimiento de Fibroblastos/genética , Factor 3 de Crecimiento de Fibroblastos/genética , Factores de Crecimiento de Fibroblastos/genética , Polimorfismo Genético , Trastornos de la Articulación Temporomandibular/genética , Adolescente , Adulto , Artralgia , Artritis , Femenino , Humanos , Masculino , Persona de Mediana Edad , Cirugía Ortognática , Procedimientos Quirúrgicos Ortognáticos , Osteoartritis/diagnóstico , Encuestas y Cuestionarios , Trastornos de la Articulación Temporomandibular/diagnóstico , Trastornos de la Articulación Temporomandibular/cirugía , Adulto Joven
13.
Vet J ; 252: 105355, 2019 Oct.
Artículo en Inglés | MEDLINE | ID: mdl-31554587

RESUMEN

Accelerometer measurements are frequently reported as total weekly activity counts (AC). Methods of utilizing activity parameters to allow differentiation of activity intensities (i.e., manually derived cut-points) have been described. While this information may provide valuable data for researchers, only few investigators have utilized these methods. This may, in part, be due to the challenge associated with data processing. Some devices, however, generate activity intensity data automatically. This study was conducted to evaluate a novel accelerometer that allows for remote download of data via Wi-Fi (Heyrex), to compare automatically generated parameters quantifying activity levels to previously established cut-points (Actical) and to describe the variability of accelerometer data in dogs with osteoarthritis. Twelve client-owned dogs with osteoarthritis were fitted with a collar with two accelerometers (Heyrex and Actical). Accelerometer data were recorded for 28 days. Pearson bivariate correlations and coefficient of variation (CV%) were calculated for accelerometer data. There was a strong correlation between the AC reported by Heyrex and Actical devices. Several automatically generated parameters showed strong correlations to previously validated cut-points and displayed lower CV% than weekly AC. The activity intensity derived from the Heyrex was associated with the lowest CV% of all parameters from both accelerometers. Automatically generated activity intensity parameters should be considered as potential outcome measures in clinical trials for dogs with osteoarthritis. This novel technology may allow for convenient acquisition of activity intensity data in companion animals. However, technical difficulties (e.g., lack of Wi-Fi connectivity) may pose challenges when using this novel device.


Asunto(s)
Acelerometría/veterinaria , Enfermedades de los Perros/diagnóstico , Actividad Motora , Osteoartritis/veterinaria , Acelerometría/instrumentación , Animales , Ensayos Clínicos como Asunto , Enfermedades de los Perros/fisiopatología , Perros , Femenino , Masculino , Osteoartritis/diagnóstico , Reproducibilidad de los Resultados
14.
J Orthop Surg Res ; 14(1): 247, 2019 Aug 06.
Artículo en Inglés | MEDLINE | ID: mdl-31387631

RESUMEN

PURPOSE: MIR4435-2HG is an oncogenic lncRNA in gastric cancer and lung cancer. Our preliminary microarray data showed that MIR4435-2HG was downregulated in osteoarthritis plasma specimen, indicating the possible involvement of MIR4435-2HG in osteoarthritis. RESULTS: MIR4435-2HG was downregulated in plasma of osteoarthritis than in plasma of healthy controls. Reduced levels of MIR4435-2HG expression effectively distinguished osteoarthritis patients from the control group. Expression levels of MIR4435-2HG increased after treatment. Overexpression of MIR4435-2HG promoted, while MIR4435-2HG knockdown inhibited the proliferation of chondrocytes. In contrast, MIR4435-2HG overexpression inhibited, while MIR4435-2HG knockdown promoted the apoptosis of chondrocytes. CONCLUSION: MIR4435-2HG is downregulated in osteoarthritis and regulates chondrocyte cell proliferation and apoptosis.


Asunto(s)
Apoptosis/fisiología , Condrocitos/metabolismo , Regulación hacia Abajo/fisiología , MicroARNs/sangre , Osteoartritis/sangre , ARN Largo no Codificante/sangre , Anciano , Biomarcadores/sangre , Línea Celular , Femenino , Humanos , Masculino , Persona de Mediana Edad , Osteoartritis/diagnóstico
15.
Clin Lab ; 65(8)2019 Aug 01.
Artículo en Inglés | MEDLINE | ID: mdl-31414759

RESUMEN

BACKGROUND: The current study aims to verify the abnormal expression of miR-29b-3p in peripheral blood mono-nuclear cells and synovial fluid of patients with osteoarthritis (OA), and to explore whether this abnormality is related to the severity of OA. METHODS: The level of miR-29b-3p was detected by real-time quantitative PCR in peripheral blood mononuclear cells (PBMCs) and joint fluid. Kellgren-Lawrence X-ray grading was performed in patients with OA, and the correlation between miR-29b-3p and age, weight and Kellgren-Lawrence X-ray grading was analyzed. RESULTS: The expression of miR-29b-3p in PBMCs of patients with OA was higher than that of the healthy control group ((4.48 ± 2.44) vs. (7.40 ± 4.10), p < 0.05), and the difference was statistically significant. In the synovial fluid of OA patients, the expression of miR-29b-3p was higher than that of the non-OA group ((4.90 ± 2.33) vs. (77.55 ± 2.79), p < 0.05), and the difference was statistically significant. Meanwhile, the relative expression of miR-29b-3p in PBMCs of patients with OA was positively correlated with age, body mass index (BMI), Kellgren-Lawrence X-ray classification (r = 0.896, p < 0.001; r = 0.880, p < 0.001; r = 0.357, p = 0.005). CONCLUSIONS: The high expression of miR-29b-3p in PBMCs and synovial fluid of patients with OA was positively correlated with age, body mass index and Kellgren-Lawrence X-ray classification. Therefore, miR-29b-3p may be involved in the pathogenesis of OA, and miR-29b-3p may be used as a potential biomarker for OA.


Asunto(s)
Biomarcadores/metabolismo , Leucocitos Mononucleares/metabolismo , MicroARNs/genética , Osteoartritis/genética , Líquido Sinovial/metabolismo , Adulto , Anciano , Índice de Masa Corporal , Células Cultivadas , Femenino , Expresión Génica , Humanos , Masculino , Persona de Mediana Edad , Osteoartritis/diagnóstico
16.
Orthopade ; 48(9): 795-808, 2019 Sep.
Artículo en Alemán | MEDLINE | ID: mdl-31432200

RESUMEN

Primary osteoarthritis of the shoulder represents a destructive joint disease with associated synovitis, which in the first line seems to be genetically determined. Clinically, patients suffer from shoulder pain with progressive impairment of both active and passive range of motion. The diagnostics include a clinical examination, imaging by native radiography and magnetic resonance imaging (MRI) for assessment of the rotator cuff. Current classification systems consider the formation of humeral osteophytes, glenoid morphology and loss of humeral sphericity. Non-surgical measures include, apart from topical and oral analgesics, injection of corticosteroids and hyaluronic acid supported by physiotherapeutic measures. After failure of non-surgical therapeutic measures, arthroscopic joint-preserving arthroplasty in terms of the comprehensive arthroscopic management (CAM) procedure can be performed in young patients with early stage osteoarthritis, whereas in advanced stages endoprosthetic joint replacement is indicated.


Asunto(s)
Osteoartritis/diagnóstico , Articulación del Hombro , Artroplastia de Reemplazo , Humanos , Osteoartritis/terapia , Rango del Movimiento Articular , Hombro , Resultado del Tratamiento
17.
Biomed Res Int ; 2019: 7165406, 2019.
Artículo en Inglés | MEDLINE | ID: mdl-31467907

RESUMEN

Early detection and treatment are critical in the management of osteoarthritis (OA). OA is closely associated with angiogenesis and the inhibition of angiogenesis presents a novel therapeutic approach to reduce inflammation and pain in OA. Recent reports suggest that circulating microRNAs (miRNAs) have great potential as biomarkers for the diagnosis and prognosis in OA. In this study, we aimed to explore the clinical significance of miR-210 in synovial fluid samples from 10 healthy volunteers and 20 early-stage OA and 20 late-stage OA patients. miR-210 expression was assessed by real-time RT-PCR. VEGF protein levels were examined by ELISA. The results show that miR-210 is significantly upregulated in early-stage OA and late-stage OA patients compared with healthy individuals. Higher levels of VEGF are also found in OA compared with the control. Moreover, miR-210 levels are positively correlated with VEGF levels, suggesting that miR-210 might contribute to OA development through promoting VEGF expression and angiogenesis. In conclusion, upregulation of miR-210 in synovial fluid may occur in the early stage of OA and can be a useful biomarker for early diagnosis of OA.


Asunto(s)
Biomarcadores/metabolismo , Diagnóstico Precoz , MicroARNs/genética , Osteoartritis/diagnóstico , Anciano , MicroARN Circulante , Femenino , Regulación de la Expresión Génica/genética , Humanos , Masculino , Persona de Mediana Edad , Osteoartritis/genética , Osteoartritis/patología , Líquido Sinovial/metabolismo
18.
J Orthop Traumatol ; 20(1): 25, 2019 Jul 02.
Artículo en Inglés | MEDLINE | ID: mdl-31267254

RESUMEN

BACKGROUND: Primary trapezio-metacarpal osteoarthritis can be painful and disabling. Surgical treatment is used when conservative treatment, such as splinting or oral analgesics, fails. The purpose of this study was to report the long-term outcomes obtained in 40 patients (50 thumbs) surgically treated for thumb osteoarthritis by trapeziectomy and ligament reconstruction without tendon interposition. MATERIALS AND METHODS: Forty patients (50 thumbs), with severe trapezio-metacarpal osteoarthritis, surgically treated by trapeziectomy and ligament reconstruction without tendon interposition were reviewed after an average follow-up of 8 years. All patients were women. At follow-up, clinical results were evaluated on the basis of the DASH score, possible presence of pain and the following criteria: palmar abduction of the thumb, carpometacarpal joint opposition of the thumb (Kapandji), extension of the metacarpophalangeal joint and strength of the hand. RESULTS: The DASH score improved from 42.65 (preoperatively) to 16 (at follow-up), and most patients were asymptomatic. Palmar abduction of the thumb averaged 57 mm. Carpometacarpal joint opposition averaged 8.8. Metacarpophalangeal extension was abnormally increased in 86% of the cases. The strength of the operated hand was comparable to the contralateral side in 46 cases. Radiographic examinations showed a slight proximal migration of the first metacarpal bone (< 3 mm) in all cases but mild signs of carpometacarpal osteoarthritis in only 4 cases. CONCLUSIONS: Based on the reported experience, we believe that primary trapezio-metacarpal osteoarthritis surgically treated by trapeziectomy and ligament reconstruction without tendon interposition allows good long-term results. LEVEL OF EVIDENCE: Therapeutic IV.


Asunto(s)
Articulaciones Carpometacarpianas/cirugía , Osteoartritis/cirugía , Osteotomía/métodos , Procedimientos Quirúrgicos Reconstructivos/métodos , Hueso Trapecio/cirugía , Adulto , Articulaciones Carpometacarpianas/diagnóstico por imagen , Femenino , Humanos , Masculino , Persona de Mediana Edad , Osteoartritis/diagnóstico , Radiografía , Hueso Trapecio/diagnóstico por imagen
19.
Artículo en Alemán | MEDLINE | ID: mdl-31273415

RESUMEN

BACKGROUND: Little is known about the utilization of individual health services performed by a physician (IGeL) and the services and supplements provided outside a doctor's office (MuPaP) for osteoarthritis patients. OBJECTIVES: The aims of this study are to analyze the use of osteoarthritis-specific IGeL and MuPaP as well as predictors for their utilization. MATERIALS AND METHODS: For this cross-sectional study, claims data was used to identify all persons with hip, knee, or polyarticular osteoarthritis in 2014 (n = 657,807). A random sample (n = 8995) was sent a questionnaire about their usage of IGeL and MuPaP. Furthermore, the type of physicians conducting or recommending services was evaluated. Applying multivariable logistic regression, predictors associated with the utilization of IGeL, MuPaP, and overall individual health services were analyzed. RESULTS: After validating the data and osteoarthritis diagnosis, 2363 persons were enrolled (mean age: 65.5 years, 72% female). In the last 12 months, 39% of patients had used at least one IGeL (MuPaP: 76%), with 86% being primarily performed by orthopedists (MuPaP: 88% patient self-motivated). Knee osteoarthritis was associated with increased utilization of IGeL. Having female gender, higher income, residence in Western Germany, higher disease burden, and lower satisfaction with the healthcare system were influences on the use of overall individual health services. CONCLUSIONS: Since patients with high disease burden in particular tend to use these therapies with varying treatment success, detailed information, especially about the risks and existing evidence, should be a prerequisite for trustworthy doctor-patient relationships.


Asunto(s)
Costo de Enfermedad , Gastos en Salud/estadística & datos numéricos , Formulario de Reclamación de Seguro/estadística & datos numéricos , Osteoartritis de la Cadera/terapia , Osteoartritis de la Rodilla/terapia , Osteoartritis/terapia , Reclamos Administrativos en el Cuidado de la Salud , Anciano , Artroplastia de Reemplazo de Cadera/estadística & datos numéricos , Artroplastia de Reemplazo de Rodilla/estadística & datos numéricos , Estudios Transversales , Femenino , Alemania , Accesibilidad a los Servicios de Salud , Investigación sobre Servicios de Salud , Humanos , Masculino , Osteoartritis/diagnóstico , Clase Social , Encuestas y Cuestionarios
20.
Z Rheumatol ; 78(8): 713-721, 2019 Oct.
Artículo en Alemán | MEDLINE | ID: mdl-31273459

RESUMEN

BACKGROUND: The objective of the research consortium PROCLAIR was to gain population level knowledge on the treatment of patients with rheumatoid arthritis (RA), axial spondylarthritis (axSpA) and osteoarthritis (OA) in Germany. AIMS: A main question of the consortium was whether it is possible to identify groups of people who were exposed to a particular risk of undersupply or oversupply of treatment. In addition, the study investigated the validity of claims data for these diseases as a basis for further studies. PATIENTS AND METHODS: Cross-sectional surveys were carried out among insurees of the BARMER statutory health insurance fund whose claims data included RA, axSpA and OA diagnoses. The questionnaire data were linked with the claims data of the insured persons if they agreed. RESULTS: In all three diseases risk groups for care deficits could be identified. Persons with RA who are not treated by a specialist have less access to drug treatment. Physical therapy is prescribed for all three diagnoses at a low level, even for people undergoing joint replacement surgery. A connection between depressive symptoms and disease activity or function in axSpA was shown. In addition to the results relevant to care, the PROCLAIR network has also made contributions to critically assess the quality of health insurance data. DISCUSSION: The combination of billing data with survey data enables a comprehensive description of the treatment of musculoskeletal diseases. Particularly relevant factors are the specialization of the physician, sociodemographic parameters of the patients and the region of residence. In particular, access to treatment cannot be investigated in randomized clinical trials.


Asunto(s)
Artritis Reumatoide , Osteoartritis , Espondiloartritis , Artritis Reumatoide/diagnóstico , Artritis Reumatoide/terapia , Productos Biológicos/uso terapéutico , Estudios Transversales , Alemania , Humanos , Osteoartritis/diagnóstico , Osteoartritis/terapia , Modalidades de Fisioterapia , Espondiloartritis/diagnóstico , Espondiloartritis/terapia , Encuestas y Cuestionarios
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