The effect of multimorbidity on functional and quality of life outcomes in women with generalized osteoarthritis / A multimorbiditás hatása a funkcionális és életminoség-eredményekre generalizált osteoarthrosisban

INTRODUCTION: Osteoarthritis (OA) as the most common joint disease is a major public health concern. AIM: To investigate the effect of multimorbidity on functional and quality of life outcomes in women with generalized osteoathritis (hand and knee arthritis, GOA). METHOD: In this cross-sectional study, patients according to the American College of Rheumatology (ACR) criteria for OA were invited. The control group consisted of subjects without any musculoskeletal symptoms, osteoarthritis or inflammatory rheumatic disease. Comorbidity count was calculated from the investigated comorbidities. In the GOA group, the function was assessed by Western Ontario and McMaster Universities Arthritis Index (WOMAC), Cochin Hand Scale, Knee Injury and Osteoarthritis Outcome Score (KOOS), Health Assessment Questionnaire (HAQ), while quality of life was measured in both groups with the EuroQol-5D Scale. Interaction between summarized comorbidity count, age, body mass index (BMI) and scores were analysed. Descriptive statistics, two-sample t-test and Pearson's correlation test were used for data analysis. RESULTS: The study groups included 200-200 participants with a similar age spread. Significant correlation was demonstrated in both study groups between higher comorbidity count and older age (0.37, p<0.001, and 0.24, p<0.001 in the GOA and the control group, respectively) and higher BMI (0.18, p: 0.01, and 0.45, p<0.001 in the GOA and the control group, respectively). In GOA, the increasing comorbidity number had a negative effect on the measured outcomes. CONCLUSIONS: Age and BMI showed strong correlation with multimorbidity in both groups. The lower correlation between BMI and comorbidity count in the GOA group requires further investigation and may suggest different interactions. Orv Hetil. 2020; 161(32): 1332-1340.

The effects of Tiszasüly and Kolop mud pack therapy on knee osteoarthritis: a double-blind, randomised, non-inferiority controlled study.

The aim of this non-inferiority study was to evaluate and compare the effects of Tiszasüly and Kolop mud pack therapy on pain, function and quality of life in patients with knee osteoarthritis. In this double-blind, randomised, follow-up study, 60 patients with knee osteoarthritis were treated with either Tiszasüly hot mud pack (group 1) or with Kolop hot mud pack (group 2) on 10 occasions for 2 weeks (10 working days). One hundred millimetre visual analogue scale (VAS) for knee pain, the Western Ontario and McMaster Universities Arthritis Index (WOMAC), the Knee injury and Osteoarthritis Outcome Score (KOOS), the Lequesne Index for physical function and EuroQoL-5D for quality-of-life measurements were recorded at baseline, at the end of treatment (week 2) and 3 months later (week 12). In both groups, all measured parameters improved significantly from the baseline until the end of treatment and during the follow-up period (p < 0.05). There were no significant differences between the groups in terms of the WOMAC, KOOS, EQ-5D and Lequesne Index at any visits. Knee pain improved in both groups at week 2 and week 12; the only significant difference visible between the groups was at the end of the treatment in favour of the Tiszasüly mud pack group (p = 0.009). Tiszasüly and Kolop mud packs both have a favourable effect on knee pain, physical function and quality of life in patients with knee osteoarthritis. Our results proved non-inferiority of Tiszasüly mud pack.

Development of semiquantitative ultrasound scoring system to assess cartilage in rheumatoid arthritis.

OBJECTIVES: To develop and test the reliability of a new semiquantitative scoring system for the assessment of cartilage changes by ultrasound in a web-based exercise as well as a patient exercise of patients with RA. METHODS: A taskforce of the Outcome Measures in Rheumatology Ultrasound Working Group performed a systematic literature review on the US assessment of cartilage in RA, followed by a Delphi survey on cartilage changes and a new semiquantitative US scoring system, and finally a web-based exercise as well as a patient exercise. For the web-based exercise, taskforce members scored a dataset of anonymized static images of MCP joints in RA patients and healthy controls, which also contained duplicate images. Subsequently, 12 taskforce members used the same US to score cartilage in MCP and proximal interphalangeal joints of six patients with RA in in a patient reliability exercise. Percentage agreement and prevalence of lesions were calculated, as intrareader reliability was assessed by weighted kappa and interreader reliability by Light's kappa. RESULTS: The three-grade semiquantitative scoring system demonstrated excellent intrareader reliability (kappa: 0.87 and 0.83) in the web-based exercise and the patient exercise, respectively. Interreader reliability was good in the web-based exercise (kappa: 0.64) and moderate (kappa: 0.48) in the patient exercise. CONCLUSION: Our study demonstrates that ultrasound is a reliable tool for evaluating cartilage changes in the MCP joints of patients with RA and supports further development of a new reliable semiquantitative ultrasound scoring system for evaluating cartilage involvement in RA.

[Functional outcome of arthroscopic rotator cuff repair]. / Artroszkópos rotátorköpeny-rekonstrukció prospektív vizsgálata.

INTRODUCTION: Functional outcome after rotator cuff reconstruction is influenced by several factors of which re-rupture is probably the most important. AIM: The aim of the study was to evaluate the postoperative outcome including re-rupture rate after arthroscopic rotator cuff reconstruction. METHOD: 23 shoulders of 22 patients were examined prospectively. Physical examination, ultrasound and radiography were performed. Quality of life and functional outcome were evaluated using Constant Score and Visual Analog Scale. RESULTS: Excellent or good results were found in 80% of the patients. The Constant Score has increased from 45 to 79, and the level of pain decreased from 6.6 to 2.5. Full-thickness rotator cuff tear was absent, but partial tear occurred in 7 cases (30%). Average acromiohumeral distance in the operated side was 8.5 mm compared to 9.5 mm measured on the contralateral shoulder. CONCLUSIONS: Arthroscopic rotator cuff repair is a safe and reliable procedure that provides good results.

[Midterm outcome after rotator cuff reconstruction]. / Rotátorköpeny-rekonstrukció utáni középtávú eredmények.

UNLABELLED: Rotator cuff tear is a common degenerative shoulder disorder that often requires surgical treatment. However, the correlation between the size of the tear and the functional results is somewhat controversial, which generates inconsistency among orthopaedic surgeons about the indications for and methods of rotator cuff reconstruction. AIMS: The aim of the authors was to evaluate the midterm functional outcome after rotator cuff reconstruction and the possible connection between the results and the surgical technique or the postoperative ultrasound examination. In addition, recently published corresponding studies are also reviewed by the authors. METHODS: Twenty-seven patients with full thickness rotator cuff tear were enrolled into the study who were treated either by arthroscopic (14 patients) or by open repair (13 patients) technique. Functional results were assessed using clinical tests. Ultrasound examination was also performed. RESULTS: The average postoperative Constant Score was 73, the average DASH (Disabilities of the arm, shoulder and hand score) was 14. The Constant scores averaged 80 for the arthroscopic and 70 for the open group. Ultrasound examination showed partial or full thickness retear of the cuff in 40% of the cases. CONCLUSION: More than 70% of the patients had excellent or good results two years after the reconstruction. The change in the acromiohumeral distance or partial retear failed to affect the results significantly, but full thickness tear had an effect on them.