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1.
Medicine (Baltimore) ; 101(37): e30105, 2022 Sep 16.
Artigo em Inglês | MEDLINE | ID: mdl-36123942

RESUMO

The purposes were to analyze correlations between the frequency of beverage drinking (coffee, green tea, milk, and soft drinks) and the presence of radiographic knee osteoarthritis (OA) in relation to sex. We performed this study using the Korea National Health and Nutrition Examination Survey (KHANES V-1, 2). We examined data from 5503 subjects after exclusion. We utilized the food frequency questionnaires from KHANES, and reorganized them into 2 or 3 groups according to the frequency of beverage consumption. We analyzed the relationship between radiographic knee OA and beverage consumption statistically after adjusting confounding factors with multivariable logistic regression analysis. Knee OA was inversely associated with coffee consumption only in women (P < .05). The odds ratio of knee OA was lower in those who drank at least a cup of coffee than in those who did not drink coffee in women (P for trend < .05). However, there was no significant linear trend of the odds ratio of each group in both sexes for drinking other beverages. As the coffee consumption increased, the radiographic knee OA group showed decreasing linear trend only in women. However, other beverages did not show a significant relation to the radiographic knee OA in both sexes.


Assuntos
Osteoartrite do Joelho , Bebidas , Estudos Transversais , Feminino , Humanos , Masculino , Inquéritos Nutricionais , Osteoartrite do Joelho/diagnóstico por imagem , Osteoartrite do Joelho/epidemiologia , Osteoartrite do Joelho/etiologia , República da Coreia/epidemiologia , Chá/efeitos adversos
2.
Clin J Sport Med ; 32(5): 523-530, 2022 Sep 01.
Artigo em Inglês | MEDLINE | ID: mdl-36083328

RESUMO

OBJECTIVE: To assess the variation in changes in patient-reported outcomes 4 to 6 years after arthroscopic partial meniscectomy (APM). DESIGN: Prospective cohort study. SETTING: Orthopedic departments at public hospitals. PATIENTS: Patients (n = 447) from the Knee Arthroscopy Cohort Southern Denmark undergoing APM. INTERVENTIONS: All patients underwent APM. MAIN OUTCOME MEASURES: Change in KOOS4 scores from baseline before surgery to ∼5 years (range 4-6 years) after surgery. KOOS4 is the average aggregated score of 4 of 5 of the Knee injury and Osteoarthritis Outcome Score (KOOS) excluding the activities of daily living subscale (minimal clinical important improvement ∼10 points). A mixed linear model adjusted for sex and body mass index was used to assess change from baseline to ∼5-year follow-up. Change in KOOS4 was divided into 5 categories based on change from baseline to ∼5-year follow-up: <0 points, 0 to 9 points, 10 to 19 points, 20 to 29 points, and ≥30 points. RESULTS: On average, patient-reported outcomes continued to improve from baseline to ∼5-year follow-up (mean KOOS4 change: 26, 95% CI, 24-28). Proportions in the different response groups were <0 points (12%), 0 to 9 points (13%), 10 to 19 points (16%), 20 to 29 points (19%), and ≥30 points (40%), with no difference between younger (≤40 years, n = 75) and older (>40 years, n = 337) patients (P = 0.898). CONCLUSIONS: Patient-reported outcomes on average improved up to ∼5 years after APM; however, large variability was observed. The similar variability in younger and older patients questions the assumption that younger patients with traumatic injuries experience larger benefits from APM.


Assuntos
Meniscectomia , Osteoartrite do Joelho , Atividades Cotidianas , Artroscopia/efeitos adversos , Humanos , Osteoartrite do Joelho/etiologia , Medidas de Resultados Relatados pelo Paciente , Estudos Prospectivos
3.
Arch Iran Med ; 25(5): 324-328, 2022 05 01.
Artigo em Inglês | MEDLINE | ID: mdl-35943009

RESUMO

BACKGROUND: High tibial osteotomy (HTO) and unicondylar knee arthroplasty (UKA) are two procedures of choice in moderate medial-sided knee osteoarthritis. In this study, we aimed to compare the outcomes of patients undergoing either unilateral knee arthroplasty or open-wedge HTO both clinically and radiologically. METHODS: Clinical records of 105 patients treated surgically with either medial unilateral knee arthroplasty or high tibial osteotomies were reviewed. Fifty-one cases of HTO (group 1) and 54 cases of unicompartmental knee arthroplasty (group 2) were reviewed. Radiographic follow-up data included Kellgren Lawrence index and mechanical alignment measurements using the PACS system. Clinical and functional follow-up data included range of motion degrees and functional assessment scores (Tegner, Lysholm, Knee Society Score and VAS). RESULTS: Mean time of follow-up was 66.10±8.14 months and 65.27±6.95 months for groups 1 and 2, respectively. The HTO group had better radiographic improvement and greater range of motion than the unicompartmental knee arthroplasty group. Despite a significant difference in Lysholm Knee Score and a slight difference in VAS score in favor of HTO, both groups were similar with regard to functional outcomes. CONCLUSION: Both techniques are satisfactory in terms of functional outcomes about five years after the operation and may be considered in cases of middle-aged medial-sided gonarthrosis (<65 years of age) who do not have additional ligament or compartmental pathology.


Assuntos
Artroplastia do Joelho , Osteoartrite do Joelho , Artroplastia do Joelho/efeitos adversos , Artroplastia do Joelho/métodos , Humanos , Articulação do Joelho/diagnóstico por imagem , Articulação do Joelho/cirurgia , Pessoa de Meia-Idade , Osteoartrite do Joelho/diagnóstico por imagem , Osteoartrite do Joelho/etiologia , Osteoartrite do Joelho/cirurgia , Osteotomia/efeitos adversos , Osteotomia/métodos , Estudos Retrospectivos , Tíbia/diagnóstico por imagem , Tíbia/cirurgia , Resultado do Tratamento
4.
Am J Sports Med ; 50(11): 2972-2979, 2022 09.
Artigo em Inglês | MEDLINE | ID: mdl-35914309

RESUMO

BACKGROUND: Although biomechanical and clinical studies have reported adverse effects on the patellofemoral joint after medial open-wedge high tibial osteotomy (MOWHTO), there is a paucity of literature that describes outcomes longer than midterm follow-up. PURPOSE: We aimed to evaluate the mid- to long-term radiologic and clinical outcomes of the patellofemoral joint after MOWHTO and to assess whether radiologic deterioration of the patellofemoral joint affected clinical outcomes or survivorship after MOWHTO. STUDY DESIGN: Case series; Level of evidence, 4. METHODS: We retrospectively reviewed 170 knees that underwent MOWHTO and had a minimum 5-year follow-up. In radiologic evaluation, serial postoperative changes in the patellofemoral joint compared with the preoperative status were evaluated on the Merchant view according to the Kellgren-Lawrence grade. The American Knee Society (AKS) score, Knee injury and Osteoarthritis Outcome Score (KOOS), Kujala score, incidence of anterior knee pain, and survivorship were used to assess clinical outcomes. Using radiologic assessment of the patellofemoral joint, we divided the patients into a radiologic progression group and a radiologic nonprogression group to evaluate whether radiologic progression of patellofemoral arthritis affected long-term clinical outcomes and survivorship after MOWHTO. RESULTS: The mean follow-up period was 96.3 months (range, 60-163 months). Arthritic progression of the patellofemoral joint on the Merchant view was observed in 44.9%, 56.3%, 66.0%, and 84.0% of the cases at 5, 7, 9, and 11 years, respectively. Clinical outcomes such as AKS scores and KOOS significantly improved after MOWHTO (P < .001) at the latest follow-up. The incidence of anterior knee pain was 5.3% (9/170 knees). One knee (0.6%) underwent conversion to TKA due to progressive medial osteoarthritis, so the survival rate was 99.4% at a mean follow-up of 96.3 months. Despite patellofemoral degeneration over time, there were no significant differences in clinical outcomes or survivorship between patients with and without radiologic progression at the latest follow-up. CONCLUSION: Although degeneration of the patellofemoral joint was observed with time after MOWHTO, the related symptoms were minimal and arthritic changes in the patellofemoral joint did not affect the clinical outcomes or survivorship after MOWHTO over a mid- to long-term follow-up.


Assuntos
Osteoartrite do Joelho , Articulação Patelofemoral , Humanos , Articulação do Joelho/cirurgia , Osteoartrite do Joelho/diagnóstico por imagem , Osteoartrite do Joelho/etiologia , Osteoartrite do Joelho/cirurgia , Osteotomia/efeitos adversos , Dor/etiologia , Articulação Patelofemoral/diagnóstico por imagem , Articulação Patelofemoral/cirurgia , Estudos Retrospectivos , Tíbia/diagnóstico por imagem , Tíbia/cirurgia
5.
Int Orthop ; 46(10): 2213-2218, 2022 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-35844014

RESUMO

PURPOSE: Intra-articular injections of autologous, minimally manipulated, cell therapies such as bone marrow concentrate (BMC) to treat knee osteoarthritis (OA) may delay or prevent future total knee arthroplasty (TKA). Arthroplasty has the known and substantial risk of venous thromboembolism (VTE) and requires routine prophylaxis, whereas the VTE risk associated with knee BMC injections is unknown. We report on the rate of VTE from a large orthobiologics patient registry and assess whether knee BMC procedures require routine prophylaxis. METHODS: A retrospective analysis of knee osteoarthritis cases tracked in a treatment registry and treated at 72 clinical sites with BMC from 2007 to 2020 who were not prophylactically anticoagulated was performed to identify adverse events (AEs) associated with VTE. Treating physicians were contacted to improve discovery of possible occurrences of VTE. RESULTS: Twenty cases (0.16%) of VTE were identified from the registry of 12,780 knee BMC treatments. These events were less frequent than the published data demonstrate for anticoagulated TKA patients. CONCLUSION: Based on the rates of VTE from our retrospective treatment registry analysis compared to the risk of medication-induced haemorrhage, routine prophylactic anticoagulation is not recommended for intra-articular knee BMC procedures. Further research into safety and efficacy of BMC treatment for knee OA is warranted. CLINICAL TRIAL IDENTIFIER: NCT03011398, retrospectively registered.


Assuntos
Artroplastia de Quadril , Osteoartrite do Joelho , Embolia Pulmonar , Tromboembolia Venosa , Anticoagulantes/efeitos adversos , Artroplastia de Quadril/efeitos adversos , Medula Óssea , Humanos , Osteoartrite do Joelho/etiologia , Embolia Pulmonar/etiologia , Estudos Retrospectivos , Tromboembolia Venosa/epidemiologia , Tromboembolia Venosa/etiologia , Tromboembolia Venosa/prevenção & controle
6.
Sci Rep ; 12(1): 11372, 2022 07 05.
Artigo em Inglês | MEDLINE | ID: mdl-35790839

RESUMO

Most studies on osteoarthritis (OA) and vitamin D status were performed in Whites with relatively adequate vitamin D status. Associations may differ by baseline 25-hydroxyvitamin D (25(OH)D) and race. We assessed the odds of OA and joint pain according to vitamin D status in Korean adults ≥ 50 years of age in the nationally representative Korea National Health and Nutrition Examination Survey (n = 8575). Agreement between radiologic OA (ROA) and self-reported OA were also assessed. Multivariate logistic regression was performed and participants were stratified by sex. Adults with serum 25(OH)D < 12 ng/mL and 12 to < 20 ng/mL had 26% and 18% lower odds of knee ROA, respectively, compared to those with 25(OH)D ≥ 20 ng/mL. Similar results were observed in men, but not women. No associations were found between 25(OH)D and knee ROA severity, lumbar spine ROA, symptomatic OA, or knee pain. Sensitivity of self-reported OA was low (27%), indicating a weak possibility of reverse causation. Prospective studies are required to identify the possible causality of vitamin D on OA in Korean men.


Assuntos
Osteoartrite do Joelho , Deficiência de Vitamina D , Adulto , Humanos , Masculino , Inquéritos Nutricionais , Osteoartrite do Joelho/diagnóstico por imagem , Osteoartrite do Joelho/epidemiologia , Osteoartrite do Joelho/etiologia , Vitamina D , Vitaminas
7.
Knee ; 37: 188-195, 2022 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-35820266

RESUMO

BACKGROUND: Some studies have shown that the position of the tibial component in Oxford unicompartmental knee arthroplasty with a mobile bearing will affect the clinical outcome of patients. Hence, our study aimed to investigate the relationship between the overhang distance of the tibial component and the survival of the implant. METHODS: A retrospective analysis of patients who underwent unicompartmental knee arthroplasty at the same institution from 2014 to 2018 was presented. The study was divided into three groups: minor underhang group (underhang between -3 and 0 mm); minor overhang group (overhang 0-3 mm); and major overhang group (overhang ≥ 3 mm). Demographic and clinical profile characteristics of each group were compared, and survival curves of each group were also compared using Kaplan-Meier and modeled using multivariate Cox regression. RESULTS: A total of 351 knees were included in this study with a minimum follow up of three years and a mean follow up of 4.8 ± 1.5 years. The revision rates in each group were 3.6% (minor underhang group), 2.7% (minor overhang group), and 20.9% (major overhang group) (P < 0.001). From the three groups' cumulative survival rates, the major overhang group was significantly lower than the other two groups (log rank P < 0.001). Multivariate Cox regression showed an association between the major overhang group and implant survival rate (hazard ratio = 7.515, 95% confidence interval = 2.500-22.593, P < 0.001) CONCLUSION: The risk of revision will increase if the tibial component overhangs more than 3 mm medially. Moreover, the reasons for revision are generally bearing dislocation and aseptic loosening.


Assuntos
Artroplastia do Joelho , Prótese do Joelho , Osteoartrite do Joelho , Artroplastia do Joelho/efeitos adversos , Humanos , Articulação do Joelho/diagnóstico por imagem , Articulação do Joelho/cirurgia , Osteoartrite do Joelho/etiologia , Osteoartrite do Joelho/cirurgia , Falha de Prótese , Reoperação , Estudos Retrospectivos , Sobrevivência , Resultado do Tratamento
8.
Rev Med Chil ; 150(1): 46-53, 2022 Jan.
Artigo em Espanhol | MEDLINE | ID: mdl-35856964

RESUMO

BACKGROUND: Osteoarthritis (OA) is a health problem affecting millions of individuals worldwide. AIM: To evaluate risk factors for hip and knee osteoarthritis (OA) in women aged 40 to 59 years. MATERIAL AND METHODS: Analysis of a prospective cohort of 1159 women attending preventive health care programs and followed during 28 years. They underwent a clinical and laboratory evaluation from 1990 to 1993. The diagnosis of OA was retrieved from registries of a special program for osteoarthritis in 2020. RESULTS: Twenty four percent of participants developed osteoarthritis during the follow-up. At the beginning of the study and compared with women without OA, they were older (median [interquartile range or IQR]: 49.6 [8.5] and 47.2 [8.2] years respectively), had a higher body mass index (26.3 [5.3] and 25.1 [5.3] respectively), and a higher frequency of jobs with low qualification (76 and 62% respectively). The presence of type 2 diabetes mellitus, chronic hypertension, a previous history of alcohol or cigarette consumption, postmenopausal status and lipid and glucose blood levels did not differ between women with or without OA. Cox regression showed a final model that incorporates body mass index (hazard ratio (HR): 1.04; 95% confidence intervals (CI): 1.01-1.07), age (HR: 1.05; 95% CI: 1.03-1.08) and having an unqualified job (HR: 1.88; 95% CI: 1.43-2.47) as risk factors for OA. CONCLUSIONS: Obesity and the type of job are the most relevant risk factors found for OD: both may be modified with proper care.


Assuntos
Diabetes Mellitus Tipo 2 , Osteoartrite do Quadril , Osteoartrite do Joelho , Diabetes Mellitus Tipo 2/complicações , Feminino , Humanos , Pessoa de Meia-Idade , Osteoartrite do Quadril/diagnóstico , Osteoartrite do Quadril/epidemiologia , Osteoartrite do Quadril/etiologia , Osteoartrite do Joelho/epidemiologia , Osteoartrite do Joelho/etiologia , Estudos Prospectivos , Fatores de Risco
9.
J Bone Joint Surg Am ; 104(18): 1621-1628, 2022 Sep 21.
Artigo em Inglês | MEDLINE | ID: mdl-35766399

RESUMO

BACKGROUND: Lateral unicompartmental knee arthroplasty (UKA) is an excellent option to alleviate disability and restore function in patients with lateral compartment knee osteoarthritis (OA). The purpose of the present study was to determine the survivorship and long-term outcomes in both younger/middle-aged and older patients with lateral compartment OA following non-robotically-assisted, fixed-bearing lateral UKA and to determine if an acceptable symptom state can be achieved. METHODS: All patients were managed with fixed-bearing lateral UKA by a single surgeon utilizing a lateral parapatellar approach without robotic assistance. The primary outcome variables were the Knee injury and Osteoarthritis Outcome Score (KOOS) Activities of Daily Living (ADL) and Sport subscale scores. In addition, the other KOOS subscores, the Lysholm score, the achievement of the Patient Acceptable Symptom State (PASS), and the Veterans RAND (VR-12) Physical Component Summary score (PCS) and Mental Component Summary score (MCS) were collected. Failure was defined as conversion to total knee arthroplasty (TKA). Patients were divided into 2 cohorts: younger/middle-aged patients (<60 years of age) and older patients (≥60 years of age). RESULTS: A cohort of 256 patients underwent medial (n = 193) or lateral (n = 63) UKA. Sixty-one patients met the inclusion criteria. At mean of 10 years (range, 4 to 17 years) of follow-up, there were no significant differences between the groups in terms of any patient-reported outcome measures (p > 0.05). The percentage of patients in whom PASS was achieved on the KOOS ADL and Sport subscores was 82% and 88%, respectively, in the younger cohort and 80% and 80%, respectively, in the older cohort. The mean survival estimate of the prothesis was 15.3 years (95% confidence interval [CI], 14.5 to 16.2 years) for the entire cohort. The estimated rate of implant survival in the younger cohort was 100% at 5 and 10 years, and the estimated rate of implant survival in the older cohort was 98% at 5 years and 96% at 10 years. CONCLUSIONS: Lateral fixed-bearing, non-robotic UKA for the treatment of isolated lateral compartment OA resulted in >80% of patients reaching an acceptable symptom state in terms of both activities of daily living and sporting activities. UKA provides an excellent option that provides longevity with high PASS rates and return to activities with a low risk of complications and failure. LEVEL OF EVIDENCE: Therapeutic Level III . See Instructions for Authors for a complete description of levels of evidence.


Assuntos
Artroplastia do Joelho , Prótese do Joelho , Osteoartrite do Joelho , Atividades Cotidianas , Idoso , Artroplastia do Joelho/métodos , Seguimentos , Humanos , Articulação do Joelho/cirurgia , Pessoa de Meia-Idade , Osteoartrite do Joelho/etiologia , Osteoartrite do Joelho/cirurgia , Reoperação , Estudos Retrospectivos , Sobrevivência , Resultado do Tratamento
10.
Am J Sports Med ; 50(9): 2417-2423, 2022 07.
Artigo em Inglês | MEDLINE | ID: mdl-35722806

RESUMO

BACKGROUND: Posttraumatic osteoarthritis (PTOA) is a common sequela of anterior cruciate ligament (ACL) injury, even when surgical treatment is selected. The effect of patient sex on cartilage health after ACL injury and surgical treatment has been less studied. PURPOSE/HYPOTHESIS: The study objective was to compare the macroscopic cartilage damage that develops after ACL surgery in male and female Yucatan minipigs. It was hypothesized that after ACL surgery, the macroscopic cartilage damage of the tibiofemoral joints from female animals would be greater than that from male animals. Additionally, it was hypothesized that the effect of sex on the macroscopic cartilage damage would depend on surgical treatment. STUDY DESIGN: Controlled laboratory study. METHODS: Twelve-month follow-up data were obtained for 55 adolescent Yucatan minipigs (22 female/33 male) that were randomized to 1 of 3 experimental groups: no treatment (ACL transection [ACLT]), ACL reconstruction, and bridge-enhanced ACL restoration. The Osteoarthritis Research Society International guidelines were used to determine a standardized macroscopic cartilage damage score on 5 surfaces of the knee joint. RESULTS: Females had significantly worse mean total macroscopic cartilage damage scores on the surgical side (adjusted P value [P adj] = .04) and significantly better scores on the contralateral side (P adj = .01) when compared with males. The trochlear damage scores were also significantly worse in females for surgical limbs (P adj = .009) and significantly better for the contralateral limbs (P adj < .001) when compared with males. Although there were no significant differences in total macroscopic cartilage damage scores between sexes within treatment groups on the surgical limbs (ACLT, P adj = 0.45; ACL reconstruction, P adj = .56; bridge-enhanced ACL restoration, P adj = .23), the mean trochlear scores on the surgical limb of females were significantly worse than those of the males in the ACLT group (P adj = .003). CONCLUSION: Mean total macroscopic cartilage damage scores of Yucatan minipigs were significantly worse in females than males, regardless of treatment. These differences were predominantly found in the trochlear scores across all treatment groups. CLINICAL RELEVANCE: These data suggest that patient sex could be more influential in the progression of PTOA than surgical treatment after ACL injury. Identifying factors responsible for this discrepancy may prove valuable to identify targets to slow PTOA progression in male and female ACL-injured populations.


Assuntos
Lesões do Ligamento Cruzado Anterior , Cartilagem Articular , Osteoartrite do Joelho , Osteoartrite , Animais , Ligamento Cruzado Anterior/cirurgia , Lesões do Ligamento Cruzado Anterior/complicações , Lesões do Ligamento Cruzado Anterior/cirurgia , Feminino , Articulação do Joelho/cirurgia , Masculino , Osteoartrite/etiologia , Osteoartrite do Joelho/etiologia , Osteoartrite do Joelho/cirurgia , Suínos , Porco Miniatura
11.
Arch. pediatr. Urug ; 93(1): e302, jun. 2022. ilus, tab
Artigo em Espanhol | LILACS, BNUY, UY-BNMED | ID: biblio-1383637

RESUMO

Se expone el caso de un recién nacido que desarrolló sepsis connatal precoz a Streptococcus agalactiae, con meningitis aguda supurada y osteoartritis de rodilla izquierda. Como factor de riesgo la madre no tenía realizado el exudado rectovaginal, pesquisa que detecta la colonización por estreptococo del grupo B (EGB). Se aisló el germen en hemocultivo y en líquido de punción articular. Recibió tratamiento antibiótico adecuado a la sensibilidad del microorganismo y según pauta de sepsis con meningitis, evolucionando favorablemente. En este trabajo se describe la epidemiología de la sepsis neonatal y los cambios ocurridos luego de la implementación de la profilaxis antibiótica en el preparto.


We hereby present the case of a newborn with early connatal sepsis due to Streptococcus agalactiae, with acute suppurative meningitis and left knee osteoarthritis. As a risk factor, the mother had not performed the rectus vaginal exudate screening that detects colonization by Group B Streptococcus (GBS). The germ was isolated in blood culture and in joint puncture fluid. The patient received germ-sensitive antibiotic treatment for meningitis sepsis and evolved favorably. This paper describes the epidemiology of neonatal sepsis and the changes that have occurred after the administration of the antibiotic prophylaxis during pregnancy.


Apresentamos o caso de um recém-nascido com sepse neonatal precoce por Streptococcus agalactiae, com meningite supurativa aguda e osteoartrite de joelho esquerdo. Como fator de risco, a mãe não realizou teste de exsudato vaginal do reto que detecta a colonização por estreptococos do grupo B (SGB). O germe foi isolado em hemocultura e líquido de punção articular. A paciente recebeu tratamento com antibióticos germinativos para padrão meningite sepse e evoluiu favoravelmente. Este artigo descreve a epidemiologia da sepse neonatal e as mudanças ocorridas após a administração da profilaxia antibiótica durante a gravidez.


Assuntos
Humanos , Feminino , Recém-Nascido , Infecções Estreptocócicas/diagnóstico , Infecções Estreptocócicas/tratamento farmacológico , Streptococcus agalactiae , Gentamicinas/uso terapêutico , Ampicilina/uso terapêutico , Antibacterianos/uso terapêutico , Meningites Bacterianas/diagnóstico , Meningites Bacterianas/etiologia , Meningites Bacterianas/tratamento farmacológico , Osteoartrite do Joelho/diagnóstico , Osteoartrite do Joelho/etiologia , Osteoartrite do Joelho/tratamento farmacológico , Sepse Neonatal/complicações , Sepse Neonatal/diagnóstico , Sepse Neonatal/tratamento farmacológico
12.
J Orthop Surg Res ; 17(1): 315, 2022 Jun 14.
Artigo em Inglês | MEDLINE | ID: mdl-35701787

RESUMO

BACKGROUND: Abnormal epiphyseal growth plate development of the proximal tibia in hemophilia patients leads to notable morphological changes in the mature knee joint. This study aimed to compare the morphological characteristics of tibial component placement cut surface in patients with hemophilic arthritis (HA) and osteoarthritis (OA) and to determine the tibial component rotational alignment axis' best position for HA patients. METHODS: Preoperative computed tomography scans of 40 OA and 40 HA patients who underwent total knee arthroplasty were evaluated using a three-dimensional (3D) software. The tibial component's placement morphological parameters were measured. The tibial component's rotational mismatch angles were evaluated, and the most appropriate 0°AP axis position for HA patients was investigated. RESULTS: In the two groups, the morphology was significantly different in some of the parameters (p < 0.05). The tibial component rotational mismatch angles were significantly different between both groups (p < 0.05). The medial 9.26° of the medial 1/3 of the patellar tendon was the point through which 0°AP axis passed for the HA patients. Similarly, the medial 13.02° of the medial 1/3 of the tibial tubercle was also the point through which the 0°AP axis passed. CONCLUSIONS: The ratio of the anteroposterior length to the geometric transverse length of the placement section of the tibial component in HA patients was smaller than that in OA patients. The medial 9.26° of the medial 1/3 of the patellar tendon or the medial 13.02° of the medial 1/3 of the tibial tubercle seem to be an ideal reference position of the rotational alignment axis of the tibial component for HA patients.


Assuntos
Artroplastia do Joelho , Hemofilia A , Osteoartrite do Joelho , Artroplastia do Joelho/métodos , Hemofilia A/complicações , Hemofilia A/diagnóstico por imagem , Humanos , Articulação do Joelho/diagnóstico por imagem , Articulação do Joelho/cirurgia , Osteoartrite do Joelho/diagnóstico por imagem , Osteoartrite do Joelho/etiologia , Osteoartrite do Joelho/cirurgia , Rotação , Tíbia/anatomia & histologia , Tíbia/diagnóstico por imagem , Tíbia/cirurgia
13.
J Bone Joint Surg Am ; 104(15): 1386-1392, 2022 08 03.
Artigo em Inglês | MEDLINE | ID: mdl-35703139

RESUMO

BACKGROUND: The aim of this study was to investigate the relationship of obesity with all-cause revision and revision for infection, loosening, instability, and pain after total knee arthroplasty (TKA) performed in Australia. METHODS: Data for patients undergoing primary TKA for osteoarthritis from January 1, 2015, to December 31, 2020, were obtained from the Australian Orthopaedic Association National Joint Replacement Registry (AOANJRR). The rates of all-cause revision and revision for infection, loosening, instability, and pain were compared for non-obese patients (body mass index [BMI], 18.50 to 29.99 kg/m 2 ), class-I and II obese patients (BMI, 30.00 to 39.99 kg/m 2 ), and class-III obese patients (BMI, ≥40.00 kg/m 2 ). The results were adjusted for age, sex, tibial fixation, prosthesis stability, patellar component usage, and computer navigation usage. RESULTS: During the study period, 141,673 patients underwent primary TKA for osteoarthritis in Australia; of these patients, 48.0% were class-I or II obese, and 10.6% were class-III obese. The mean age was 68.2 years, and 54.7% of patients were female. The mean follow-up period was 2.8 years. Of the 2,655 revision procedures identified, the reasons for the procedures included infection in 39.7%, loosening in 14.8%, instability in 12.0%, and pain in 6.1%. Class-I and II obese patients had a higher risk of all-cause revision (hazard ratio [HR], 1.12 [95% confidence interval (CI), 1.03 to 1.22]; p = 0.007) and revision for infection (HR, 1.25 [95% CI, 1.10 to 1.43]; p = 0.001) than non-obese patients. Class-III obese patients had a higher risk of all-cause revision after 1 year (HR, 1.30 [95% CI, 1.14 to 1.52]; p < 0.001), revision for infection after 3 months (HR, 1.72 [95% CI, 1.33 to 2.17]; p < 0.001), and revision for loosening (HR, 1.39 [95% CI, 1.00 to 1.89]; p = 0.047) than non-obese patients. The risks of revision for instability and pain were similar among groups. CONCLUSIONS: Obese patients with knee osteoarthritis should be counseled with regard to the increased risks associated with TKA, so they can make informed decisions about their health care. Health services and policymakers need to address the issue of obesity at a population level. LEVEL OF EVIDENCE: Prognostic Level III . See Instructions for Authors for a complete description of levels of evidence.


Assuntos
Artroplastia do Joelho , Prótese do Joelho , Ortopedia , Osteoartrite do Joelho , Idoso , Artroplastia do Joelho/métodos , Austrália , Feminino , Humanos , Estudos Longitudinais , Masculino , Obesidade/complicações , Osteoartrite do Joelho/etiologia , Osteoartrite do Joelho/cirurgia , Dor/etiologia , Estudos Prospectivos , Sistema de Registros , Reoperação
14.
J Nutr Health Aging ; 26(6): 581-589, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35718867

RESUMO

OBJECTIVES: High salt intake results in various harmful effects on human health including hypertension, cardiovascular disease, and reduced bone density. Despite this, there are very few studies in the literature that have investigated the association between sodium intake and osteoarthritis (OA). Therefore, we aimed to explore these associations in a Korean population. METHODS: This study used cross-sectional data from adult subjects aged 50-75 years from two consecutive periods of the Korean National Health and Nutrition Examination Survey V-VII (2010-2011 and 2014-2016). The estimated 24-hour urinary sodium excretion (24HUNa) was used as a surrogate marker of salt intake. In the 2010-2011 dataset, knee OA (KOA) was defined as the presence of the radiographic features of OA and knee pain. The association between KOA and salt intake was analysed using univariable and multivariable logistic regression methods. For the sensitivity analysis, the same procedures were conducted on subjects with self-reported OA (SR-OA) with knee pain in the 2010-2011 dataset and any site SR-OA in the 2014-2016 dataset. RESULTS: Subjects with KOA had significantly lower energy intake, but higher 24HUNa than those without KOA. The restricted cubic spline plots demonstrated a J-shaped distribution between 24HUNa and prevalent KOA. When 24HUNa was stratified into five groups (<2, 2-3, 3-4, 4-5 and ≥5 g/day), subjects with high sodium intake (≥5 g/day) had a higher risk of KOA (odds ratio [OR] = 1.64, 95% confidence interval [CI] 1.03-2.62) compared to the reference group (3-4 g/day) after adjusting for covariates. The sensitivity analysis based on SR-OA with knee pain showed that high sodium intake was also significantly associated with increased prevalence of OA (OR = 1.84, 95% CI 1.10-3.10) compared with the reference group. Regarding SR-OA at any site in the 2014-2016 dataset, estimated 24HUNa showed a significantly positive association with the presence of SR-OA after adjusting for potential confounders. CONCLUSIONS: This nationwide Korean representative study showed a significant association between symptomatic KOA and high sodium intake (≥5 g/day). Avoidance of a diet high in salt might be beneficial as a non-pharmacologic therapy for OA.


Assuntos
Osteoartrite do Joelho , Estudos Transversais , Humanos , Inquéritos Nutricionais , Osteoartrite do Joelho/epidemiologia , Osteoartrite do Joelho/etiologia , Dor/etiologia , Sódio , Cloreto de Sódio na Dieta
15.
Occup Environ Med ; 79(8): 543-549, 2022 08.
Artigo em Inglês | MEDLINE | ID: mdl-35618387

RESUMO

OBJECTIVE: Occupations involving greater physical activity may increase risk for knee osteoarthritis (OA). Existing studies have not evaluated work-related physical activity before OA onset. Hence, we aimed to evaluate the association between work-related physical activity and knee OA incidence. METHODS: We performed a person-based longitudinal study using Osteoarthritis Initiative (OAI) data among people who volunteered or worked for pay without baseline radiographic knee OA or knee pain. Bilateral knee radiographs were obtained at baseline and annual follow-ups. We defined radiographic OA as Kellgren-Lawrence grade ≥2. Questions from the Physical Activity Scale for the Elderly at baseline and annual OAI visits provided information about work-related physical activity level and hours. We performed logistic regression with work-related physical activity level ( mainly sitting , standing and some walking , walking while handling some materials ) and hours as predictors. The outcome was incident person-based radiographic OA within the ensuing 12 months, over 48 months. RESULTS: Among 951 participants (2819 observations), higher work-related physical activity levels had greater adjusted ORs for incident radiographic OA (people with jobs with standing and some walking : 1.11 (0.60-2.08), and walking while handling some materials : 1.90 (1.03-3.52), when compared with those with mainly sitting work-related activity ). There was no association between number of hours worked and incident radiographic OA. CONCLUSIONS: People performing work that require walking while handling some materials have greater odds of incident knee OA than those with jobs mostly involving sitting. Strategies are needed to mitigate risk factors predisposing them to radiographic OA.


Assuntos
Osteoartrite do Joelho , Idoso , Exercício Físico , Humanos , Articulação do Joelho , Estudos Longitudinais , Osteoartrite do Joelho/diagnóstico por imagem , Osteoartrite do Joelho/epidemiologia , Osteoartrite do Joelho/etiologia , Radiografia , Fatores de Risco
16.
Sports Med Arthrosc Rev ; 30(2): 97-101, 2022 Jun 01.
Artigo em Inglês | MEDLINE | ID: mdl-35533061

RESUMO

PURPOSE: Whether sport participation is a risk factor for osteoarthritis (OA) development or progression is controversial. Mechanical overload, injuries, genetics, and acquired disorders concur to the onset of OA, with high variability between sports and participants. This study investigated the association between participation in specific sports and the risk of developing knee and hip OA in athletes at different ages. We hypothesized that young athletes who are exposed to high levels of physical activities have a greater risk of developing OA. MATERIALS AND METHODS: This systematic review was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. PubMed, Google scholar, EMABSE, and Web of Science were accessed in October 2021. No time constrains were used for the search. All the published clinical studies reporting data about relationship between physical activity, OA, and age were included. RESULTS: The Newcastle-Ottawa Scale resulted in a final score ≥7 for all studies, attesting good quality of the methodological assessment. Data from 27,364 patients were retrieved. The mean age was 48.2±16.7 years. In all, 21.8% were women. CONCLUSIONS: Our systematic review suggests an association between high levels of physical activities and knee and hip OA in men younger than 50 years. People who practice intense physical activity, such as professional athletes or heavy workers, are more prone to develop early-onset OA.


Assuntos
Osteoartrite do Quadril , Osteoartrite do Joelho , Esportes , Adulto , Atletas , Feminino , Humanos , Articulação do Joelho , Masculino , Pessoa de Meia-Idade , Osteoartrite do Quadril/complicações , Osteoartrite do Quadril/etiologia , Osteoartrite do Joelho/epidemiologia , Osteoartrite do Joelho/etiologia
17.
Am J Sports Med ; 50(8): 2075-2082, 2022 07.
Artigo em Inglês | MEDLINE | ID: mdl-35604336

RESUMO

BACKGROUND: Arthroscopic partial meniscectomy (APM) is widely performed and remains an important therapeutic option for patients with a meniscal tear. However, it is debated whether or not APM accelerates the progression of osteoarthritis (OA) in the long term. PURPOSE/HYPOTHESIS: The purpose was to compare the progression of OA measured by the change in tibiofemoral joint space width (JSW)-a quantitative measure of OA radiographic severity-across 3 groups with a midterm follow-up: (1) patients undergoing APM; (2) those with a meniscal tear treated nonoperatively; and (3) those without a tear. We hypothesized that the reduction in JSW would be greatest in patients undergoing APM and least in those patients without a tear. STUDY DESIGN: Cohort study; Level of evidence, 3. METHODS: Using the Osteoarthritis Initiative cohort, a total of 144 patients were identified that underwent APM with at least 12 months of follow up and without previous knee surgery. Those with a meniscal tear who did not have APM (n = 144) and those without a tear (n = 144) were matched to patients who had APM by sex, age, Kellgren-Lawrence (KL) grade, and follow up time. Participants underwent magnetic resonance imaging at baseline. Knee radiographs to assess JSW were collected annually or biannually. The change in minimum medial compartment JSW was calculated using a validated automated method. A piecewise linear mixed effects model was constructed to examine the relationship between JSW decline over time and treatment group-adjusting for age, body mass index, smoking status, KL grade, and baseline JSW. RESULTS: All groups had comparable baseline JSW-ranging from 4.33 mm to 4.38 mm. The APM group had a rate of JSW decline of -0.083 mm/mo in the first 12 months and -0.014 mm/mo between 12 and 72 months. The rate of JSW decline in the APM group was approximately 27 times greater in the first 12 months than that in the nonsurgical group (-0.003 mm/mo) and 5 times greater than that in the no tear group (-0.015 mm/mo); however, there was no significant difference between groups for 12 to 72 months (nonsurgical group: -0.009 mm/mo; no tear group: -0.010 mm/mo). The adjusted JSW in the APM group was 4.38 mm at baseline and decreased to 2.57 mm at 72 months; the JSW in the nonsurgical group declined from 4.31 mm to 3.73 mm, and in the no tear group it declined from 4.33 mm to 3.54 mm. There was a statistically significant difference in JSW change between baseline and 72 months for the APM group compared with the other groups (P < .001), but not between the nonsurgical and no tear groups (P = .12). CONCLUSION: In the first postoperative year, APM results in a faster rate of joint space narrowing compared with knees undergoing nonsurgical management of meniscal tears. Thereafter, there are comparable rates of OA progression regardless of the chosen management. APM results in a persistent decrease in JSW over at least 72 months. An untreated meniscal tear does not contribute to radiographic progression-assessed by JSW-as compared with an intact meniscus.


Assuntos
Traumatismos do Joelho , Osteoartrite do Joelho , Lesões do Menisco Tibial , Artroscopia/métodos , Estudos de Coortes , Humanos , Traumatismos do Joelho/cirurgia , Articulação do Joelho/cirurgia , Meniscectomia/métodos , Meniscos Tibiais/diagnóstico por imagem , Meniscos Tibiais/patologia , Meniscos Tibiais/cirurgia , Osteoartrite do Joelho/diagnóstico por imagem , Osteoartrite do Joelho/etiologia , Osteoartrite do Joelho/cirurgia , Ruptura/etiologia , Lesões do Menisco Tibial/diagnóstico por imagem , Lesões do Menisco Tibial/cirurgia
18.
BMC Musculoskelet Disord ; 23(1): 497, 2022 May 26.
Artigo em Inglês | MEDLINE | ID: mdl-35619060

RESUMO

BACKGROUND: To evaluate the difference in surgical planning of osteotomies around the knee between preoperative standing and supine radiographs and to identify risk factors for discrepancies in surgical planning. METHODS: This study included 117 knees of 100 patients who underwent osteotomies around the knee for knee osteoarthritis with genu varum. Surgical planning was performed so that the target point of the postoperative weight-bearing line (WBL) ratio was 62.5% in preoperative standing and supine radiographs. If the opening gap would be > 13 mm in open-wedge high tibial osteotomy (OWHTO), closed-wedge HTO (CWHTO) was planned. If the postoperative mMPTA would be > 95° in isolated HTO, double-level osteotomy (DLO) was planned. In DLO, lateral closed-wedge distal femoral osteotomy was performed so that the postoperative mechanical lateral distal femoral angle (mLDFA) was 85°, and any residual varus deformity was corrected with HTO. RESULTS: Surgical planning differed between standing and supine radiographs in 43.6% of cases. In all knees for which surgical planning differed between standing and supine radiographs, a more invasive type of osteotomy was suggested by standing radiographs than by supine radiographs. The risk factors for discrepancies in surgical planning were a lower WBL ratio in standing radiographs and a lower joint line convergence angle in supine radiographs. CONCLUSIONS: Surgical planning of DLO, CWHTO and OWHTO, in standing radiographs differed from that in supine radiographs in nearly half of the cases. Surgical planning based on standing radiographs leads to more invasive surgical procedures compared to supine radiographs.


Assuntos
Osteoartrite do Joelho , Tíbia , Humanos , Joelho , Articulação do Joelho/diagnóstico por imagem , Articulação do Joelho/cirurgia , Osteoartrite do Joelho/diagnóstico por imagem , Osteoartrite do Joelho/etiologia , Osteoartrite do Joelho/cirurgia , Osteotomia/métodos , Tíbia/diagnóstico por imagem , Tíbia/cirurgia
19.
Reumatismo ; 74(1)2022 May 03.
Artigo em Inglês | MEDLINE | ID: mdl-35506320

RESUMO

The aim of this narrative review is to discuss the results of studies investigating the role of physical activity in knee osteoarthritis (OA). We also formulated two evidence-based exercise programs that could be prescribed to patients with symptomatic knee OA or after joint replacement. The PubMed and Google Scholar databases were searched for articles related to knee OA and physical activity. A total of 86 papers written in English and published from 1957 to 2021 were selected. Adapted physical activity, even at high intensity, does not appear to trigger or exacerbate knee OA; on the contrary, it may prevent obesity or lower limb muscle weakness, both of which are considered predisposing factors for the disease. In patients already diagnosed with knee OA, scientific evidence suggests that both land-based and aquatic activities combining aerobics, strength, and endurance programs are safe and effective. Physical interventions tailored to the patient may also accelerate recovery time after knee arthroplasty. Knee OA is a painful and disabling rheumatic disease that is very common in the elderly population. Pharmacotherapy has a modest effect in controlling disease progression, possibly due to the still limited understanding of OA pathogenesis. Non-pharmacologic interventions, including dietary and lifestyle changes and physical activity, may be more effective and safer than drugs in preventing or treating knee OA.


Assuntos
Osteoartrite do Joelho , Idoso , Progressão da Doença , Exercício Físico , Terapia por Exercício/métodos , Humanos , Osteoartrite do Joelho/etiologia , Osteoartrite do Joelho/prevenção & controle
20.
J Arthroplasty ; 37(9): 1783-1792, 2022 09.
Artigo em Inglês | MEDLINE | ID: mdl-35447276

RESUMO

BACKGROUND: Computer navigation techniques can potentially improve both the accuracy and precision of prosthesis implantation in total knee arthroplasty (TKA) but its impact on quality-of-life outcomes following surgery remains unestablished. METHODS: An institutional arthroplasty registry was queried to identify patients with TKA performed between January 1, 2007 and December 31, 2019. Propensity score matching based on demographical, medical, and surgical variables was used to match computer-navigated to conventionally referenced cases. The primary outcomes were Veterans RAND 12 Item Health Survey scores (VR-12 PCS and MCS), Short Form 6 Dimension utility values (SF-6D), and quality-adjusted life years (QALYs) in the first 7 years following surgery. RESULTS: A total of 629 computer-navigated TKAs were successfully matched to 1,351 conventional TKAs. The VR-12 PCS improved by a mean of 12.75 and 11.94 points in computer-navigated and conventional cases at 12-month follow-up (P = .25) and the VR-12 MCS by 6.91 and 5.93 points (P = .25), respectively. The mean VR-12 PCS improvement at 7-year follow-up (34.4% of the original matched cohort) for navigated and conventional cases was 13.00 and 12.92 points (P = .96) and for the VR-12 MCS was 4.83 and 6.30 points (P = .47), respectively. The mean improvement in the SF-6D utility score was 0.164 and 0.149 points at 12 months (P = .11) and at 7 years was 0.115 and 0.123 points (P = .69), respectively. Computer-navigated cases accumulated 0.809 QALYs in the first 7 years, compared to 0.875 QALYs in conventionally referenced cases (P = .65). There were no differences in these outcomes among a subgroup analysis of obese patients (body mass index ≥ 30 kg/m2). CONCLUSION: The use of computer navigation did not provide an incremental benefit to quality-of-life outcomes at a mean of 2.9 years following primary TKA performed for osteoarthritis when compared to conventional referencing techniques.


Assuntos
Artroplastia do Joelho , Osteoartrite do Joelho , Cirurgia Assistida por Computador , Artroplastia do Joelho/efeitos adversos , Computadores , Humanos , Osteoartrite do Joelho/etiologia , Osteoartrite do Joelho/cirurgia , Pontuação de Propensão , Qualidade de Vida , Cirurgia Assistida por Computador/métodos , Resultado do Tratamento
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