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Osteoarthritis Year In Review 2024: Rehabilitation and outcomes 骨关节炎 2024 年回顾：康复与成果。

IF 7.2 2区医学 Q1 ORTHOPEDICS

Osteoarthritis and Cartilage

Pub Date : 2024-08-06 DOI: 10.1016/j.joca.2024.08.001

Belinda J. Lawford , Kim L. Bennell , Travis Haber , Michelle Hall , Rana S. Hinman , Filippo Recenti , Andrea Dell’isola

This Year in Review presents key highlights from recent research relating to osteoarthritis rehabilitation and its outcomes, defined as any non-pharmacological and non-surgical treatment that aims to improve osteoarthritis symptoms at any joint. Three databases (Medline, Embase, and CINAHL Plus) were searched between 1 March 2023 to 12 March 2024. Relevant studies were chosen based on the predefined inclusion/exclusion criteria, perceived clinical importance, quality, controversy in the field, or personal interest, and organised into four overarching themes (with 1–5 sub-themes each). The first theme related to uncertainties regarding exercise benefits. New work has challenged the clinical effectiveness of exercise on symptoms, as well as highlighted uncertainty around our understanding of both mechanisms of effects, how to enhance effectiveness and adherence, and which subgroups of people are more or less likely to improve with exercise. However, we also highlight new work confirming the role of exercise as a first-line management strategy. The second theme related to digital modes of service delivery. There was new evidence to support its effectiveness in improving symptoms and clear potential for creating and evaluating new mobile apps. New work also highlighted the potential future role artificial intelligence can have in providing treatment information and recommendations. The third theme related to patient education, and the call for change to the impairment-based narrative that prevails in osteoarthritis information. The fourth theme is related to weight loss. New work compared the effectiveness of different weight loss diets and explored alternative models of weight loss delivery.

本年度回顾介绍了与骨关节炎康复及其结果有关的最新研究的主要亮点，骨关节炎康复是指旨在改善任何关节的骨关节炎症状的任何非药物和非手术疗法。我们在 2023 年 3 月 1 日至 2024 年 3 月 12 日期间检索了三个数据库（Medline、Embase 和 CINAHLplus）。根据预定义的纳入/排除标准、认为的临床重要性、质量、该领域的争议或个人兴趣选择相关研究，并将其归纳为四个总主题（每个主题有 1-5 个子主题）。第一个主题与运动益处的不确定性有关。新的研究工作对运动对症状的临床疗效提出了质疑，并强调了我们对疗效机制、如何提高疗效和依从性以及哪些亚群人群更有可能或更不可能通过运动得到改善的理解存在不确定性。不过，我们也强调了新的工作，证实了运动作为一线管理策略的作用。第二个主题与数字化服务模式有关。有新的证据支持其在改善症状方面的有效性，而且在创建和评估新的移动应用程序方面具有明显的潜力。新的工作还强调了人工智能在提供治疗信息和建议方面的潜在作用。第三个主题与患者教育有关，呼吁改变骨关节炎信息中普遍存在的以损伤为基础的叙述方式。第四个主题与减肥有关。新的研究工作比较了不同减肥饮食的效果，并探索了减肥方法的替代模式。

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引用次数: 0

Disentangling the detrimental effects of local from systemic adipose tissue dysfunction on articular cartilage in the knee 厘清局部和全身脂肪组织功能障碍对膝关节软骨的有害影响。

IF 7.2 2区医学 Q1 ORTHOPEDICS

Osteoarthritis and Cartilage

Pub Date : 2024-08-03 DOI: 10.1016/j.joca.2024.07.006

Jessica J. McClure , George D. McIlroy , Rebecca A. Symons , Susan M. Clark , Iain Cunningham , Weiping Han , Karolina Kania , Fabio Colella , Justin J. Rochford , Cosimo De Bari , Anke J. Roelofs

Objective

Obesity increases osteoarthritis (OA) risk due to adipose tissue dysfunction with associated metabolic syndrome and excess weight. Lipodystrophy syndromes exhibit systemic metabolic and inflammatory abnormalities similar to obesity without biomechanical overloading. Here, we used lipodystrophy mouse models to investigate the effects of systemic versus intra-articular adipose tissue dysfunction on the knee.

Methods

Intra-articular adipose tissue development was studied using reporter mice. Mice with selective lipodystrophy of intra-articular adipose tissue were generated by conditional knockout (cKO) of Bscl2 in Gdf5-lineage cells, and compared with whole-body Bscl2 knockout (KO) mice with generalised lipodystrophy and associated systemic metabolic dysfunction. OA was induced by surgically destabilising the medial meniscus (DMM) and obesity by high-fat diet (HFD). Gene expression was analysed by quantitative RT-PCR and tissues were analysed histologically.

Results

The infrapatellar fat pad (IFP), in contrast to overlying subcutaneous adipose tissue, developed from a template established from the Gdf5-expressing joint interzone during late embryogenesis, and was populated shortly after birth by adipocytes stochastically arising from Pdgfrα-expressing Gdf5-lineage progenitors. While female Bscl2 KO mice with generalised lipodystrophy developed spontaneous knee cartilage damage, Bscl2 cKO mice with intra-articular lipodystrophy did not, despite the presence of synovial hyperplasia and inflammation of the residual IFP. Furthermore, male Bscl2 cKO mice showed no worse cartilage damage after DMM. However, female Bscl2 cKO mice showed increased susceptibility to the cartilage-damaging effects of HFD-induced obesity.

Conclusion

Our findings emphasise the prevalent role of systemic metabolic and inflammatory effects in impairing cartilage homeostasis, with a modulatory role for intra-articular adipose tissue.

目的：肥胖会增加骨关节炎（OA）的风险，这是由于脂肪组织功能障碍以及相关的代谢综合征和超重造成的。脂肪营养不良综合征表现出与肥胖相似的全身代谢和炎症异常，但没有生物力学超负荷。在此，我们使用脂肪营养不良小鼠模型来研究全身与关节内脂肪组织功能障碍对膝关节的影响：方法：使用报告小鼠研究关节内脂肪组织的发育情况。通过条件性敲除（cKO）Gdf5系细胞中的Bscl2，产生了关节内脂肪组织选择性脂肪营养不良的小鼠，并与患有全身性脂肪营养不良和相关全身代谢功能障碍的先天性Bscl2 KO小鼠进行了比较。通过手术破坏内侧半月板（DMM）和高脂饮食（HFD）诱发肥胖。通过定量 RT-PCR 分析基因表达，并对组织进行组织学分析：结果：与上覆皮下脂肪组织不同，髌下脂肪垫（IFP）是在胚胎发育晚期从Gdf5表达的关节间区建立的模板上发育而成的，并在出生后不久由Pdgfrα+ Gdf5系祖细胞随机产生的脂肪细胞填充。患有全身性脂肪营养不良症的雌性 Bscl2 KO 小鼠会出现自发性膝关节软骨损伤，而患有关节内脂肪营养不良症的 Bscl2 cKO 小鼠尽管出现了滑膜增生和残余 IFP 的炎症，却没有出现膝关节软骨损伤。此外，雄性 Bscl2 cKO 小鼠在 DMM 后没有出现更严重的软骨损伤。然而，患有关节内脂肪营养不良症的雌性Bscl2 cKO小鼠对HFD诱导的肥胖造成的软骨损伤效应表现出更高的易感性：我们的研究结果强调了全身代谢和炎症效应在损害软骨稳态中的普遍作用，以及关节内脂肪组织的调节作用。

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引用次数: 0

Association of serum biomarkers with radiographic knee osteoarthritis, knee pain and function in a young, male, trauma-exposed population – Findings from the ADVANCE study 血清生物标志物与放射学膝关节骨性关节炎、膝关节疼痛和功能的关系--来自 ADVANCE 研究的发现。

IF 7.2 2区医学 Q1 ORTHOPEDICS

Osteoarthritis and Cartilage

Pub Date : 2024-08-03 DOI: 10.1016/j.joca.2024.07.016

Oliver O’Sullivan , Joanne Stocks , Susie Schofield , James Bilzon , Christopher J. Boos , Anthony M.J. Bull , Nicola T. Fear , Fiona E. Watt , Alexander N. Bennett , Stefan Kluzek , Ana M. Valdes

Objective

The ArmeD SerVices TrAuma RehabilitatioN OutComE (ADVANCE) study is investigating long-term combat-injury outcomes; this sub-study aims to understand the association of osteoarthritis (OA) biomarkers with knee radiographic OA (rOA), pain and function in this high-risk population for post-traumatic OA.

Design

ADVANCE compares combat-injured participants with age, rank, deployment and job-role frequency-matched uninjured participants. Post-injury immunoassay-measured serum biomarkers, knee radiographs, Knee Injury and Osteoarthritis Outcome Scale, and six-minute walk tests are reported. The primary analysis, adjusted for age, body mass, socioeconomic status, and ethnicity, was to determine any differences in biomarkers between those with/without combat injury, rOA and pain. Secondary analyses were performed to compare post-traumatic/idiopathic OA, painful/painfree rOA and injury patterns.

Results

A total of 1145 male participants were recruited, aged 34.1 ± 5.4, 8.9 ± 2.2 years post-injury (n = 579 trauma-exposed, of which, traumatic-amputation n = 161) or deployment (n = 566 matched). Cartilage oligomeric matrix protein (COMP) was significantly higher in the combat-injured group compared to uninjured (p = 0.01). Notably, COMP was significantly lower in the traumatic-amputation group compared to non-amputees (p < 0.001), decreasing relative to number of amputations (p < 0.001). Leptin was higher (p = 0.005) and adiponectin lower (p = 0.017) in those with v without knee pain, associated with an increased risk of 22% and 17% for pain, and 46% and 34% for painful rOA, respectively. There were no significant differences between trauma-exposed and unexposed participants with rOA.

Conclusions

The most notable findings of this large, unique study are the similarities between those with rOA regardless of trauma-exposure, the injury-pattern and traumatic-amputation-associated differences in COMP, and the relationship between adipokines and pain.

目标：ADVANCE研究正在调查长期战伤结果；本项子研究旨在了解骨关节炎（OA）生物标志物与这一创伤后OA高危人群的膝关节放射学OA（rOA）、疼痛和功能之间的关系：设计：ADVANCE 将在战斗中受伤的参试者与年龄、军衔、部署和工作角色频率相匹配的未受伤参试者进行比较。报告内容包括受伤后免疫测定测定的血清生物标志物、膝关节X光片、膝关节损伤和骨关节炎结果量表（KOOS）以及六分钟步行测试（6MWT）。主要分析对年龄、体重、社会经济地位和种族进行了调整，以确定有/无战斗损伤、rOA 和疼痛的患者之间在生物标志物方面是否存在差异。此外，还进行了二次分析，以比较创伤后/特发性骨质疏松症、疼痛/无疼痛骨质疏松症和受伤模式：招募了1145名男性参与者，年龄为34.1±5.4岁、受伤后8.9±2.2年（外伤暴露者579人，其中外伤性截肢者161人）或部署后8.9±2.2年（匹配者566人）。与未受伤者相比，作战受伤组的软骨寡聚基质蛋白（COMP）明显更高（P=0.01）。值得注意的是，与非截肢者相比，创伤性截肢组的 COMP 明显较低（p 结论：这项大型、独特的研究中最值得注意的发现是，无论是否受过创伤，rOA 患者之间都存在相似之处，COMP 的损伤模式和创伤性截肢相关性差异，以及脂肪因子与疼痛之间的关系。

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引用次数: 0

Osteoarthritis year in review 2024: Epidemiology and therapy 骨关节炎 2024 年回顾：流行病学与治疗

IF 7.2 2区医学 Q1 ORTHOPEDICS

Osteoarthritis and Cartilage

Pub Date : 2024-08-03 DOI: 10.1016/j.joca.2024.07.014

Alice Courties , Inès Kouki , Nadine Soliman , Sylvain Mathieu , Jérémie Sellam

This "Year in Review" presents a curated selection of research themes and individual studies within the clinical osteoarthritis (OA) field, focusing on epidemiology and therapy. The search was conducted in electronic database MEDLINE from March 4, 2023, to March 31, 2024, specifically targeting English-language articles involving human participants. Inclusions were based on perceived importance and relevance to identifying risk factors or advancing OA treatments. A total of 6539 studies were screened by the 5 authors, resulting in 157 studies considered for potential inclusion. Ultimately, 44 studies were selected, uncovering six key OA-related themes: i) the burden of OA (mostly from Global Burden of Disease studies), ii) pain drivers and trajectories, iii) impacts of sex/gender, iv) OA risk factors, and treatments for v) hand and vi) knee OA. The prevalence of OA continues to rise, particularly affecting women, with unclear distinctions in risk factors and treatment responses between sexes. Associations with atopy were demonstrated in two significant databases. Notably, the authors were particularly interested in recent high-quality methodology randomized controlled trials focusing on hand (methotrexate, denosumab, colchicine, topical betamethasone) and knee OA with conflicting results about stem cell injection. These findings collectively contribute to show the growing burden of OA, but also to help the understanding of OA pathophysiology and inform ongoing efforts to enhance management for people with OA.

本 "年度回顾 "精选了临床骨关节炎（OA）领域的研究主题和单项研究，重点关注流行病学和治疗。检索在电子数据库 MEDLINE 中进行，检索时间为 2023 年 3 月 4 日至 2024 年 3 月 31 日，检索对象为涉及人类参与者的英文文章。纳入研究的依据是对识别风险因素或推进 OA 治疗的重要性和相关性的认识。5 位作者共筛选了 6539 项研究，最终有 157 项研究被考虑纳入。最终，44 项研究被选中，揭示了与 OA 相关的六个关键主题：i) OA 负担（大部分来自全球疾病负担研究）；ii) 疼痛驱动因素和轨迹；iii) 性别影响；iv) OA 风险因素；v) 手部和 vi) 膝部 OA 的治疗方法。OA 的发病率持续上升，对女性的影响尤为严重，但不同性别在风险因素和治疗反应方面的区别并不明显。两个重要的数据库显示了与过敏症的关系。值得注意的是，作者们对近期的高质量方法学随机对照试验特别感兴趣，这些试验主要针对手部（甲氨蝶呤、地诺苏单抗、秋水仙碱、局部倍他米松）和膝关节OA，而干细胞注射的结果却相互矛盾。这些研究结果共同显示了OA带来的日益沉重的负担，同时也有助于人们了解OA的病理生理学，并为加强OA患者管理的持续努力提供信息。

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引用次数: 0

Prevalence of osteoarthritis-related imaging abnormalities in asymptomatic healthy adults 无症状健康成年人中与 OA 相关的成像异常的患病率。

IF 7.2 2区医学 Q1 ORTHOPEDICS

Osteoarthritis and Cartilage

Pub Date : 2024-07-31 DOI: 10.1016/j.joca.2024.07.011

Win Min Oo , James Linklater

引用次数: 0

From cartilage to culture: Opportunities for unraveling the complexities of osteoarthritis through sex and gender 从软骨到文化：通过性和性别揭示骨关节炎复杂性的机会。

IF 7.2 2区医学 Q1 ORTHOPEDICS

Osteoarthritis and Cartilage

Pub Date : 2024-07-30 DOI: 10.1016/j.joca.2024.07.009

Tristan Maerz , Dieuwke Schiphof

引用次数: 0

Frequent use of prescription NSAIDs among people with knee or hip osteoarthritis despite contraindications to or precautions with NSAIDs 尽管有非甾体抗炎药禁忌症或注意事项，膝关节或髋关节骨性关节炎患者仍频繁使用处方非甾体抗炎药。

IF 7.2 2区医学 Q1 ORTHOPEDICS

Osteoarthritis and Cartilage

Pub Date : 2024-07-26 DOI: 10.1016/j.joca.2024.07.010

Tuhina Neogi , Andrea Dell’Isola , Martin Englund , Aleksandra Turkiewicz

Objective

To describe the use of non-steroidal anti-inflammatory drugs (NSAID), opioids, and physiotherapy (PT) among persons with newly diagnosed knee or hip osteoarthritis (OA) with and without NSAID contraindications or precautions.

Design

We used population-based register data to identify adults aged ≥35 as of January 1, 2014, residing in Skåne region (Sweden) between 2004 and 2013, without a previous knee or hip OA diagnosis. Among this cohort, we identified people with incident knee or hip OA diagnosis between 2014 and 2018 and the presence of contraindications to or precautions for oral NSAIDs at the time of OA diagnosis. We estimated the risk of 1) regular oral NSAID use, 2) regular opioid use, and 3) PT during the first year after diagnosis among those with vs. without contraindications or precautions using confounder-adjusted logistic regression with standardization.

Results

We identified 35,173 persons with newly diagnosed OA, of whom 3257 and 8351 had ≥1 contraindication to oral NSAIDs and ≥1 precaution, respectively. Overall, 27% of individuals used oral NSAIDs (with or without opioids or PT), 10% used opioids, and 57% attended PT. Among patients with contraindications, 21% used oral NSAIDs compared to 31% without (absolute adjusted difference −0.06 (95% CIs: −0.08, −0.05)), 53% vs 59% used PT (adjusted difference −0.03 (−0.05, −0.01)), while 14% vs. 8% had prescribed dispensed opioids (adjusted difference 0.02 (0.01, 0.03)). Similar results were observed for those with precautions.

Conclusions

We highlight the need for safer treatment options. People with OA and contraindications/precautions to NSAIDs have a higher risk of opioid use, slightly lower risk of PT use, and continue to be prescribed NSAIDs.

目的描述新诊断为膝关节或髋关节骨性关节炎（OA）的患者使用非甾体类抗炎药（NSAID）、阿片类药物和物理治疗（PT）的情况，包括有无NSAID禁忌症或注意事项：我们利用基于人口的登记数据，对 2004-2013 年间居住在斯科纳地区（瑞典）、截至 2014 年 1 月 1 日年龄≥35 岁、既往未确诊过膝关节或髋关节 OA 的成年人进行了识别。在这一队列中，我们确定了在 2014-2018 年间诊断出膝关节或髋关节 OA 的人群，以及在诊断出 OA 时是否存在口服非甾体抗炎药的禁忌症或预防措施的人群。我们估计了以下情况的风险使用混杂因素调整的标准化逻辑回归，我们估算了：1）定期使用口服非甾体抗炎药；2）定期使用阿片类药物；3）在诊断后第一年内，有禁忌症或预防措施与无禁忌症或预防措施者的 PT 风险：我们发现了35173名新确诊的OA患者，其中3257人和8351人分别有≥1个口服非甾体抗炎药禁忌症和≥1个预防措施。总体而言，27%的人使用了口服非甾体抗炎药（使用或不使用阿片类药物或PT），10%的人使用了阿片类药物，57%的人参加了PT。在有禁忌症的患者中，21%的人使用口服非甾体抗炎药，而 31% 的人不使用（调整后绝对差异为 -0.06 (95% CIs: -0.08, -0.05)）；53% 的人使用 PT，而 59% 的人不使用 PT（调整后差异为 -0.03 (-0.05, -0.01)）；14% 的人使用处方配发的阿片类药物，而 8% 的人不使用处方配发的阿片类药物（调整后差异为 0.02 (0.01, 0.03)）。在有预防措施的人群中也观察到了类似的结果：我们强调需要更安全的治疗方案。患有 OA 且有非甾体抗炎药禁忌症/注意事项的患者使用阿片类药物的风险较高，使用 PT 的风险略低，且继续被开具非甾体抗炎药处方：研究中使用的所有数据均可向瑞典国家有关部门索取。

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引用次数: 0

Epigenomic differences between osteoarthritis grades in primary cartilage 原发性软骨中不同等级骨关节炎的表观基因组差异

IF 7.2 2区医学 Q1 ORTHOPEDICS

Osteoarthritis and Cartilage

Pub Date : 2024-07-23 DOI: 10.1016/j.joca.2024.07.008

Peter Kreitmaier , Diane Swift , J. Mark Wilkinson , Eleftheria Zeggini

Objective

Osteoarthritis is a common and complex joint disorder that shows higher prevalence and greater disease severity in women. Here, we investigate genome-wide methylation profiles of primary chondrocytes from osteoarthritis patients.

Design

We compare genome-wide methylation profiles of macroscopically intact (low-grade) and degraded (high-grade) osteoarthritis cartilage samples matched from osteoarthritis patients undergoing knee replacement surgery. We perform an epigenome-wide association study for cartilage degeneration across 170 patients and separately in 96 women and 74 men.

Results

We reveal widespread epigenetic differences with enrichments of nervous system and apoptosis-related processes. We further identify substantial similarities between sexes, but also sex-specific markers and pathways.

Conclusions

Together, we provide the largest genome-wide methylation profiles of primary cartilage to date with enhanced and sex-specific insights into epigenetic processes underlying osteoarthritis progression.

目的：骨关节炎是一种常见且复杂的关节疾病，女性发病率更高，病情也更严重。在此，我们研究了骨关节炎患者原发性软骨细胞的全基因组甲基化图谱：我们比较了与接受膝关节置换手术的骨关节炎患者相匹配的宏观完整（低级）和退化（高级）骨关节炎软骨样本的全基因组甲基化图谱。我们对170名患者中的96名女性和74名男性分别进行了软骨退化表观基因组关联研究（EWAS）：结果：我们发现了广泛的表观遗传学差异，其中神经系统和细胞凋亡相关过程的差异较大。结果：我们发现了广泛的表观遗传学差异，其中神经系统和细胞凋亡相关过程富集，我们还发现了两性之间的大量相似性，以及性别特异性标记和通路：总之，我们提供了迄今为止最大规模的原发性软骨全基因组甲基化图谱，增强了对骨关节炎进展的表观遗传过程的洞察力，并具有性别特异性。

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引用次数: 0

People with short symptom duration of knee osteoarthritis benefit more from exercise therapy than people with longer symptom duration: An individual participant data meta-analysis from the OA trial bank 症状持续时间短的膝骨关节炎患者比症状持续时间长的患者更容易从运动疗法中获益：来自 OA 试验库的个体参与者数据荟萃分析。

IF 7.2 2区医学 Q1 ORTHOPEDICS

Osteoarthritis and Cartilage

Pub Date : 2024-07-18 DOI: 10.1016/j.joca.2024.07.007

M. van Middelkoop , D. Schiphof , M. Hattle , J. Simkins , K.L. Bennell , R.S. Hinman , K.D. Allen , J. Knoop , M.E. van Baar , D. Bossen , J. Wallis , M. Hurley , M.A. Holden , S.M.A. Bierma-Zeinstra

Objective

To investigate whether duration of knee symptoms influenced the magnitude of the effect of exercise therapy compared to non-exercise control interventions on pain and physical function in people with knee osteoarthritis (OA).

Method

We undertook an individual participant data (IPD) meta-analysis utilising IPD stored within the OA Trial Bank from randomised controlled trials (RCTs) comparing exercise to non-exercise control interventions among people with knee OA. IPD from RCTs were analysed to determine the treatment effect by considering both study-level and individual-level covariates in the multilevel regression model. To estimate the interaction effect (i.e., treatment x duration of symptoms (dichotomised)), on self-reported pain or physical function (standardised to 0–100 scale), a one-stage multilevel regression model was applied.

Results

We included IPD from 1767 participants with knee OA from 10 RCTs. Significant interaction effects between the study arm and symptom duration (≤1 year vs >1 year, and ≤2 years vs>2 years) were found for short- (∼3 months) (Mean Difference (MD) −3.57, 95%CI −6.76 to −0.38 and −4.12, 95% CI-6.58 to −1.66, respectively) and long-term (∼12 months) pain outcomes (MD −8.33, 95%CI −12.51 to −4.15 and −8.00, 95%CI −11.21 to −4.80, respectively), and long-term function outcomes (MD −5.46, 95%CI −9.22 to −1.70 and −4.56 95%CI −7.33 to-1.80, respectively).

Conclusions

This IPD meta-analysis demonstrated that people with a relatively short symptom duration benefit more from therapeutic exercise than those with a longer symptom duration. Therefore, there seems to be a window of opportunity to target therapeutic exercise in knee OA.

目的研究膝关节症状持续时间是否会影响运动疗法与非运动对照干预对膝关节骨性关节炎（OA）患者疼痛和身体功能的影响程度：我们利用 OA 试验库（OA Trial Bank）中存储的个人参与者数据（IPD）进行了荟萃分析，这些数据来自随机对照试验（RCT），对膝关节 OA 患者进行了运动与非运动对照干预的比较。通过在多层次回归模型中考虑研究水平和个体水平的协变量，对来自随机对照试验的IPD进行分析，以确定治疗效果。为了估计交互效应（即治疗 x 症状持续时间（二分法））对自我报告疼痛或身体功能（标准化为 0-100 分）的影响，我们采用了单阶段多层次回归模型：我们纳入了来自 10 项研究性临床试验的 1767 名膝关节 OA 患者的 IPD。研究臂和症状持续时间（≤1年 vs >1年，≤2年 vs >2年）之间的显著交互效应在短期（约3个月）（平均差（MD）分别为-3.57，95%CI -6.76至-0.38和-4.12，95%CI-6.58至-1.66）和长期（约3个月）（平均差（MD）分别为-3.57，95%CI -6.76至-0.38和-4.12，95%CI-6.58至-1.66）被发现。66）和长期（约12个月）疼痛结果（MD分别为-8.33，95%CI为-12.51至-4.15和-8.00，95%CI为-11.21至-4.80），以及长期功能结果（MD分别为-5.46，95%CI为-9.22至-1.70和-4.56，95%CI为-7.33至-1.80）：这项IPD荟萃分析表明，与症状持续时间较长的患者相比，症状持续时间较短的患者从治疗性运动中获益更多。因此，针对膝关节 OA 的治疗性运动似乎存在机会之窗。

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引用次数: 0

Development of a core domain set for ankle osteoarthritis: An international consensus study of patients and health professionals 踝关节骨关节炎核心领域集的开发：患者和医疗专业人员的国际共识研究。

IF 7.2 2区医学 Q1 ORTHOPEDICS

Osteoarthritis and Cartilage

Pub Date : 2024-07-17 DOI: 10.1016/j.joca.2024.07.004

Sultan Ayyadah Alanazi , Bill Vicenzino , Christiaan J.A. van Bergen , David J. Hunter , Erik A. Wikstrom , Hylton B. Menz , Yvonne M. Golightly , Michelle D. Smith , Core Domain Set for Ankle Osteoarthritis Consensus group

Objectives

To develop an internationally agreed-upon core domain set for ankle osteoarthritis (OA).

Methods

In a three-part Delphi process, a group of multidisciplinary health professionals with expertise in ankle OA and people with ankle OA responded to online questionnaires. The questionnaires proposed a list of 29 candidate domains derived from a systematic review of ankle OA research, and interviews with people with ankle OA and health professionals. Consensus was defined a priori as ≥70% agreement in people with ankle OA and health professionals whether a domain should or should not be included in a core domain set. An online consensus meeting was held to discuss and resolve undecided candidate domains.

Results

A total of 100 people (75 health professionals and 25 people with ankle OA) from 18 countries (4 continents) participated in this study. Five domains reached consensus for inclusion in a core domain set for ankle OA – pain severity, health-related quality of life, function, disability and ankle range of motion. Twenty-one candidate domains reached agreement not to be included in the core domain set, and three domains remained undecided (ankle instability, physical capacity, and mental health).

Conclusion

This international consensus study, which included people with ankle OA and health professionals, has established a core domain set for ankle OA with five domains that should be measured and reported in all ankle OA trials – pain severity, health-related quality of life, function, disability and ankle range of motion. This core domain set will guide the reporting of outcomes in clinical trials on ankle OA. Future research should determine which outcome measurement instruments should be used to measure each of the core domains.

目的：为踝关节骨关节炎（OA）制定一套国际公认的核心领域：为踝关节骨关节炎（OA）制定一套国际公认的核心领域：在一个由三部分组成的德尔菲过程中，一组具有踝关节 OA 方面专业知识的多学科医疗专业人士和踝关节 OA 患者对在线问卷做出了回答。调查问卷提出了一份 29 个候选领域的清单，这些领域来自于对踝关节 OA 研究的系统回顾，以及对踝关节 OA 患者和医疗专业人员的访谈。共识的先验定义是，踝关节OA患者和医疗专业人员对某一领域是否应纳入核心领域集的共识度≥70%：共有来自 18 个国家（4 大洲）的 100 人（75 名医疗专业人员和 25 名踝关节 OA 患者）参与了这项研究。有五个领域达成了纳入踝关节 OA 核心领域集的共识：疼痛严重程度、与健康相关的生活质量、功能、残疾和踝关节活动范围。21个候选领域达成共识，不纳入核心领域集，3个领域仍未确定（踝关节不稳定性、体能和心理健康）：这项国际共识研究包括了踝关节 OA 患者和医疗专业人员，它确立了踝关节 OA 核心领域集，所有踝关节 OA 试验都应测量和报告这五个领域--疼痛严重程度、与健康相关的生活质量、功能、残疾和踝关节活动范围。该核心领域集将指导踝关节 OA 临床试验结果的报告。未来的研究应确定应使用哪些结果测量工具来测量每个核心领域。

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引用次数: 0