Intra-articular injections of platelet-rich plasma (PRP) are increasingly utilized in the management of knee osteoarthritis (KOA) and various other medical specialties. However, the efficacy of PRP remains a contentious issue; some experts consider it to be a placebo, while others advocate for its therapeutic value. Evidence from controlled clinical trials and meta-analyses has often yielded contradictory results, frequently failing to demonstrate a clear clinical benefit despite favorable outcomes observed in real-world settings. Several factors may contribute to these inconsistencies, with the lack of standardization in PRP preparation and the heterogeneity of KOA phenotypes being the most significant. Phenotyping is more effectively accomplished in specialized clinical environments, which may elucidate the improved outcomes associated with better patient selection. After delineating the specific characteristics of PRP injections and the primary sources of variability, we emphasize the necessity for comprehensive characterization of the injected product and accurate phenotyping of KOA. Additionally, we examine the methodological biases that impede the interpretation of clinical results and propose a treat-to-target approach as a more suitable evaluation strategy. These methodological challenges should not undermine the potential of regenerative medicine, which offers considerable promise. Compared to conventional therapies, regenerative medicine is generally more compatible with human physiology, better tolerated, and potentially less expensive. However, the advancement of this field necessitates strict scientific rigor and objectivity. This involves a meticulous recognition of biases and methodological limitations, as well as a deeper understanding of the underlying mechanisms of action, to refine and optimize therapeutic protocols.
{"title":"Platelet-rich plasma and knee osteoarthritis: A critical overview of the multiple biases and methodological complexity","authors":"Hervé Bard , Paul Ornetti , Éric Noël , Florent Eymard","doi":"10.1016/j.jbspin.2025.106014","DOIUrl":"10.1016/j.jbspin.2025.106014","url":null,"abstract":"<div><div>Intra-articular injections of platelet-rich plasma (PRP) are increasingly utilized in the management of knee osteoarthritis (KOA) and various other medical specialties. However, the efficacy of PRP remains a contentious issue; some experts consider it to be a placebo, while others advocate for its therapeutic value. Evidence from controlled clinical trials and meta-analyses has often yielded contradictory results, frequently failing to demonstrate a clear clinical benefit despite favorable outcomes observed in real-world settings. Several factors may contribute to these inconsistencies, with the lack of standardization in PRP preparation and the heterogeneity of KOA phenotypes being the most significant. Phenotyping is more effectively accomplished in specialized clinical environments, which may elucidate the improved outcomes associated with better patient selection. After delineating the specific characteristics of PRP injections and the primary sources of variability, we emphasize the necessity for comprehensive characterization of the injected product and accurate phenotyping of KOA. Additionally, we examine the methodological biases that impede the interpretation of clinical results and propose a treat-to-target approach as a more suitable evaluation strategy. These methodological challenges should not undermine the potential of regenerative medicine, which offers considerable promise. Compared to conventional therapies, regenerative medicine is generally more compatible with human physiology, better tolerated, and potentially less expensive. However, the advancement of this field necessitates strict scientific rigor and objectivity. This involves a meticulous recognition of biases and methodological limitations, as well as a deeper understanding of the underlying mechanisms of action, to refine and optimize therapeutic protocols.</div></div>","PeriodicalId":54902,"journal":{"name":"Joint Bone Spine","volume":"93 3","pages":"Article 106014"},"PeriodicalIF":4.3,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145643133","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2026-05-01Epub Date: 2025-11-13DOI: 10.1016/j.jbspin.2025.106006
Juan-Manuel Anaya , Ivan David Lozada-Martinez
{"title":"One Health and rheumatology: Research gaps and opportunities for action","authors":"Juan-Manuel Anaya , Ivan David Lozada-Martinez","doi":"10.1016/j.jbspin.2025.106006","DOIUrl":"10.1016/j.jbspin.2025.106006","url":null,"abstract":"","PeriodicalId":54902,"journal":{"name":"Joint Bone Spine","volume":"93 3","pages":"Article 106006"},"PeriodicalIF":4.3,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145531043","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2026-05-01Epub Date: 2025-11-13DOI: 10.1016/j.jbspin.2025.106008
Adamah Amouzougan , Myriam Normand , Hervé Locrelle , Laure Mathevon , Elisa Dalix , Pierre Garnier , Paul Calmels , Hubert Marotte , Thierry Thomas
Objectives
Stroke is the leading cause of acquired physical disability. In recent years, there has been a decline in early mortality due to acute medical care as well as better and earlier prevention of adverse events after stroke, therefore exposing more these patients to fragility fractures. We report very early assessment of bone microarchitecture changes in the first months following stroke-induced hemiplegia in a monocentric prospective study.
Methods
Patients had to be included within 15 days of stroke and 2 follow-up visits were planned at 3 and 6 months. At each time points, microarchitecture parameters were assessed by high-resolution peripheral quantitative computed tomography (HR-pQCT) at the tibia and the radius sites on both paretic and non-paretic sides. P-values were adjusted for multiple comparisons.
Results
Ten patients were included. All were all right-handed, hemiplegia occurring on dominant side in 6 of them. Cortical thickness decreased from baseline on paretic side (PS) as early as 3 months and 6 months both at radius (P = 0.031) and tibia (P = 0.005), while it remained stable on non-paretic side (NPS). The radius cortical area also significantly decreased only on PS (P = 0.049). There was an increase in Ct.Po on both sides over time, only at the tibia. No early changes in trabecular parameters were observed. As a result, failure load rapidly changed at both radial and tibial locations regardless of side, with numerically greater changes at the tibia PS.
Conclusion
Stroke-induced hemiplegia was associated with microarchitectural damages in both tibial and radial cortical envelopes regardless of body side, as early as 3 months post-event. These results suggest the need for early bone loss prevention including pharmacologic treatments.
{"title":"Early upper and lower limbs bone microarchitecture alterations evaluated by HR-PQCT after stroke with hemiplegia","authors":"Adamah Amouzougan , Myriam Normand , Hervé Locrelle , Laure Mathevon , Elisa Dalix , Pierre Garnier , Paul Calmels , Hubert Marotte , Thierry Thomas","doi":"10.1016/j.jbspin.2025.106008","DOIUrl":"10.1016/j.jbspin.2025.106008","url":null,"abstract":"<div><h3>Objectives</h3><div>Stroke is the leading cause of acquired physical disability. In recent years, there has been a decline in early mortality due to acute medical care as well as better and earlier prevention of adverse events after stroke, therefore exposing more these patients to fragility fractures. We report very early assessment of bone microarchitecture changes in the first months following stroke-induced hemiplegia in a monocentric prospective study.</div></div><div><h3>Methods</h3><div>Patients had to be included within 15<!--> <!-->days of stroke and 2 follow-up visits were planned at 3 and 6<!--> <!-->months. At each time points, microarchitecture parameters were assessed by high-resolution peripheral quantitative computed tomography (HR-pQCT) at the tibia and the radius sites on both paretic and non-paretic sides. <em>P</em>-values were adjusted for multiple comparisons.</div></div><div><h3>Results</h3><div>Ten patients were included. All were all right-handed, hemiplegia occurring on dominant side in 6 of them. Cortical thickness decreased from baseline on paretic side (PS) as early as 3<!--> <!-->months and 6<!--> <!-->months both at radius (<em>P</em> <!-->=<!--> <!-->0.031) and tibia (<em>P</em> <!-->=<!--> <!-->0.005), while it remained stable on non-paretic side (NPS). The radius cortical area also significantly decreased only on PS (<em>P</em> <!-->=<!--> <!-->0.049). There was an increase in Ct.Po on both sides over time, only at the tibia. No early changes in trabecular parameters were observed. As a result, failure load rapidly changed at both radial and tibial locations regardless of side, with numerically greater changes at the tibia PS.</div></div><div><h3>Conclusion</h3><div>Stroke-induced hemiplegia was associated with microarchitectural damages in both tibial and radial cortical envelopes regardless of body side, as early as 3<!--> <!-->months post-event. These results suggest the need for early bone loss prevention including pharmacologic treatments.</div></div>","PeriodicalId":54902,"journal":{"name":"Joint Bone Spine","volume":"93 3","pages":"Article 106008"},"PeriodicalIF":4.3,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145531038","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2026-05-01Epub Date: 2025-11-01DOI: 10.1016/j.jbspin.2025.106002
Giulia La Barbera , Francesco Ciodaro , Giovanni Luppino , Federica Li Pomi , Sabrina Loteta , Giovanni Miceli , Clelia Cusmano , Valeria Chirico , Angela Alibrandi , Roberto Chimenz , Carmela Visalli , Francesco Borgia , Giovanni Conti
Objective
The incudomalleal and incudostapedial articulations are synovial joints that may be involved in the inflammatory process in patients with juvenile idiophathic arthritis (JIA). The aim of the study was to assess the frequency of hearing impairment and associated risk factors in JIA patients.
Methods
We performed a cohort study on 45 patients with three JIA subtype (oligoarticular, polyarticular and psoriatic) aged between 3 and 18 years. The control group consisted of 30 healthy sex and age-matched children. Subjects underwent audiological exams and clinical-rheumatologic evaluations, including joint count (Juvenile Arthritis Disease Activity Score = cJADAS10) and inflammatory markers.
Results
Audiological impairment was detected in 16/45 (35.5%) patients with JIA. Hypoacusis was found in a significant number of ears in JIA patients (16/90 = 17.8%; P < 0.05) compared with to control group ears. Hypoacusis was frequently observed in patients with psoriasis (6/16 ears). Abnormal findings in tympanometry were observed in five types of As (with a shallow peak), four with type B (flat pattern), and in two with type C (with a negative pressure). The stapedius reflex was absent in only one patient (3%). JIA patients with hypoacusis had a significantly greater cJADAS10 (P < 0.001) and Childhood Health Assessment Questionnaire (CHAQ) (P < 0.001), a functional and quality of life assessment tool, than JIA patients with normal audiometry.
Conclusion
Hearing impairment and/or abnormal tympanograms suggest ear involvement in patients with JIA. This may be considered a complication of the disease and/or a marker of JIA activity, according cJADAS10, and could represent a valuable criterion to select the best therapeutic strategy. Therefore, JIA patients should perform an Ear, Nose and Throat (ENT) evaluation to allow early detection of auditory system involvement to prevent the impact of hearing loss.
{"title":"Ear involvement in patients affected by juvenile idiopathic arthritis","authors":"Giulia La Barbera , Francesco Ciodaro , Giovanni Luppino , Federica Li Pomi , Sabrina Loteta , Giovanni Miceli , Clelia Cusmano , Valeria Chirico , Angela Alibrandi , Roberto Chimenz , Carmela Visalli , Francesco Borgia , Giovanni Conti","doi":"10.1016/j.jbspin.2025.106002","DOIUrl":"10.1016/j.jbspin.2025.106002","url":null,"abstract":"<div><h3>Objective</h3><div>The incudomalleal and incudostapedial articulations are synovial joints that may be involved in the inflammatory process in patients with juvenile idiophathic arthritis (JIA). The aim of the study was to assess the frequency of hearing impairment and associated risk factors in JIA patients.</div></div><div><h3>Methods</h3><div>We performed a cohort study on 45 patients with three JIA subtype (oligoarticular, polyarticular and psoriatic) aged between 3 and 18<!--> <!-->years. The control group consisted of 30 healthy sex and age-matched children. Subjects underwent audiological exams and clinical-rheumatologic evaluations, including joint count (Juvenile Arthritis Disease Activity Score<!--> <!-->=<!--> <!-->cJADAS10) and inflammatory markers.</div></div><div><h3>Results</h3><div>Audiological impairment was detected in 16/45 (35.5%) patients with JIA. Hypoacusis was found in a significant number of ears in JIA patients (16/90<!--> <!-->=<!--> <!-->17.8%; <em>P</em> <!--><<!--> <!-->0.05) compared with to control group ears. Hypoacusis was frequently observed in patients with psoriasis (6/16 ears). Abnormal findings in tympanometry were observed in five types of As (with a shallow peak), four with type B (flat pattern), and in two with type C (with a negative pressure). The stapedius reflex was absent in only one patient (3%). JIA patients with hypoacusis had a significantly greater cJADAS10 (<em>P</em> <!--><<!--> <!-->0.001) and Childhood Health Assessment Questionnaire (CHAQ) (<em>P</em> <!--><<!--> <!-->0.001), a functional and quality of life assessment tool, than JIA patients with normal audiometry.</div></div><div><h3>Conclusion</h3><div>Hearing impairment and/or abnormal tympanograms suggest ear involvement in patients with JIA. This may be considered a complication of the disease and/or a marker of JIA activity, according cJADAS10, and could represent a valuable criterion to select the best therapeutic strategy. Therefore, JIA patients should perform an Ear, Nose and Throat (ENT) evaluation to allow early detection of auditory system involvement to prevent the impact of hearing loss.</div></div>","PeriodicalId":54902,"journal":{"name":"Joint Bone Spine","volume":"93 3","pages":"Article 106002"},"PeriodicalIF":4.3,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145440157","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2026-05-01Epub Date: 2025-11-13DOI: 10.1016/j.jbspin.2025.106004
Daniel Wendling , Philippe Goupille , Renaud Felten , Thao Pham , Anna Molto , Frank Verhoeven , Clément Prati , French spondyloArthritiS Taskforce (FAST)
Axial spondyloarthritis has undergone major changes since the turn of the century, concerning terminology (from ankylosing spondylitis to radiographic axial spondyloarthritis), classification criteria, introduction of targeted therapies (anti-TNF, anti-IL17, JAK inhibitors), and management strategies. Epidemiological data indicate an increasing incidence and a shorter diagnostic delay. Over the past 25 years, additional modifications have been observed: recognition of non-radiographic forms (up to 50% in recent studies), lower male predominance with a sex ratio tending to parity, reduced frequency of HLA-B27 and uveitis, wider use of targeted treatments, and changes in treatment response profiles. Overall disease severity appears to be reduced according to several indicators, including mortality, hip involvement, structural progression, and amyloidosis. The determinants of these changes remain debated and discussed in this narrative review, in the absence of long-term longitudinal studies and because of limited comparability across different time periods. The impact of environmental factors still needs to be assessed.
{"title":"The changing face of axial spondyloarthritis over the last 25 years","authors":"Daniel Wendling , Philippe Goupille , Renaud Felten , Thao Pham , Anna Molto , Frank Verhoeven , Clément Prati , French spondyloArthritiS Taskforce (FAST)","doi":"10.1016/j.jbspin.2025.106004","DOIUrl":"10.1016/j.jbspin.2025.106004","url":null,"abstract":"<div><div>Axial spondyloarthritis has undergone major changes since the turn of the century, concerning terminology (from ankylosing spondylitis to radiographic axial spondyloarthritis), classification criteria, introduction of targeted therapies (anti-TNF, anti-IL17, JAK inhibitors), and management strategies. Epidemiological data indicate an increasing incidence and a shorter diagnostic delay. Over the past 25 years, additional modifications have been observed: recognition of non-radiographic forms (up to 50% in recent studies), lower male predominance with a sex ratio tending to parity, reduced frequency of HLA-B27 and uveitis, wider use of targeted treatments, and changes in treatment response profiles. Overall disease severity appears to be reduced according to several indicators, including mortality, hip involvement, structural progression, and amyloidosis. The determinants of these changes remain debated and discussed in this narrative review, in the absence of long-term longitudinal studies and because of limited comparability across different time periods. The impact of environmental factors still needs to be assessed.</div></div>","PeriodicalId":54902,"journal":{"name":"Joint Bone Spine","volume":"93 3","pages":"Article 106004"},"PeriodicalIF":4.3,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145531024","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2026-05-01Epub Date: 2025-11-01DOI: 10.1016/j.jbspin.2025.106001
Marion Geoffroy , Myriam Beissat , L. Kanagaratnam , Stanley Ackah Miezan , Jean Hugues Salmon
Objectives
The primary objective of the study was to demonstrate the superiority of platelet-rich plasma injections in treating facet joint syndrome, compared to corticosteroid injections. Secondary objectives were to assess the efficacy of PRP compared to CTC on pain, functional impact, tolerance, and healthcare utilization following the initial infiltrative management.
Methods
Patients were randomized (1:1) to receive intra-articular injections into the painful facet joints with either PRP or CTC under radiographic guidance. The primary outcome measure was a 50% improvement in the NRS (from 0 to 10) for spontaneous lumbar pain at 6 months. Study design: Superiority, controlled, randomized (1:1), prospective, double-blind study.
Results
A total of 76 patients were included, at 6 months, 6 patients in the PRP group and 5 in the CTC group showed a 50% improvement in spontaneous NRS. No statistically significant differences were found in pain at 3, 6, or 12 months. Regarding functional evaluation, a statistically significant difference was observed in the PRP group at 3 months according to the ODI. No significant differences were found between groups in terms of satisfaction. Four patients experienced transient adverse effects, only 1 in the PRP group.
Conclusion
In patients with facet joint syndrome, PRP injections did not demonstrate superiority over CTC injections in terms of pain relief or clinically significant functional improvement at 6 months. These results do not support the use of PRP injections for facet joint syndrome.
{"title":"Platelet-rich plasma versus corticosteroids in facet joint syndrome: A controlled, randomized, double-blind study","authors":"Marion Geoffroy , Myriam Beissat , L. Kanagaratnam , Stanley Ackah Miezan , Jean Hugues Salmon","doi":"10.1016/j.jbspin.2025.106001","DOIUrl":"10.1016/j.jbspin.2025.106001","url":null,"abstract":"<div><h3>Objectives</h3><div>The primary objective of the study was to demonstrate the superiority of platelet-rich plasma injections in treating facet joint syndrome, compared to corticosteroid injections. Secondary objectives were to assess the efficacy of PRP compared to CTC on pain, functional impact, tolerance, and healthcare utilization following the initial infiltrative management.</div></div><div><h3>Methods</h3><div>Patients were randomized (1:1) to receive intra-articular injections into the painful facet joints with either PRP or CTC under radiographic guidance. The primary outcome measure was a 50% improvement in the NRS (from 0 to 10) for spontaneous lumbar pain at 6<!--> <!-->months. Study design: Superiority, controlled, randomized (1:1), prospective, double-blind study.</div></div><div><h3>Results</h3><div>A total of 76 patients were included, at 6<!--> <!-->months, 6 patients in the PRP group and 5 in the CTC group showed a 50% improvement in spontaneous NRS. No statistically significant differences were found in pain at 3, 6, or 12<!--> <!-->months. Regarding functional evaluation, a statistically significant difference was observed in the PRP group at 3<!--> <!-->months according to the ODI. No significant differences were found between groups in terms of satisfaction. Four patients experienced transient adverse effects, only 1 in the PRP group.</div></div><div><h3>Conclusion</h3><div>In patients with facet joint syndrome, PRP injections did not demonstrate superiority over CTC injections in terms of pain relief or clinically significant functional improvement at 6<!--> <!-->months. These results do not support the use of PRP injections for facet joint syndrome.</div></div>","PeriodicalId":54902,"journal":{"name":"Joint Bone Spine","volume":"93 3","pages":"Article 106001"},"PeriodicalIF":4.3,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145440230","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2026-03-19DOI: 10.1016/j.jbspin.2026.106052
Antonio Lopez, Martin Decourt, Cyril Lopez, Laurence Baumann, Jeremie Sellam, François Rannou, Christelle Nguyen, Yves-Marie Pers, Agnes Oude Engberink
Introduction: International and French recommendations emphasize non-pharmacological interventions (NPIs) for knee osteoarthritis (OA). These elements are essential to improve patient outcomes and foster behavior change. We aimed to understand patient and healthcare professionals' experiences regarding exercise, weight reduction, education and self-management programs.
Methods: We conducted a systematic review of qualitative studies using data from PubMed, Cochrane, Pascal and Francis, and the Public Health Database, published between 2001 and 2024. The selected articles were evaluated using the Critical Appraisal Skills Program checklist, followed by thematic synthesis.
Results: Out of 529 preselected articles, 75 were included, involving 1,313 patients, 389 healthcare providers, and 46 family caregivers. The thematic synthesis highlights how perceptions shape behaviors through barriers and facilitators. Barriers included a fatalistic view of knee OA as an inevitable degenerative process, providers' doubts about patient engagement, and the perception of NPIs as ineffective or harmful. Facilitators comprised an optimistic view of patient's remaining abilities, recognition of physical activity and weight management benefits, and supportive approaches such as patient-centered care, professional supervision, and peer support. Recognizing each professional's role in multidisciplinary care enhanced NPI implementation. Patient-centered education programs combining exercise and weight control provided physical, psychological, and social benefits. Enhancing professional skills and optimizing resources were identified as essential to strengthen NPI uptake.
Conclusion: This review emphasizes the importance of perceptions and a personalized, patient-centered approach. Highlighting remaining abilities and non-pharmacological interventions empowers patients, whereas a fatalistic view of joint wear hinders engagement.
国际和法国的建议强调非药物干预（npi）治疗膝骨关节炎（OA）。这些因素对于改善患者预后和促进行为改变至关重要。我们旨在了解患者和医疗保健专业人员在运动、减肥、教育和自我管理计划方面的经验。方法：我们对2001年至2024年间发表的PubMed、Cochrane、Pascal and Francis和公共卫生数据库的数据进行了定性研究的系统综述。选定的文章使用关键评估技能计划清单进行评估，然后进行主题综合。结果：在529篇预选文章中，纳入75篇，涉及1313名患者、389名医疗保健提供者和46名家庭照顾者。主题综合强调了感知如何通过障碍和促进因素塑造行为。障碍包括将膝关节OA视为不可避免的退行性过程的宿宿论观点，提供者对患者参与的怀疑，以及认为npi无效或有害。辅导员包括对患者剩余能力的乐观看法，对身体活动和体重管理益处的认识，以及支持性方法，如以患者为中心的护理，专业监督和同伴支持。认识到每个专业人员在多学科护理中的作用可以增强NPI的实施。以病人为中心的教育项目，结合锻炼和体重控制，提供了身体、心理和社会效益。提高专业技能和优化资源被认为是加强国家原创的必要条件。结论：本综述强调了认知和个性化、以患者为中心的方法的重要性。强调剩余的能力和非药物干预赋予患者权力，而关节磨损的宿命论观点阻碍了参与。
{"title":"Physical activity, education, and weight loss in knee osteoarthritis: a systematic review of qualitative studies on patients', caregivers', and professionals' experiences.","authors":"Antonio Lopez, Martin Decourt, Cyril Lopez, Laurence Baumann, Jeremie Sellam, François Rannou, Christelle Nguyen, Yves-Marie Pers, Agnes Oude Engberink","doi":"10.1016/j.jbspin.2026.106052","DOIUrl":"https://doi.org/10.1016/j.jbspin.2026.106052","url":null,"abstract":"<p><strong>Introduction: </strong>International and French recommendations emphasize non-pharmacological interventions (NPIs) for knee osteoarthritis (OA). These elements are essential to improve patient outcomes and foster behavior change. We aimed to understand patient and healthcare professionals' experiences regarding exercise, weight reduction, education and self-management programs.</p><p><strong>Methods: </strong>We conducted a systematic review of qualitative studies using data from PubMed, Cochrane, Pascal and Francis, and the Public Health Database, published between 2001 and 2024. The selected articles were evaluated using the Critical Appraisal Skills Program checklist, followed by thematic synthesis.</p><p><strong>Results: </strong>Out of 529 preselected articles, 75 were included, involving 1,313 patients, 389 healthcare providers, and 46 family caregivers. The thematic synthesis highlights how perceptions shape behaviors through barriers and facilitators. Barriers included a fatalistic view of knee OA as an inevitable degenerative process, providers' doubts about patient engagement, and the perception of NPIs as ineffective or harmful. Facilitators comprised an optimistic view of patient's remaining abilities, recognition of physical activity and weight management benefits, and supportive approaches such as patient-centered care, professional supervision, and peer support. Recognizing each professional's role in multidisciplinary care enhanced NPI implementation. Patient-centered education programs combining exercise and weight control provided physical, psychological, and social benefits. Enhancing professional skills and optimizing resources were identified as essential to strengthen NPI uptake.</p><p><strong>Conclusion: </strong>This review emphasizes the importance of perceptions and a personalized, patient-centered approach. Highlighting remaining abilities and non-pharmacological interventions empowers patients, whereas a fatalistic view of joint wear hinders engagement.</p>","PeriodicalId":54902,"journal":{"name":"Joint Bone Spine","volume":" ","pages":"106052"},"PeriodicalIF":4.3,"publicationDate":"2026-03-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147494800","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2026-03-19DOI: 10.1016/j.jbspin.2026.106056
Fadi Hassan, Eugene Merzon, Mohammad E Naffaa, Ariel Israel
Objectives: Rheumatoid arthritis (RA) may initially present with nonspecific musculoskeletal symptoms before formal diagnosis, often prompting orthopedic visits and subsequent orthopedic procedures. We aimed to examine whether such procedures are more frequent among individuals prior to RA diagnosis compared to RA-free matched controls.
Methods: We conducted a retrospective case-control study using Leumit Healthcare Services electronic database. Each subject diagnosed with RA between 2002 and 2023 was matched with 5 controls based on age, sex, and socioeconomic status (SES). Orthopedic visits and procedures during the 5-year periods before diagnosis were identified.
Results: The study included 4,405 RA patients and 22,025 age, sex and socioeconomic status matched controls. RA cases were more likely to have comorbidities, including higher rates of diabetes, chronic obstructive pulmonary disease, osteoporosis, and fibromyalgia (all p<0.01). Orthopedic visits were significantly more frequent among RA cases compared to controls (79.7% vs. 58.4%; OR 2.80, 95% CI 2.28-2.72), with 7.9% of cases consulting hand specialists compared to 3.3% of controls (OR 2.3, 95% CI 2.00-2.63). A temporal gradient was observed, with the strongest associations occurring in the year preceding RA diagnosis. Orthopedic surgical procedures were also more common, with notable differences in hand-related surgeries, including carpal tunnel release (1.23% vs. 0.48%; OR 2.57, 95% CI 1.81-3.60), trigger finger repair (0.48% vs. 0.10%; OR 1.88, 95% CI 1.08-3.16), and arthroplasty of the hand, fingers, or wrist (0.18% vs. 0.04%; OR 4.01, 95% CI 1.37-11.28). No significant differences were observed for most other surgical procedures, including shoulder, spine, or foot.
Conclusion: Prior to their formal diagnosis, RA patients seek more orthopedic and hand surgeon services in the years preceding diagnosis, compared to matched controls. These findings highlight the importance of orthopedic care in early referral for rheumatologic services to facilitate early and timely diagnosis.
{"title":"Orthopedic Visits and Procedures Preceding Rheumatoid Arthritis Diagnosis: A Nationwide Case-Control Study.","authors":"Fadi Hassan, Eugene Merzon, Mohammad E Naffaa, Ariel Israel","doi":"10.1016/j.jbspin.2026.106056","DOIUrl":"https://doi.org/10.1016/j.jbspin.2026.106056","url":null,"abstract":"<p><strong>Objectives: </strong>Rheumatoid arthritis (RA) may initially present with nonspecific musculoskeletal symptoms before formal diagnosis, often prompting orthopedic visits and subsequent orthopedic procedures. We aimed to examine whether such procedures are more frequent among individuals prior to RA diagnosis compared to RA-free matched controls.</p><p><strong>Methods: </strong>We conducted a retrospective case-control study using Leumit Healthcare Services electronic database. Each subject diagnosed with RA between 2002 and 2023 was matched with 5 controls based on age, sex, and socioeconomic status (SES). Orthopedic visits and procedures during the 5-year periods before diagnosis were identified.</p><p><strong>Results: </strong>The study included 4,405 RA patients and 22,025 age, sex and socioeconomic status matched controls. RA cases were more likely to have comorbidities, including higher rates of diabetes, chronic obstructive pulmonary disease, osteoporosis, and fibromyalgia (all p<0.01). Orthopedic visits were significantly more frequent among RA cases compared to controls (79.7% vs. 58.4%; OR 2.80, 95% CI 2.28-2.72), with 7.9% of cases consulting hand specialists compared to 3.3% of controls (OR 2.3, 95% CI 2.00-2.63). A temporal gradient was observed, with the strongest associations occurring in the year preceding RA diagnosis. Orthopedic surgical procedures were also more common, with notable differences in hand-related surgeries, including carpal tunnel release (1.23% vs. 0.48%; OR 2.57, 95% CI 1.81-3.60), trigger finger repair (0.48% vs. 0.10%; OR 1.88, 95% CI 1.08-3.16), and arthroplasty of the hand, fingers, or wrist (0.18% vs. 0.04%; OR 4.01, 95% CI 1.37-11.28). No significant differences were observed for most other surgical procedures, including shoulder, spine, or foot.</p><p><strong>Conclusion: </strong>Prior to their formal diagnosis, RA patients seek more orthopedic and hand surgeon services in the years preceding diagnosis, compared to matched controls. These findings highlight the importance of orthopedic care in early referral for rheumatologic services to facilitate early and timely diagnosis.</p>","PeriodicalId":54902,"journal":{"name":"Joint Bone Spine","volume":" ","pages":"106056"},"PeriodicalIF":4.3,"publicationDate":"2026-03-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147494754","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2026-03-19DOI: 10.1016/j.jbspin.2026.106054
Baptiste Quéré, Héloïse de Coutures, Valérie Devauchelle-Pensec, Alain Saraux
{"title":"Can artificial intelligence be used to write research protocols on polymyalgia rheumatica?","authors":"Baptiste Quéré, Héloïse de Coutures, Valérie Devauchelle-Pensec, Alain Saraux","doi":"10.1016/j.jbspin.2026.106054","DOIUrl":"https://doi.org/10.1016/j.jbspin.2026.106054","url":null,"abstract":"","PeriodicalId":54902,"journal":{"name":"Joint Bone Spine","volume":" ","pages":"106054"},"PeriodicalIF":4.3,"publicationDate":"2026-03-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147494704","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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