Osteoarthritis and cartilage open最新文献

How are patient-reported pain outcomes associated with biomarker and structural pathology subtypes in knee osteoarthritis? An explorative evaluation in the IMI-APPROACH cohort 膝关节骨关节炎患者报告的疼痛结果与生物标志物和结构病理学亚型之间的关系如何？IMI-APPROACH队列的探索性评价

IF 2.8

Osteoarthritis and cartilage open

Pub Date : 2025-12-11 DOI: 10.1016/j.ocarto.2025.100726

M.P. Jansen , S.C. Mastbergen , W. Wirth , F.W. Roemer , J. Bacardit , A.C. Bay-Jensen , M. Kloppenburg , F.J. Blanco , I.K. Haugen , F. Berenbaum , N. Eijkelkamp , M. Jarraya

Objective

To explore associations between patient-reported pain outcomes and knee osteoarthritis (OA) subtypes based on systemic biochemical markers and joint structural pathology as defined by MRI.

Methods

Data were obtained from 297 knee OA patients from the IMI-APPROACH study. Pain outcomes were assessed using the KOOS, WOMAC, ICOAP, NRS, PainDETECT, and a pain diary. Biochemical markers in serum and urine were used to classify patients into systemic biomarker subtypes (low tissue turnover, structural damage, and systemic inflammation) via k-means clustering. Structural pathology subtypes were determined using MRI into an inflammatory, meniscus/cartilage damage, and subchondral bone pathology subtype. Associations between pain measures and subtypes were analyzed using multivariable regression models adjusted for age, sex, and BMI.

Results

The systemic inflammation biomarker subtype was significantly associated with higher KOOS pain, WOMAC weight-bearing pain, NRS knee pain, and PainDETECT scores (all p ≤ 0.042 and β ≥ 0.12). The low tissue turnover subtype negatively associated with lower KOOS, WOMAC, and ICOAP constant pain (all p ≤ 0.22 and β ≤ −0.13), and the structural damage subtype with lower PainDETECT scores (more nociceptive-like pain; p = 0.046 and β = −0.12). Among MRI subtypes, meniscus/cartilage damage was significantly associated with lower PainDETECT scores (p = 0.005 and β = −0.16). No significant associations were found for the subchondral bone subtype or pain diary outcomes.

Conclusion

For commonly used pain questionnaires, pain severity seems linked with inflammatory activity more than structural damage. Structural damage is primarily associated with nociceptive-like pain according to PainDETECT, which might be valuable for patient selection to clinical trials and observational studies.

目的探讨患者报告的疼痛结局与膝关节骨性关节炎（OA）亚型之间的关系，该关系基于MRI定义的全身生化标志物和关节结构病理学。方法收集来自IMI-APPROACH研究的297例膝关节OA患者的数据。采用kos、WOMAC、ICOAP、NRS、PainDETECT和疼痛日记评估疼痛结局。血清和尿液中的生化标志物通过k-均值聚类将患者分为系统性生物标志物亚型（低组织更新、结构损伤和全身性炎症）。结构病理亚型通过MRI确定为炎症、半月板/软骨损伤和软骨下骨病理亚型。使用调整了年龄、性别和BMI的多变量回归模型分析疼痛测量和亚型之间的关联。结果全身性炎症标志物亚型与较高的KOOS疼痛、WOMAC负重疼痛、NRS膝关节疼痛和PainDETECT评分显著相关（p≤0.042,β≥0.12）。低组织转换亚型与较低的kos、WOMAC和ICOAP持续性疼痛呈负相关（均p≤0.22,β≤- 0.13），结构损伤亚型与较低的PainDETECT评分呈负相关（更多的伤害性样痛，p = 0.046, β = - 0.12）。在MRI亚型中，半月板/软骨损伤与较低的PainDETECT评分显著相关（p = 0.005和β = - 0.16）。软骨下骨亚型或疼痛日记结果未发现显著相关性。结论对于常用的疼痛问卷，疼痛严重程度似乎与炎症活动的关系大于与结构损伤的关系。根据PainDETECT，结构损伤主要与伤害性疼痛相关，这可能对临床试验和观察性研究的患者选择有价值。

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引用次数: 0

Osteoarthritis physical activity care pathway: Results of an exploratory trial 骨关节炎身体活动护理途径：一项探索性试验的结果

IF 2.8

Osteoarthritis and cartilage open

Pub Date : 2025-12-08 DOI: 10.1016/j.ocarto.2025.100724

Kelli D. Allen , Katie F. Huffman , Leigh F. Callahan , Natalie Fullenkamp , Yvonne M. Golightly , Derek P. Hales , Amanda E. Nelson , Stephanie Ntim , Ami Pathak , Jennifer Rees , Riya Vasa , Maihan B. Vu , Rebecca J. Cleveland

Objective

To conduct an exploratory randomized controlled trial of a physical activity intervention for individuals with osteoarthritis (OA) involving telephone-delivered coaching, activity self-monitoring, and connection with resources to support activity (Osteoarthritis Physical Activity Care Pathway; OA-PCP).

Methods

Older adults (age ≥65 years) with symptomatic hip or knee OA and comorbid health conditions (N = 240) were randomized to OA-PCP or an attention control (AC) condition. OA-PCP included coaching calls at baseline and at 3-month intervals through 12 months, as well as email-delivered content. The ACgroup received calls and emails focused on OA education. The primary outcome was minutes of moderate to vigorous physical activity (MVPA) per week, measured at baseline, 6-months and 12-months via accelerometer. Secondary outcomes included other physical activity metrics and the Western Ontario and McMaster Universities Osteoarthritis Index pain and function subscales. Linear mixed regression was used to estimate between-group differences from baseline to follow-up time points.

Results

At 6-month and 12-month follow-up, the changes in weekly MVPA favored the OA-PCP by 9.5 min (95 % Confidence Interval −6.7, 25.8; p = 0.252) and 12.3 min (95 % Confidence Interval −3.8, 28.4; p = 0.136), respectively, but differences were not statistically or clinically significant. There were no significant between-group differences in secondary outcomes other than steps per day at 12-months

Conclusions

A more intensive intervention approach may be needed to enhance physical activity among older adults with OA and comorbid health conditions.

目的开展一项针对骨关节炎（OA）患者的身体活动干预的探索性随机对照试验，包括电话指导、活动自我监测以及与支持活动的资源联系（osteoarthritis physical activity Care Pathway; OA- pcp）。方法将有症状性髋关节或膝关节骨关节炎并伴有合并症的成人（年龄≥65岁）（N = 240）随机分为OA- pcp组或注意控制组。OA-PCP包括基线和3个月至12个月间隔的指导电话，以及电子邮件传递的内容。ACgroup收到了关于OA教育的电话和电子邮件。主要终点是每周中度至剧烈体力活动分钟数（MVPA），在基线、6个月和12个月时通过加速度计测量。次要结果包括其他身体活动指标和西安大略省和麦克马斯特大学骨关节炎指数疼痛和功能亚量表。采用线性混合回归估计从基线到随访时间点的组间差异。结果随访6个月和12个月，每周MVPA的变化对OA-PCP分别有利9.5 min（95%可信区间- 6.7,25.8,p = 0.252）和12.3 min(95%可信区间- 3.8,28.4,p = 0.136)，但差异无统计学意义和临床意义。在12个月时，除了每天步数外，其他次要结局在组间无显著差异。结论：可能需要更强化的干预方法来增强OA和共病健康状况的老年人的身体活动。

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引用次数: 0

Corrigendum to ‘Effect of a multidisciplinary lifestyle intervention on body composition in people with osteoarthritis: Secondary analysis of the “Plants for Joints” randomized controlled trial’ [Osteoarthritis and Cartilage Open 6 (2024) 100524] 多学科生活方式干预对骨关节炎患者身体成分的影响：对“关节植物”随机对照试验的二次分析[骨关节炎和软骨开放6(2024)100524]的更正

IF 2.8

Osteoarthritis and cartilage open

Pub Date : 2025-12-07 DOI: 10.1016/j.ocarto.2025.100722

C.A. Wagenaar , W. Walrabenstein , C.S. de Jonge , M. Bisschops , M. van der Leeden , M. van der Esch , P.J.M. Weijs , M.A. Troelstra , M.A. Korteweg , A.J. Nederveen , D. van Schaardenburg

引用次数: 0

Biopsychosocial predictive factors for developing chronic postsurgical pain after hip replacement surgery: A systematic review 髋关节置换术后慢性术后疼痛的生物心理社会预测因素：一项系统综述

IF 2.8

Osteoarthritis and cartilage open

Pub Date : 2025-12-04 DOI: 10.1016/j.ocarto.2025.100725

Rachel J.H. Smits , Rosa Poppen , Jetze Visser , Kris C.P. Vissers , Selina E.I. van der Wal

Objective

Total hip arthroplasty for end stage osteoarthritis is a common and often successful procedure. However, 14 % of patients experience chronic postsurgical pain after 1 year. The risk of developing chronic pain is multifactorial. The aim of this systematic review is to provide an overview of recent literature on predictive factors for developing postsurgical chronic pain after total hip arthroplasty to create a prognostic model for better recognition, perioperative optimization or reconsideration.

Design

Studies were eligible if patients were over 18 years old, biopsychosocial risk factors and the occurrence of pain >3 months after surgery was reported. PubMed, EMBASE and CENTRAL were searched up to June 16th, 2025. The selected studies were screened and assessed on quality and risk of bias.

Results

Fifteen studies met the inclusion criteria. These studies identified multiple biopsychosocial factors that may contribute to the development of chronic postsurgical pain. These include body mass index, preoperative (neuropathic) pain, the presence of comorbidities and functional disability, smoking, non-white race, sleep disturbances, depressive symptoms, anxiety, central sensitization, and pain catastrophizing. Additional associations were found for (younger) age and female sex. Some studies failed to demonstrate significant associations of certain factors, highlighting the complexity of chronic pain.

Conclusion

The identified, modifiable risk factors could be targets for prehabilitation and optimization. Personalized multimodal analgesia strategies might be more beneficial in high risk patients. Chronic postsurgical pain should be part of the informed consent and non-operative options could be considered in high risk patients.

目的全髋关节置换术治疗终末期骨关节炎是一种常见且成功的手术方法。然而，14%的患者在1年后出现慢性术后疼痛。发生慢性疼痛的风险是多因素的。本系统综述的目的是提供关于全髋关节置换术后发生慢性疼痛的预测因素的最新文献综述，以建立更好的识别、围手术期优化或重新考虑的预后模型。如果患者年龄大于18岁，有生物-心理-社会风险因素和术后3个月疼痛发生的报告，则纳入设计研究。PubMed， EMBASE和CENTRAL检索截止到2025年6月16日。对选定的研究进行筛选，并对其质量和偏倚风险进行评估。结果15项研究符合纳入标准。这些研究确定了多种可能导致慢性术后疼痛的生物心理社会因素。这些因素包括体重指数、术前（神经性）疼痛、合并症和功能残疾、吸烟、非白种人、睡眠障碍、抑郁症状、焦虑、中枢敏感化和疼痛灾难化。在（年轻的）年龄和女性中发现了额外的关联。一些研究未能证明某些因素的显著关联，突出了慢性疼痛的复杂性。结论已识别的、可改变的危险因素可作为预防和优化的目标。个性化的多模式镇痛策略可能对高危患者更有益。慢性术后疼痛应该是知情同意的一部分，高风险患者可以考虑非手术治疗。

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引用次数: 0

Sex-specific patterns and limited bilateral symmetry in coronal knee alignment: Insights from the modified coronal plane alignment of the knee classification 膝关节冠状面排列中的性别特异性模式和有限的双侧对称性：来自改良的膝关节冠状面排列分类的见解

IF 2.8

Osteoarthritis and cartilage open

Pub Date : 2025-11-28 DOI: 10.1016/j.ocarto.2025.100721

Kyota Ishibashi , Ryoto Kura , Eiji Sasaki , Hikaru Kristi Ishibashi , Yuka Kimura , Yukiko Sakamoto , Eiichi Tsuda , Yasuyuki Ishibashi

Objective

The modified Coronal Plane Alignment of the Knee (CPAK) classification broadens the neutral boundaries of arithmetic hip–knee–ankle angle (aHKA) and introduces the concept of arithmetic joint line obliquity (aJLO). This study aimed to compare the original and modified CPAK classifications and to evaluate their impact on sex-specific distribution and bilateral asymmetry.

Design

A total of 673 adults (400 women) from the Iwaki Health Promotion Project were analyzed. The aHKA was calculated as follows: aHKA = medial proximal tibial angle (MPTA) – lateral distal femoral angle (LDFA). The aJLO was calculated as follows: 90° – (LDFA + MPTA)/2. The original CPAK classification categorized knees into nine phenotypes using the aHKA and JLO, with neutral boundaries defined as 0° ± 2°. The modified CPAK classification adopted a wider neutral boundary of 0° ± 3° for the aHKA and aJLO. Sex-stratified analyses and bilateral comparisons were conducted.

Results

The modified CPAK classification redistributed the phenotypes more evenly and increased the proportion of neutral–neutral type V knees to 23.2% (vs. only 3.1% with the original CPAK classification). Men more frequently showed varus phenotypes, particularly type I (20.8%), whereas women had a higher prevalence of neutral (25.8%) and valgus phenotypes. Bilateral knee analysis revealed strong correlations with aHKA (r = 0.71, p < 0.001) and aJLO (r = 0.73, p < 0.001). However, only 58% of individuals showed identical CPAK types bilaterally.

Conclusions

Compared with the original system, the modified CPAK classification offers a more balanced representation of coronal alignment in Asian knees.

目的改进的膝关节冠状面对齐（CPAK）分类拓宽了算术髋关节-膝关节-踝关节角（aHKA）的中性边界，引入了算术关节线倾角（aJLO）的概念。本研究旨在比较原始和修改后的CPAK分类，并评估其对性别特异性分布和双侧不对称的影响。设计分析了来自磐城健康促进项目的673名成年人（400名女性）。aHKA计算公式如下：aHKA =胫骨内侧近端角(MPTA) -股骨外侧远端角（LDFA）。aJLO计算公式为：90°- (LDFA + MPTA)/2。最初的CPAK分类使用aHKA和JLO将膝关节分为9种表型，中性边界定义为0°±2°。修正后的CPAK分类对aHKA和aJLO采用了更宽的中性边界0°±3°。进行了性别分层分析和双边比较。结果改良后的CPAK分类更均匀地重新分配了表型，使中性-中性型V型膝关节的比例增加到23.2%（而原始CPAK分类仅为3.1%）。男性更常表现为内翻型，特别是I型（20.8%），而女性则有更高的中性型（25.8%）和外翻型。双侧膝关节分析显示aHKA （r = 0.71, p < 0.001）和aJLO （r = 0.73, p < 0.001）有很强的相关性。然而，只有58%的个体显示出相同的CPAK类型。结论与原始系统相比，改良的CPAK分类能更平衡地反映亚洲膝的冠状排列。

{"title":"Sex-specific patterns and limited bilateral symmetry in coronal knee alignment: Insights from the modified coronal plane alignment of the knee classification","authors":"Kyota Ishibashi , Ryoto Kura , Eiji Sasaki , Hikaru Kristi Ishibashi , Yuka Kimura , Yukiko Sakamoto , Eiichi Tsuda , Yasuyuki Ishibashi","doi":"10.1016/j.ocarto.2025.100721","DOIUrl":"10.1016/j.ocarto.2025.100721","url":null,"abstract":"<div><h3>Objective</h3><div>The modified Coronal Plane Alignment of the Knee (CPAK) classification broadens the neutral boundaries of arithmetic hip–knee–ankle angle (aHKA) and introduces the concept of arithmetic joint line obliquity (aJLO). This study aimed to compare the original and modified CPAK classifications and to evaluate their impact on sex-specific distribution and bilateral asymmetry.</div></div><div><h3>Design</h3><div>A total of 673 adults (400 women) from the Iwaki Health Promotion Project were analyzed. The aHKA was calculated as follows: aHKA = medial proximal tibial angle (MPTA) – lateral distal femoral angle (LDFA). The aJLO was calculated as follows: 90° – (LDFA + MPTA)/2. The original CPAK classification categorized knees into nine phenotypes using the aHKA and JLO, with neutral boundaries defined as 0° ± 2°. The modified CPAK classification adopted a wider neutral boundary of 0° ± 3° for the aHKA and aJLO. Sex-stratified analyses and bilateral comparisons were conducted.</div></div><div><h3>Results</h3><div>The modified CPAK classification redistributed the phenotypes more evenly and increased the proportion of neutral–neutral type V knees to 23.2% (vs. only 3.1% with the original CPAK classification). Men more frequently showed varus phenotypes, particularly type I (20.8%), whereas women had a higher prevalence of neutral (25.8%) and valgus phenotypes. Bilateral knee analysis revealed strong correlations with aHKA (<em>r</em> = 0.71, <em>p</em> < 0.001) and aJLO (<em>r</em> = 0.73, <em>p</em> < 0.001). However, only 58% of individuals showed identical CPAK types bilaterally.</div></div><div><h3>Conclusions</h3><div>Compared with the original system, the modified CPAK classification offers a more balanced representation of coronal alignment in Asian knees.</div></div>","PeriodicalId":74377,"journal":{"name":"Osteoarthritis and cartilage open","volume":"8 1","pages":"Article 100721"},"PeriodicalIF":2.8,"publicationDate":"2025-11-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145694227","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Physical activity and diurnal variation have no impact on plasma microRNA-140 expression levels in patients with knee osteoarthritis and healthy controls 体力活动和日变化对膝关节骨关节炎患者和健康对照者血浆microRNA-140表达水平无影响

IF 2.8

Osteoarthritis and cartilage open

Pub Date : 2025-11-27 DOI: 10.1016/j.ocarto.2025.100720

Tommy Frøseth Aae , Rune Bruhn Jakobsen , Mai Britt Dahl , Asbjørn Årøen , Per-Henrik Randsborg , Myrthle Slettvåg Hoel , Øystein Bjerkestrand Lian

Objective

This study aimed to determine whether physical activity or diurnal variation influence circulating microRNA-140-3p (miR-140-3p) and miR-140-5p expression levels in patients with knee osteoarthritis (OA) compared to healthy controls.

Method

Twenty-one patients with knee OA and ten healthy controls ran on a treadmill for 20 min and blood samples were taken prior to and after running. To assess diurnal variation, blood samples were drawn at six different times during a 24-h period. RNA was extracted from plasma and used for cDNA synthesis. Expression levels were assessed with real-time quantitative polymerase chain reaction and compared between patients and controls.

Results

All participants had detectable expression levels of miR-140-3p and miR-140-5p. A paired analysis could not demonstrate statistically significant differences between the groups.

Conclusions

Plasma miR-140-3p and miR-140-5p expression levels were found in all samples; however, the expression levels were not affected by physical activity and did not show diurnal variation. The observation of stable miR-140 expression supports its potential as a reliable biomarker for OA, providing a methodological foundation for future diagnostic and translational studies.

目的本研究旨在确定与健康对照相比，体力活动或日变化是否会影响膝关节骨关节炎（OA）患者循环microRNA-140-3p （miR-140-3p）和miR-140-5p的表达水平。方法21例膝关节OA患者和10例健康对照者在跑步机上跑步20 min，并在跑步前后采集血液样本。为了评估昼夜变化，在24小时内的六个不同时间抽取血液样本。从血浆中提取RNA，用于cDNA合成。用实时定量聚合酶链反应评估表达水平，并将患者与对照组进行比较。结果所有参与者均检测到miR-140-3p和miR-140-5p的表达水平。配对分析不能证明组间有统计学上的显著差异。结论miR-140-3p和miR-140-5p在所有样本中均有表达水平；然而，表达水平不受身体活动的影响，也不表现出日变化。miR-140稳定表达的观察支持其作为OA可靠生物标志物的潜力，为未来的诊断和转化研究提供方法学基础。

{"title":"Physical activity and diurnal variation have no impact on plasma microRNA-140 expression levels in patients with knee osteoarthritis and healthy controls","authors":"Tommy Frøseth Aae , Rune Bruhn Jakobsen , Mai Britt Dahl , Asbjørn Årøen , Per-Henrik Randsborg , Myrthle Slettvåg Hoel , Øystein Bjerkestrand Lian","doi":"10.1016/j.ocarto.2025.100720","DOIUrl":"10.1016/j.ocarto.2025.100720","url":null,"abstract":"<div><h3>Objective</h3><div>This study aimed to determine whether physical activity or diurnal variation influence circulating microRNA-140-3p (miR-140-3p) and miR-140-5p expression levels in patients with knee osteoarthritis (OA) compared to healthy controls.</div></div><div><h3>Method</h3><div>Twenty-one patients with knee OA and ten healthy controls ran on a treadmill for 20 min and blood samples were taken prior to and after running. To assess diurnal variation, blood samples were drawn at six different times during a 24-h period. RNA was extracted from plasma and used for cDNA synthesis. Expression levels were assessed with real-time quantitative polymerase chain reaction and compared between patients and controls.</div></div><div><h3>Results</h3><div>All participants had detectable expression levels of miR-140-3p and miR-140-5p. A paired analysis could not demonstrate statistically significant differences between the groups.</div></div><div><h3>Conclusions</h3><div>Plasma miR-140-3p and miR-140-5p expression levels were found in all samples; however, the expression levels were not affected by physical activity and did not show diurnal variation. The observation of stable miR-140 expression supports its potential as a reliable biomarker for OA, providing a methodological foundation for future diagnostic and translational studies.</div></div>","PeriodicalId":74377,"journal":{"name":"Osteoarthritis and cartilage open","volume":"8 1","pages":"Article 100720"},"PeriodicalIF":2.8,"publicationDate":"2025-11-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145693587","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Feasibility of a randomized trial comparing exercise-based rehabilitation to no exercise-based rehabilitation after total knee arthroplasty: DRAW-TKA hybrid 1 RCT 一项比较全膝关节置换术后基于运动的康复与不基于运动的康复的随机试验的可行性：DRAW-TKA混合RCT

IF 2.8

Osteoarthritis and cartilage open

Pub Date : 2025-11-21 DOI: 10.1016/j.ocarto.2025.100708

Birk M. Grønfeldt , Søren T. Skou , Jeanette W. Kirk , Anders Troelsen , Thomas Bandholm

Objective

Trials comparing the effectiveness of exercise-based rehabilitation against no exercise-based rehabilitation are needed, but their feasibility is unclear. The DRAW-TKA feasibility trial aimed to assess recruitment-, retention-, harms-, and procedural feasibility to inform a full-scale effectiveness trial.

Design

This pragmatic, multicentre, parallel, two-arm feasibility trial included participants scheduled for total knee arthroplasty due to osteoarthritis, aged ≥18, who could read and write Danish. Participants were recruited pre-operatively from two hospitals. At discharge, participants were encouraged to be physically active and randomised (one-to-one) to “Referral to exercise” (usual care) or “No exercise”. Recruiters, outcome assessors, and intervention-deliverers were masked to allocation. The primary feasibility criteria were based on recruitment rate, retention, participation barriers, and data completeness. Secondary criteria on harms, procedural feasibility, and intervention acceptance.

Results

Between Aug 22nd^, 2023, and Feb 29th^, 2024, all 445 patients planned for TKA were screened, of whom 338 (76 %) were ineligible, 49 of 107 eligible (45·8 %) declined participation (wanted exercise), and 25 of 107 (23·4 %) were randomly assigned exercise (n = 12) or no exercise (n = 13). Because of intervention-specific withdrawals (n = 3) and attrition, 18 of 25 completed all three-month assessments. Three of four predefined, primary feasibility criteria were met. Clinicians and participants found the trial procedurally feasible and acceptable. No interventional harms occurred.

Conclusion

The trial's scientific rationale – allocation to exercise, or no exercise – introduced significant risk of selection and attrition bias in this clinical context, severely limiting the generalisability. Although recruitment was predominantly feasible, further adaptations are required to warrant full-scale initiation.

NCT05935020.

目的比较运动康复与非运动康复的有效性需要进行试验，但其可行性尚不清楚。DRAW-TKA可行性试验旨在评估招募、保留、危害和程序可行性，为全面有效性试验提供信息。设计：这项实用、多中心、平行、双臂可行性试验纳入了年龄≥18岁、能读写丹麦语的因骨关节炎而计划行全膝关节置换术的受试者。参与者术前从两家医院招募。出院时，研究人员鼓励参与者进行身体活动，并随机（一对一）分配到“转介锻炼”（常规护理）或“不锻炼”。招募者、结果评估者和干预提供者对分配不知情。主要的可行性标准是基于招募率、保留率、参与障碍和数据完整性。二级标准为危害、程序可行性和干预接受程度。结果在2023年8月22日至2024年2月29日期间，筛选了445例计划进行TKA的患者，其中338例（76%）不符合条件，107例符合条件的患者中49例（45.8%）拒绝参与（想要运动），107例患者中25例（23.4%）随机分配运动（n = 12）或不运动（n = 13）。由于特定干预措施的退出（n = 3）和减员，25人中有18人完成了所有三个月的评估。四项预先确定的主要可行性标准中有三项得到满足。临床医生和参与者认为试验在程序上是可行和可接受的。无干预性损害发生。该试验的科学原理——分配运动或不运动——在该临床背景下引入了显著的选择和消耗偏倚风险，严重限制了其普遍性。虽然招募在很大程度上是可行的，但需要进一步的调整以保证全面启动。

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引用次数: 0

Patient-reported outcomes of a comprehensive management program for osteoarthritis of the hip and knee 髋关节和膝关节骨关节炎综合治疗方案的患者报告结果

IF 2.8

Osteoarthritis and cartilage open

Pub Date : 2025-11-21 DOI: 10.1016/j.ocarto.2025.100711

Trevor A. Lentz , Preston Roundy , Emily Poehlein , Cynthia L. Green , Richard C. Mather III , William Jiranek

Objective

This study describes the 2-year self-reported joint function outcomes of patients enrolled in a US-based comprehensive hip and knee osteoarthritis management program (OAMP), and demographic characteristics associated with change in function.

Design

This is a retrospective analysis of 598 patients with hip OA and 1533 patients with knee OA enrolled in the program between October 2017 and October 2024. Outcome measures for joint function (HOOS JR and KOOS JR) were collected via questionnaire at baseline, 6 weeks, 3 months, 6 months, 12 months, and 2 years after program enrollment. Generalized estimating equations (GEE) were used to describe trends in outcomes over time, and Kaplan Meier curves were constructed to assess time to meet minimal clinically important difference (MCID) thresholds. We conducted sensitivity analyses including several imputation strategies to address follow-up non-response. Interaction terms between timepoint and age, sex, race, and employment status were included in the covariate adjusted model.

Results

We observed statistically significant improvements in joint function over time for both hip and knee patients, and these significant improvements persisted in each sensitivity analysis. By 2 years, 61 % of knee patients and 60 % of hip patients met established MCIDs. Employment status, sex, and baseline function were associated with the trajectory of HOOS JR score.

Conclusions

Patients enrolled in this US-based OAMP experienced improvements, on average, for hip and knee symptoms, with most patients meeting clinically meaningful improvement thresholds by 2 years. These findings suggest that comprehensive OAMPs may offer an effective alternative to surgery.

目的：本研究描述了参加美国髋关节和膝关节骨关节炎综合管理项目（OAMP）的患者2年自我报告的关节功能结果，以及与功能变化相关的人口统计学特征。这是对2017年10月至2024年10月期间入组的598例髋关节OA患者和1533例膝关节OA患者的回顾性分析。在项目入组后的基线、6周、3个月、6个月、12个月和2年，通过问卷收集关节功能的结局测量（HOOS JR和kos JR）。使用广义估计方程（GEE）来描述结果随时间的趋势，并构建Kaplan Meier曲线来评估满足最小临床重要差异（MCID）阈值的时间。我们进行了敏感性分析，包括几种归因策略来解决后续无反应的问题。时间点与年龄、性别、种族和就业状况之间的相互作用项包括在协变量调整模型中。结果我们观察到，随着时间的推移，髋关节和膝关节患者的关节功能都有统计学上的显著改善，并且这些显著改善在每个敏感性分析中都持续存在。2年后，61%的膝关节患者和60%的髋关节患者达到了既定的MCIDs。就业状况、性别和基线功能与HOOS JR评分轨迹相关。结论：参加美国OAMP的患者平均髋关节和膝关节症状得到改善，大多数患者在2年内达到有临床意义的改善阈值。这些发现表明，全面的oamp可能是手术的有效替代。

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引用次数: 0

PIEZO mechanosensitivity in chondrocytes is differentially modulated by L-type and T-type voltage-sensitive ion channels 软骨细胞的压电机械敏感性受l型和t型电压敏感离子通道的差异调节

IF 2.8

Osteoarthritis and cartilage open

Pub Date : 2025-11-20 DOI: 10.1016/j.ocarto.2025.100710

Alireza Savadipour , Gabrielle K. Marushack , Robert J. Nims , Jaquelin M. Garcia-Castorena , Wolfgang Liedtke , Farshid Guilak

Objective

One of the primary factors contributing to OA development is altered or excessive mechanical stress on the joint, which chondrocytes sense in part through the PIEZO mechanosensitive ion channels. These channels activate signaling pathways that result in joint inflammation and cartilage degeneration. In addition to PIEZO channels, voltage-gated calcium (Ca²⁺) channels (VGCCs) have been shown to contribute to Ca²⁺ influx into chondrocytes in response to mechanical loads.

Design

To better understand the relationship between PIEZO1 and VGCCs, we quantified porcine chondrocytes' intracellular Ca²⁺ response to mechanical loading or Yoda1 (a PIEZO1 agonist) after various classes of VGCCs were chemically inhibited. We also studied the effects of VGCC blockers on chondrocyte viability in porcine cartilage explants subjected to mechanical compression.

Results

In primary chondrocytes, nifedipine, an L-type VGCC blocker, reduced PIEZO1 sensitivity to both mechanical compression and pharmacological agonism, while NNC-55, a T-type VGCC blocker, increased PIEZO1 activation in response to both stimuli. Similarly, treating cartilage explants exposed to injurious mechanical loads with nifedipine reduced mechanically induced cell death compared to the control, while treatment with NNC-55 increased cell death.

Conclusions

In addition to contributing to the current understanding of the mechanisms through which VGCCs modify chondrocyte mechanobiology, our findings suggest the potential of L-type VGCC inhibitors as therapeutic targets for decreasing PIEZO1 signaling and reducing chondrocyte death in response to supraphysiologic mechanical loads.

目的导致骨性关节炎发生的主要因素之一是关节上机械应力的改变或过度，软骨细胞部分通过压电陶瓷机械敏感离子通道感知。这些通道激活导致关节炎症和软骨变性的信号通路。除了压电通道，电压门控钙（Ca2+）通道（VGCCs）已被证明有助于Ca2+内流到软骨细胞响应机械负荷。为了更好地理解PIEZO1和VGCCs之间的关系，我们量化了猪软骨细胞对机械负荷或Yoda1（一种PIEZO1激动剂）的细胞内Ca2+反应。我们还研究了VGCC阻滞剂对机械压迫下猪软骨外植体软骨细胞活力的影响。结果在原代软骨细胞中，l型VGCC阻滞剂硝苯地平降低了PIEZO1对机械压迫和药理激动作用的敏感性，而t型VGCC阻滞剂NNC-55增加了PIEZO1对这两种刺激的激活。同样，与对照组相比，用硝苯地平处理暴露于损伤机械负荷的软骨外植体可以减少机械诱导的细胞死亡，而用NNC-55处理则增加了细胞死亡。结论除了有助于目前对VGCC改变软骨细胞力学生物学机制的理解外，我们的研究结果表明，l型VGCC抑制剂可能作为治疗靶点，在响应超生理机械负荷时降低PIEZO1信号传导和减少软骨细胞死亡。

{"title":"PIEZO mechanosensitivity in chondrocytes is differentially modulated by L-type and T-type voltage-sensitive ion channels","authors":"Alireza Savadipour , Gabrielle K. Marushack , Robert J. Nims , Jaquelin M. Garcia-Castorena , Wolfgang Liedtke , Farshid Guilak","doi":"10.1016/j.ocarto.2025.100710","DOIUrl":"10.1016/j.ocarto.2025.100710","url":null,"abstract":"<div><h3>Objective</h3><div>One of the primary factors contributing to OA development is altered or excessive mechanical stress on the joint, which chondrocytes sense in part through the PIEZO mechanosensitive ion channels. These channels activate signaling pathways that result in joint inflammation and cartilage degeneration. In addition to PIEZO channels, voltage-gated calcium (Ca<sup>2+</sup>) channels (VGCCs) have been shown to contribute to Ca<sup>2+</sup> influx into chondrocytes in response to mechanical loads.</div></div><div><h3>Design</h3><div>To better understand the relationship between PIEZO1 and VGCCs, we quantified porcine chondrocytes' intracellular Ca<sup>2+</sup> response to mechanical loading or Yoda1 (a PIEZO1 agonist) after various classes of VGCCs were chemically inhibited. We also studied the effects of VGCC blockers on chondrocyte viability in porcine cartilage explants subjected to mechanical compression.</div></div><div><h3>Results</h3><div>In primary chondrocytes, nifedipine, an L-type VGCC blocker, reduced PIEZO1 sensitivity to both mechanical compression and pharmacological agonism, while NNC-55, a T-type VGCC blocker, increased PIEZO1 activation in response to both stimuli. Similarly, treating cartilage explants exposed to injurious mechanical loads with nifedipine reduced mechanically induced cell death compared to the control, while treatment with NNC-55 increased cell death.</div></div><div><h3>Conclusions</h3><div>In addition to contributing to the current understanding of the mechanisms through which VGCCs modify chondrocyte mechanobiology, our findings suggest the potential of L-type VGCC inhibitors as therapeutic targets for decreasing PIEZO1 signaling and reducing chondrocyte death in response to supraphysiologic mechanical loads.</div></div>","PeriodicalId":74377,"journal":{"name":"Osteoarthritis and cartilage open","volume":"8 1","pages":"Article 100710"},"PeriodicalIF":2.8,"publicationDate":"2025-11-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145624881","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Lower limb malalignment on whole-leg radiography predicts medial or lateral talar osteochondral lesion location: Implications for osteoarthritis assessment 下肢整条腿x线摄影显示的错位预测距骨内侧或外侧骨软骨病变位置：对骨关节炎评估的意义

IF 2.8

Osteoarthritis and cartilage open

Pub Date : 2025-11-19 DOI: 10.1016/j.ocarto.2025.100707

Ralf Henkelmann , Raphael Greifeldt , Pierre Hepp , Robert Hennings , Hans-Jonas Meyer , Timm Denecke , Jeanette Henkelmann

Objective

To investigate the association between coronal plane malalignment of the lower extremity and talar osteochondritis dissecans (OCD) localization, and assess the influence of mechanical axis deviations and local joint morphology on lesion distribution.

Design

This retrospective monocentric study included 50 patients (mean age 31 ± 12 years) with 52 talar OCD lesions who underwent standing whole-leg radiography, which were analyzed digitally. The primary outcome was OCD lesion localization (medial vs. lateral) in relation to coronal plane lower limb alignment (varus, neutral, valgus). Secondary outcomes included angular parameters of the knee and ankle (mLDFA, mMPTA, mLDTA, JLCA, KAJA, talar inclination, talar tilt) and associations lower limb alignment patterns with lesion location. Associations were assessed via univariate testing and binary logistic regression.

Results

Talar OCDs occurred medially in 83 % and laterally in 17 %. Lower limb malalignment was significantly associated with lesion localization (p = 0.024), with varus correlated with medial, while valgus predicted lateral OCD lesions (OR 2.63; 95 % CI 1.1–6.4; p = 0.034). Talar tilt independently correlated with lesion site (p < 0.001); tibiotalar valgus tilt increased odds for lateral lesions (OR 0.084; 95 % CI 0.01–0.73; p = 0.025). Combined knee and ankle alignment subtypes also influenced lesion laterality (p = 0.017).

Conclusions

Lower limb malalignment and talar tilt are independent predictors of OCD localization. Coronal plane deviations and joint morphology alter load across the talar dome, contributing to medial or lateral predilection. Whole-leg alignment analysis should be considered in diagnostic and surgical planning, particularly in revision cases.

目的探讨下肢冠状面畸形与距骨夹层炎（OCD）定位的关系，并探讨机械轴偏离和局部关节形态对病变分布的影响。这项回顾性单中心研究包括50例（平均年龄31±12岁）患52个距骨OCD病变的患者，他们接受了站立全腿x线摄影，并进行了数字分析。主要结果是OCD病变定位（内侧vs外侧）与冠状面下肢对齐（内翻，中性，外翻）的关系。次要结果包括膝关节和踝关节的角度参数（mLDFA、mMPTA、mLDTA、JLCA、KAJA、距骨倾斜、距骨倾斜）以及与病变位置相关的下肢对齐模式。通过单变量检验和二元逻辑回归评估相关性。结果星光性强迫症发生在内侧的占83%，外侧的占17%。下肢排列失调与病变定位显著相关（p = 0.024），内翻与内侧相关，外翻预测外侧OCD病变（OR 2.63; 95% CI 1.1-6.4; p = 0.034）。距骨倾斜与病变部位独立相关（p < 0.001）；胫距外翻倾斜增加外侧病变的几率（OR 0.084; 95% CI 0.01-0.73; p = 0.025）。膝关节和踝关节联合排列亚型也影响病变的侧边性（p = 0.017）。结论慢肢畸形和距骨倾斜是强迫症定位的独立预测因素。冠状面偏差和关节形态改变距骨穹隆的负荷，导致内侧或外侧偏向。在诊断和手术计划中应考虑全腿对齐分析，特别是在翻修病例中。

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