Osteoarthritis and cartilage open最新文献_第3页

Clinical validation of fully automated (peri-)articular tissue analysis for assessing osteoarthritis progression: A narrative review 全自动（周围）关节组织分析评估骨关节炎进展的临床验证：叙述性回顾

IF 2.8

Osteoarthritis and cartilage open

Pub Date : 2025-12-12 DOI: 10.1016/j.ocarto.2025.100719

Wolfgang Wirth , Jana Eder

Numerous studies have presented fully automated techniques for assessing structural osteoarthritis (OA) progression, with recent work increasingly relying on deep learning (DL)-based methods. The objective of this narrative review was to summarize findings from studies comparing the validity of fully automated methods for assessing progression in (peri-) articular joint tissues with reference measures (e.g., manual segmentation) in clinical OA models. A literature search in PubMed and arXiv.org identified 873 studies. Of these, nine evaluated the clinical validity of fully automated longitudinal measures for assessing progression. Five met the inclusion criteria by comparing sensitivity to differences in change in clinically defined cohorts between fully automated vs. reference assessments, and four reported at least the sensitivity to change for both methods. One of the studies evaluated longitudinal change in radiographic joint space width, five change in MRI-based cartilage thickness, two change in cartilage composition, and one change in thigh muscle and adipose tissue cross-sectional areas. Most of the studies were based on DL methods and relied on data from the Osteoarthritis Initiative (OAI). The included studies reported similar or greater sensitivity to change and similar discriminative power for detecting differences in change between clinically defined groups compared with reference measurements. Therefore, the techniques validated in these studies appear suitable for assessing structural progression provided that key requirements are met, including consistent imaging protocols, scanner settings, and data quality.

许多研究提出了评估结构性骨关节炎（OA）进展的全自动技术，最近的工作越来越依赖于基于深度学习（DL）的方法。这篇叙述性综述的目的是总结研究结果，比较全自动方法在临床OA模型中评估（周围）关节组织进展与参考措施（如手动分割）的有效性。PubMed和arXiv.org上的文献检索发现了873项研究。其中，9项评估了全自动纵向测量评估进展的临床有效性。通过比较全自动评估和参考评估在临床定义队列中对变化差异的敏感性，5项研究符合纳入标准，4项研究报告了两种方法对变化的敏感性至少相同。其中一项研究评估了x线摄影关节间隙宽度的纵向变化，五项mri软骨厚度的变化，两项软骨组成的变化，以及一项大腿肌肉和脂肪组织横截面积的变化。大多数研究基于DL方法，并依赖于骨关节炎倡议（OAI）的数据。与参考测量相比，纳入的研究报告了对变化的相似或更高的敏感性，以及检测临床定义组之间变化差异的相似判别能力。因此，在这些研究中验证的技术似乎适用于评估结构进展，前提是满足关键要求，包括一致的成像协议、扫描仪设置和数据质量。

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引用次数: 0

The potential of unstructured “physical activity” data for understanding relationships between movement-induced joint loading and osteoarthritis progression 非结构化“身体活动”数据对理解运动诱导的关节负荷与骨关节炎进展之间关系的潜力

IF 2.8

Osteoarthritis and cartilage open

Pub Date : 2025-12-12 DOI: 10.1016/j.ocarto.2025.100731

Peter Schaefer, Zoe Struk, Kerry E. Costello

Gait and exercise have been extensively studied in knee osteoarthritis (OA) as potential interventions to modify mechanical loading at the joint and, subsequently, influence biological processes and disease progression. However, this research has often failed to account for mechanical loading encountered in daily life outside structured activities. Wearable sensors help address this limitation by capturing movement as it occurs in daily life. Yet most analyses have relied on coarse summary measures (e.g., step count), overlooking biologically relevant variation in loading patterns across activities and time. Given that these sensors record millions of data points per day, there is an opportunity to move beyond summary measures and quantify within- and between-day variations in movement patterns. We propose that a deeper exploration of these rich datasets, guided by OA literature and related fields, may reveal how load-inducing human movement contributes to knee OA, informing the development of personalized, activity-based interventions.

膝关节骨性关节炎（OA）的步态和运动已被广泛研究，作为改变关节机械负荷的潜在干预措施，并随后影响生物过程和疾病进展。然而，这项研究往往未能考虑到日常生活中结构化活动之外遇到的机械负荷。可穿戴传感器通过捕捉日常生活中的运动来解决这一问题。然而，大多数分析都依赖于粗略的汇总测量（例如，步数），忽略了跨活动和时间的负荷模式的生物学相关变化。鉴于这些传感器每天记录数百万个数据点，有机会超越总结测量和量化运动模式的日内和日之间的变化。我们建议，在OA文献和相关领域的指导下，对这些丰富的数据集进行更深入的探索，可能会揭示负荷诱导的人体运动如何促进膝关节OA，为个性化、基于活动的干预措施的发展提供信息。

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引用次数: 0

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

Emerging concepts in osteoarthritis and musculoskeletal diseases: Insights from the University of Debrecen Musculoskeletal Symposium 2025 骨关节炎和肌肉骨骼疾病的新兴概念：来自德布勒森大学肌肉骨骼研讨会2025的见解

IF 2.8

Osteoarthritis and cartilage open

Pub Date : 2025-12-11 DOI: 10.1016/j.ocarto.2025.100728

Patrik Kovács , Judit Vágó , Ali Mobasheri , Zsuzsa Jenei-Lanzl , Frank Zaucke , Henning Madry , László Csernoch , Zoltán Szekanecz , Zsuzsa Szondy , Árpád Szöőr , Istvan Szatmari , Tamás Oláh , Csaba Matta

Objective

To highlight the key translational advances and interdisciplinary discussions from the 2025 University of Debrecen Musculoskeletal Symposium (UD-MUSK), focusing on osteoarthritis (OA) and related musculoskeletal (MSK) diseases.

Method

The UD-MUSK Symposium convened international and local experts for keynote presentations and scientific dialogue spanning OA and MSK disease mechanisms, translational therapies, and tissue regeneration. Core topics included extracellular matrix (ECM) remodelling, cell/gene therapies, animal disease models, chronic stress, autoimmunity, immunotherapies, and muscle and stem cell biology, reflecting the Symposium's broad interdisciplinary spectrum.

Results

ECM proteomics revealed degradation fragments that act as drivers and potential modulators of OA, offering new biomarkers and therapeutic targets. Advances in cell- and gene-based therapies were presented, including the use of growth differentiation factor 6 (GDF6) and CRISPR approaches for cartilage and intervertebral disc repair. Large animal models simulating spatio-temporal changes in human OA, and studies demonstrating chronic stress-accelerated OA via neuroendocrine mechanisms, were highlighted. Novel strategies in immune modulation, such as chimeric antigen receptor (CAR) T cell therapy for autoimmune myopathies, alongside research on muscle regeneration and circadian regulation by mechanical loading, further exemplified the translational breadth of the meeting.

Conclusion

The symposium underscored the value and need of integrating molecular research and disease modeling. Interdisciplinary collaboration continues to enhance understanding of MSK disease mechanisms and supports development of targeted, regenerative therapies with translational potential for OA and related disorders.

目的重点介绍2025年德布勒森大学肌肉骨骼研讨会（UD-MUSK）的关键转化进展和跨学科讨论，重点关注骨关节炎（OA）和相关肌肉骨骼（MSK）疾病。UD-MUSK研讨会召集国际和本地专家进行主题演讲和科学对话，涵盖OA和MSK疾病机制，转化治疗和组织再生。核心主题包括细胞外基质（ECM）重塑、细胞/基因疗法、动物疾病模型、慢性应激、自身免疫、免疫疗法、肌肉和干细胞生物学，反映了研讨会广泛的跨学科范围。结果secm蛋白质组学揭示了OA的驱动因子和潜在调节因子降解片段，为OA提供了新的生物标志物和治疗靶点。介绍了细胞和基因治疗的进展，包括使用生长分化因子6 （GDF6）和CRISPR方法进行软骨和椎间盘修复。重点介绍了模拟人类OA时空变化的大型动物模型，以及通过神经内分泌机制证明慢性应激加速OA的研究。免疫调节的新策略，如嵌合抗原受体（CAR） T细胞治疗自身免疫性肌病，以及肌肉再生和机械负荷昼夜节律调节的研究，进一步体现了会议的翻译广度。结论本次研讨会强调了分子研究与疾病建模相结合的价值和必要性。跨学科合作继续加强对MSK疾病机制的理解，并支持开发具有OA和相关疾病转化潜力的靶向再生疗法。

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引用次数: 0

Two years efficacy and safety outcomes of using allogeneic, pooled mesenchymal stromal cells for osteoarthritis of knee in a double-blind randomized placebo-controlled phase 3 study 在一项双盲随机安慰剂对照iii期研究中，使用同种异体间充质基质细胞治疗膝关节骨关节炎的两年疗效和安全性结果

IF 2.8

Osteoarthritis and cartilage open

Pub Date : 2025-12-11 DOI: 10.1016/j.ocarto.2025.100723

Pawan Kumar Gupta , Sunil Maheshwari , Joe Joseph Cherian , Vijay Goni , Arun Kumar Sharma , Sujit Kumar Tripathy , Keerthi Talari , Vivek Pandey , Parag Kantilal Sancheti , Saurabh Singh , Syamasis Bandyopadhyay , Naresh Shetty , Surendra Umesh Kamath , Purohit Sharad Prahaldbhai , Jijy Abraham , Suresh Kannan , Nikhil N. Verma , Uday Kumar

Objective

The aim of this study was to assess whether allogeneic cultured, pooled, bone marrow derived mesenchymal stromal cells (BMMSCs), has potential to impact progression of osteoarthritis (OA).

Method

Randomized, double blind, multicentric, placebo-controlled trial to assess efficacy and safety of BMMSCs in Grade 2 and 3 OA of knee. 146 patients were randomized, 73 patients each received either BMMSCs (25 million cells) or placebo followed by 20 mg HA. The primary end point was evaluation of WOMAC Composite Index and secondary end points were WOMAC sub-scores, VAS, magnetic resonance (MR) assessment (T2 mapping and cartilage volume).

Results

58 patients from BMMSC arm and 60 patients from placebo arm completed 24 months follow-up. At 24 months follow up, WOMAC composite index and WOMAC sub scores showed significant improvements in cell arm as compared to placebo (p < 0.0001); T2 mapping showed there is no worsening of the cartilage in the medial femoral tibial compartment in BMMSC arm whereas placebo arm shows gradual worsening (p < 0.0001). Cartilage volume increased in BMMSC arm. At Day 90 & 730, Urinary C – terminal cross linked telopeptide of type II collagen significantly decreased in the cell arm and increased in the placebo arm (p-value<0.0001). 5 AEs were possibly related to the study drug and were local site administration effects. By 24 months follow-up, 4 patients in the placebo group underwent TKR versus 1 patient in the BMMSC arm.

Conclusions

This study demonstrates that BMMSC's is safe and effective for the treatment of grade 2 & 3 OA of knee.

Ctri registration

CTRI/2018/09/015785 [Registered on: September 20, 2018]

本研究的目的是评估同种异体培养、汇集的骨髓间充质间质细胞（BMMSCs）是否有可能影响骨关节炎（OA）的进展。方法采用随机、双盲、多中心、安慰剂对照试验，评价BMMSCs治疗2级和3级膝关节炎的疗效和安全性。146名患者被随机分配，73名患者分别接受BMMSCs（2500万个细胞）或安慰剂，随后接受20毫克HA。主要终点为WOMAC综合指数评估，次要终点为WOMAC分值、VAS、磁共振（MR）评估（T2作图和软骨体积）。结果BMMSC组58例患者和安慰剂组60例患者完成了24个月的随访。在24个月的随访中，与安慰剂相比，WOMAC综合指数和WOMAC评分在细胞臂上有显著改善（p < 0.0001）；T2制图显示BMMSC组股骨胫骨内侧间室软骨没有恶化，而安慰剂组则显示逐渐恶化（p < 0.0001）。BMMSC组软骨体积增大。在第90和730天，II型胶原的尿C末端交联末端肽在细胞组显著减少，而在安慰剂组显著增加（p值为0.0001）。5例ae可能与研究药物有关，为局部给药效应。经过24个月的随访，安慰剂组有4例患者接受了TKR，而BMMSC组有1例患者接受了TKR。结论BMMSC治疗2、3级膝关节骨性关节炎安全有效。Ctri registrationCTRI/2018/09/015785[注册日期：2018年9月20日]

{"title":"Two years efficacy and safety outcomes of using allogeneic, pooled mesenchymal stromal cells for osteoarthritis of knee in a double-blind randomized placebo-controlled phase 3 study","authors":"Pawan Kumar Gupta , Sunil Maheshwari , Joe Joseph Cherian , Vijay Goni , Arun Kumar Sharma , Sujit Kumar Tripathy , Keerthi Talari , Vivek Pandey , Parag Kantilal Sancheti , Saurabh Singh , Syamasis Bandyopadhyay , Naresh Shetty , Surendra Umesh Kamath , Purohit Sharad Prahaldbhai , Jijy Abraham , Suresh Kannan , Nikhil N. Verma , Uday Kumar","doi":"10.1016/j.ocarto.2025.100723","DOIUrl":"10.1016/j.ocarto.2025.100723","url":null,"abstract":"<div><h3>Objective</h3><div>The aim of this study was to assess whether allogeneic cultured, pooled, bone marrow derived mesenchymal stromal cells (BMMSCs), has potential to impact progression of osteoarthritis (OA).</div></div><div><h3>Method</h3><div>Randomized, double blind, multicentric, placebo-controlled trial to assess efficacy and safety of BMMSCs in Grade 2 and 3 OA of knee. 146 patients were randomized, 73 patients each received either BMMSCs (25 million cells) or placebo followed by 20 mg HA. The primary end point was evaluation of WOMAC Composite Index and secondary end points were WOMAC sub-scores, VAS, magnetic resonance (MR) assessment (T2 mapping and cartilage volume).</div></div><div><h3>Results</h3><div>58 patients from BMMSC arm and 60 patients from placebo arm completed 24 months follow-up. At 24 months follow up, WOMAC composite index and WOMAC sub scores showed significant improvements in cell arm as compared to placebo (p < 0.0001); T2 mapping showed there is no worsening of the cartilage in the medial femoral tibial compartment in BMMSC arm whereas placebo arm shows gradual worsening (p < 0.0001). Cartilage volume increased in BMMSC arm. At Day 90 & 730, Urinary C – terminal cross linked telopeptide of type II collagen significantly decreased in the cell arm and increased in the placebo arm (p-value<0.0001). 5 AEs were possibly related to the study drug and were local site administration effects. By 24 months follow-up, 4 patients in the placebo group underwent TKR versus 1 patient in the BMMSC arm.</div></div><div><h3>Conclusions</h3><div>This study demonstrates that BMMSC's is safe and effective for the treatment of grade 2 & 3 OA of knee.</div></div><div><h3>Ctri registration</h3><div>CTRI/2018/09/015785 [Registered on: September 20, 2018]</div></div>","PeriodicalId":74377,"journal":{"name":"Osteoarthritis and cartilage open","volume":"8 1","pages":"Article 100723"},"PeriodicalIF":2.8,"publicationDate":"2025-12-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145840186","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

Baseline pain medication is associated with longer duration of high adherence in a three-month digital treatment program for hip and knee osteoarthritis 在为期三个月的髋关节和膝关节骨关节炎数字化治疗项目中，基线止痛药与高依从性的持续时间更长有关

IF 2.8

Osteoarthritis and cartilage open

Pub Date : 2025-12-11 DOI: 10.1016/j.ocarto.2025.100727

Leif E. Dahlberg , Simon P. Rowland , Jack T. Pearson , L. Stefan Lohmander , Ali Kiadaliri

Objective

To investigate whether baseline use of pain medication is associated with program adherence during a three-month digital treatment program for individuals with hip or knee osteoarthritis (OA).

Design

An observational cohort study using registry data on weekly participant adherence from 33078 participants enrolled in a digital education and exercise therapy program. Poor adherence was defined as completing less than 80 % of the approximately 20 prescribed weekly activities for two consecutive weeks during the 13-week treatment period. Baseline analgesic use was categorized into six groups: no medication, paracetamol (with/without dietary supplements), NSAIDs (with/without supplements), paracetamol combined with NSAIDs (with/without dietary supplements), dietary supplements only, and opioids (with/without other medications). Interval-censored parametric survival models adjusted for baseline characteristics were used for statistical analysis. In sensitivity analyses, alternative definitions of poor adherence were used. A complete case analysis was conducted as a subgroup analysis.

Results

Compared to the no-medication group, individuals taking paracetamol—either alone (hazard ratio 0.94, 95 % CI 0.91, 0.98) or in combination with NSAIDs (0.91, 0.87, 0.94) reached poor adherence later. In contrast, opioid users (hazard ratio 1.12, 95 % CI 1.06, 1.19) reached poor adherence earlier. Adjusted median days to reach poor adherence ranged from 39.2 (95 % CI 36.9, 41.4) for opioids to 49.2 (47.7, 50.7) for paracetamol + NSAIDs users. Alternative definitions of poor adherence and a complete-case analysis generally yielded similar findings.

Conclusion

Baseline use of paracetamol, alone or with NSAIDs, was associated with longer time to reach poor adherence, whereas opioid use predicted poor adherence earlier.

目的：探讨在为期三个月的髋关节或膝关节骨关节炎（OA）患者数字化治疗方案中，基线止痛药使用是否与方案依从性相关。设计一项观察性队列研究，使用33078名参加数字教育和运动治疗项目的参与者的每周参与者依从性登记数据。依从性差被定义为在13周治疗期间连续两周完成不到80%的每周约20项规定活动。基线镇痛药使用分为六组：无药物，扑热息痛（有/不含膳食补充剂），非甾体抗炎药（有/不含补充剂），扑热息痛联合非甾体抗炎药（有/不含膳食补充剂），仅膳食补充剂，阿片类药物（有/不含其他药物）。采用经基线特征调整的区间剔除参数生存模型进行统计分析。在敏感性分析中，使用了依从性差的替代定义。以完整的病例分析作为亚组分析。结果与不用药组相比，单独服用扑热息痛（风险比0.94,95% CI 0.91, 0.98）或联合服用非甾体抗炎药（0.91,0.87,0.94）的患者依从性较差。相反，阿片类药物使用者（风险比1.12,95% CI 1.06, 1.19）较早达到较差的依从性。阿片类药物达到不良依从性的调整中位天数从39.2天（95% CI 36.9, 41.4）到扑热息痛+非甾体抗炎药使用者49.2天（47.7,50.7）不等。对依从性差的其他定义和完整的病例分析通常得出类似的结果。结论基线使用扑热息痛，单独使用或与非甾体抗炎药联合使用，较长时间达到不良依从性，而使用阿片类药物预示较早的不良依从性。

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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}

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