Osteoarthritis and cartilage open最新文献_第7页

The relationship between circulating and tissue biomarkers and OA-related pain: A systematic literature review 循环和组织生物标志物与oa相关疼痛的关系：系统的文献综述

IF 2.8

Osteoarthritis and cartilage open

Pub Date : 2025-09-17 DOI: 10.1016/j.ocarto.2025.100684

Sylvain Mathieu , Liisa Kuhi , Marie Binvignat , Philip G. Conaghan , Niels Eijkelkamp , Yves Henrotin , Eva Kosek , Ali Mobasheri , Hans-George Schaible , Kalle Kisand , Jérémie Sellam

Objective

This study aimed to provide an overview of the relationship between osteoarthritis (OA) pain and various fluid biomarkers by conducting a systematic literature review (SLR), to help the development of OA-related pain endotyping.

Method

An SLR was conducted, using the PubMed, Embase, Scopus, Web of Science and the Cochrane Library databases, up to December 2024. Pain measures (VAS, WOMAC, HOOS/KOOS, AUSCAN, PainDETECT and Pain Pressure Threshold) were analysed for their association with circulating biomarkers in blood, urine, synovial and cerebrospinal fluids or tissue and genetic biomarkers. Biomarkers were categorised as “associated” depending on statistical significance and further subcategorised as “consistently associated”, “uncertainly associated” or “not associated” based on the quality of evidence determined by the number of studies, sample size and the strength of correlation.

Results

The five databases yielded 30,088 citations, of which 263 relevant papers were selected. Total cholesterol in the blood was the only biomarker consistently associated with pain. Among blood biomarkers, CRP, hsCRP and IL-17 showed suggestive but inconsistent associations with OA-related pain. In synovial fluid, IL-17, C2C and VEGF were consistently associated with increasing pain intensity, based on multiple concordant studies. In cerebrospinal fluid, CX3CL1 and Flt-1 were consistently associated with pain, displaying a negative correlation.

Conclusion

This SLR identified no relevant biomarkers in different body fluids that were associated with OA-related pain. Further investigation of CRP and IL-17 is required to achieve greater consistency across studies.

PROSPERO

CRD42024550244.

目的本研究旨在通过系统的文献综述（SLR），概述骨关节炎（OA）疼痛与各种液体生物标志物之间的关系，以帮助OA相关疼痛内分型的发展。方法使用PubMed， Embase, Scopus， Web of Science和Cochrane Library数据库进行SLR，截止到2024年12月。分析疼痛测量（VAS、WOMAC、HOOS/ oos、AUSCAN、PainDETECT和痛压阈值）与血液、尿液、滑膜和脑脊液或组织中的循环生物标志物和遗传生物标志物的相关性。根据统计显著性将生物标志物分类为“相关”，并根据研究数量、样本量和相关性强度确定的证据质量进一步分类为“一致相关”、“不确定相关”或“不相关”。结果5个数据库共收录引文30,088篇，共收录相关论文263篇。血液中的总胆固醇是唯一与疼痛一致的生物标志物。在血液生物标志物中，CRP、hsCRP和IL-17与oa相关性疼痛有提示但不一致的关联。在滑液中，基于多项一致性研究，IL-17、C2C和VEGF与疼痛强度增加一致相关。在脑脊液中，CX3CL1和Flt-1与疼痛一致，呈负相关。结论：该SLR在不同体液中未发现与oa相关疼痛相关的相关生物标志物。需要进一步研究CRP和IL-17，以在研究中实现更大的一致性。

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引用次数: 0

A standardized, open-source, portable model for noninvasive joint injury in mice 一种标准化、开源、便携的小鼠无创关节损伤模型

IF 2.8

Osteoarthritis and cartilage open

Pub Date : 2025-09-17 DOI: 10.1016/j.ocarto.2025.100679

Michael D. Newton , Lindsey Lammlin , Sofia Gonzalez-Nolde , Scarlet Howser , Isabelle Smith , Luke Stasikelis , Alexander J. Knights

Objective

Preclinical models of osteoarthritis (OA) are crucial for the study of disease mechanisms and development of disease-modifying therapeutics. While surgical OA models, such as destabilization of the medial meniscus (DMM), have been the gold standard in the field for decades, noninvasive joint loading-based models have increased in popularity and utility. To facilitate standardization of the noninvasive anterior cruciate ligament rupture (ACLR) model in mice, we present the Mobile Joint-Injury Operator (MoJO) - an open-source protocol with accompanying fixtures and data, designed for a low-cost, commercially-available, portable, small-footprint uniaxial testing system.

Methods

We provide 3d-printable fixture designs and a comprehensive description of the loading protocol, describe the expected mechanical output, and offer various troubleshooting strategies. We validate the mechanical accuracy and inter-operator reproducibility of the procedure and characterize the resultant post-traumatic OA phenotype by knee hyperalgesia testing, flow cytometry, μCT imaging, and histological assessment.

Results

Across n = 952 procedures, the MoJO protocol was highly accurate and repeatable, with a >99 % rate of successful ACLR and high repeatability between operators and institutions. ACLR-mediated joint injury resulted in the expected post-traumatic OA phenotype in male and female C57Bl/6 mice, including progressive hyperalgesia, histological and μCT evidence of cartilage damage, synovitis, and osteophyte formation, and increased expansion of fibroblasts, endothelial cells, and myeloid cells by flow cytometry.

Conclusions

Increased standardization of joint injury is a critical aspect of the overall refinement of animal models of OA. The MoJO represents an affordable and highly reproducible option for implementing the mouse ACLR model of OA.

目的骨关节炎（OA）的临床前模型对疾病机制的研究和疾病改善疗法的开发至关重要。虽然外科骨关节炎模型，如内侧半月板不稳定（DMM），几十年来一直是该领域的金标准，但基于无创关节负荷的模型越来越受欢迎和实用。为了促进小鼠无创前交叉韧带断裂（ACLR）模型的标准化，我们提出了移动关节损伤操作员（MoJO）——一种开源协议，附带固定装置和数据，专为低成本、商用、便携式、小占地的单轴测试系统而设计。方法我们提供了3d打印夹具设计和加载方案的全面描述，描述了预期的机械输出，并提供了各种故障排除策略。我们通过膝关节痛觉过敏测试、流式细胞术、μCT成像和组织学评估验证了该手术的机械准确性和操作人员之间的可重复性，并表征了由此产生的创伤后OA表型。结果在n = 952例手术中，MoJO方案具有很高的准确性和可重复性，ACLR成功率为>； 99%，操作人员和机构之间具有很高的可重复性。aclr介导的关节损伤在雄性和雌性C57Bl/6小鼠中导致了预期的创伤后OA表型，包括进行性痛觉过敏、软骨损伤、滑膜炎和骨赘形成的组织学和μCT证据，以及流式细胞术显示的成纤维细胞、内皮细胞和髓样细胞的扩张增加。结论提高关节损伤的标准化是OA动物模型整体完善的关键方面。MoJO是实现OA小鼠ACLR模型的一种经济实惠且高度可重复的选择。

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引用次数: 0

Development of an iPSC-based screening platform identifying enhancers of chondrogenesis 开发一种基于ipsc的筛选平台，识别软骨形成增强因子

IF 2.8

Osteoarthritis and cartilage open

Pub Date : 2025-09-15 DOI: 10.1016/j.ocarto.2025.100680

Aisling O'Brien , Maojia Xu , Enda O'Connell , Aline M. Morrison , Georgina Shaw , James R. Dutton , Mary Murphy , Frank Barry

Objective

There is currently no long-term treatment for the repair of damaged cartilage and osteoarthritis (OA). Induced pluripotent stem cells (iPSCs) are an ideal cell source for screening platforms due to their ability to self-renew and differentiate to cell types that would otherwise require invasive surgeries to obtain, such as chondrocytes and mesenchymal stromal cells (MSCs). Here, we developed an iPSC-based screening platform and tested previously described pro-chondrogenic small molecule compounds, to determine their potential to identify hits.

Design

iPSC derived chondroprogenitors (iCPs) and neural crest cell (NCC) derived MSCs (iNCC-MSCs) were generated, and their chondrogenic potential was confirmed. The iPSC derived cells and a primary bone marrow derived MSC (BM-MSC) line were cultured as pellets and treated with different concentrations of small molecule compounds, in the presence of chondrogenic inducing growth factors, over 14 days at 2 % O₂. Glycosaminoglycan (GAG) synthesis was quantified by a 1,9- dimethylmethylene blue (DMMB) assay.

Results

After 14 days of chondrogenesis, forskolin, baicalin and sesamin enhanced GAG synthesis in the iCPs, and forskolin enhanced GAG synthesis in the iNCC-MSCs, while no small molecule compounds enhanced GAG synthesis in the BM-MSCs.

Conclusion

Our findings further demonstrate how the small molecules pro-chondrogenic effects are dependent on the screening platform conditions, including the cell type, molecule concentration, 3D culture, hypoxia, and the inclusion of additional growth factors. The iPSC-based screening platform developed has the potential to identify disease modifying OA drugs (DMOADs) in novel compound screening libraries.

目的目前还没有修复受损软骨和骨关节炎（OA）的长期治疗方法。诱导多能干细胞（iPSCs）是筛选平台的理想细胞来源，因为它们具有自我更新和分化为细胞类型的能力，否则需要进行侵入性手术才能获得，如软骨细胞和间充质基质细胞（MSCs）。在这里，我们开发了一个基于ipsc的筛选平台，并测试了先前描述的促软骨形成的小分子化合物，以确定它们识别撞击的潜力。设计生成了ipsc衍生的软骨祖细胞（iCPs）和神经嵴细胞（NCC）衍生的间充质干细胞（iNCC-MSCs），并证实了它们的成软骨潜能。将iPSC衍生细胞和原代骨髓衍生间充质干细胞（BM-MSC）系培养成微球，并在诱导软骨生长因子存在的情况下，用不同浓度的小分子化合物处理，在2% O2条件下培养14天。采用1,9-二甲基亚甲基蓝（DMMB）法测定糖胺聚糖（GAG）的合成。结果软骨形成14 d后，forskolin、黄芩苷和芝麻素均能促进iCPs中GAG的合成，而forskolin能促进iNCC-MSCs中GAG的合成，而没有小分子化合物能促进BM-MSCs中GAG的合成。我们的研究结果进一步证明了小分子促软骨形成的作用是如何依赖于筛选平台条件的，包括细胞类型、分子浓度、3D培养、缺氧和包含额外的生长因子。开发的基于ipsc的筛选平台具有在新型化合物筛选文库中识别疾病修饰性OA药物（DMOADs）的潜力。

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引用次数: 0

Defining and measuring varus thrust in knee osteoarthritis: A scoping review of current evidence and challenges 定义和测量膝骨关节炎的内翻推力：对当前证据和挑战的范围审查

IF 2.8

Osteoarthritis and cartilage open

Pub Date : 2025-09-13 DOI: 10.1016/j.ocarto.2025.100683

Vincenzo E. Di Bacco , Zaryan Masood , Joshua A.J. Keogh , Matthew C. Ruder , Fatima Gafoor , Jenny Wu , Yalda Azari , Eseoghene Orogun , Dylan Kobsar

Objective

This scoping review investigated the definitions, assessment methods, and current applications of varus thrust (VT) in knee osteoarthritis (OA).

Methods

Five databases (MEDLINE, EMBASE, CINAHL, SPORTDiscus, and Web of Science Core Collection) were searched in this scoping review for studies assessing VT during walking in adults with knee OA using the terms “varus” and “lateral” in proximity to thrust. Data were extracted and categorized by study characteristics (OA sample, publication year, design, and aim) and VT assessment protocol (method and definition).

Results

A total of 63 studies were included, examining 12,569 individuals with knee OA using visual (n = 24), optical motion capture (n = 27), or inertial/wearable sensor (n = 19) methods. Designs included prospective, experimental, cross-sectional, and case series. VT was most often assessed to examine disease severity, progression, surgical outcomes, and symptom associations. Visual VT was commonly defined as dynamic worsening or abrupt onset of varus alignment during weight acceptance. Optical motion capture commonly measured VT as frontal plane knee excursion from foot contact to mid-stance, while inertial methods typically used peak lateral tibial acceleration or angular velocity.

Conclusion

Despite growing research interest in VT, inconsistent definitions and measurement protocols limit comparability across studies and hinder broader adoption. Greater standardization and validation are needed to clarify its potential clinical utility in knee OA.

目的探讨膝关节骨性关节炎（OA）内翻（VT）的定义、评估方法和目前的应用。方法在本综述中检索了5个数据库（MEDLINE、EMBASE、CINAHL、SPORTDiscus和Web of Science Core Collection），以评估成人膝关节OA患者行走过程中使用“内翻”和“侧翻”这两个术语进行VT评估的研究。根据研究特征（OA样本、出版年份、设计和目的）和VT评估方案（方法和定义）对数据进行提取和分类。结果共纳入63项研究，采用视觉（n = 24）、光学运动捕捉（n = 27）或惯性/可穿戴传感器（n = 19）方法检查了12569例膝关节OA患者。设计包括前瞻性、实验性、横断面和病例系列。VT最常用于检查疾病严重程度、进展、手术结果和症状相关性。视觉VT通常定义为体重接受期间内翻对准的动态恶化或突然发作。光学运动捕捉通常测量的VT是膝关节从足部接触到中位的前平面偏移，而惯性方法通常使用峰值胫骨外侧加速度或角速度。尽管对VT的研究兴趣日益浓厚，但不一致的定义和测量方案限制了研究之间的可比性，并阻碍了更广泛的采用。需要更大的标准化和验证来阐明其在膝关节OA中的潜在临床应用。

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引用次数: 0

Walking is the form of physical activity people with osteoarthritis in the hip or knee choose and maintain after two years 步行是患有髋关节或膝关节骨关节炎的人在两年后选择并保持的一种体育活动形式

IF 2.8

Osteoarthritis and cartilage open

Pub Date : 2025-09-11 DOI: 10.1016/j.ocarto.2025.100681

R. Bendrik , M. Peterson , K. Bröms , M. Emtner , A. Hed Ekman , L.V. Kallings , B. Sundström

Objective

To evaluate which form and type of physical activity individuals with hip or knee osteoarthritis choose and maintain one and two years after an individualised intervention for physical activity and further to evaluate whether there were differences in the most chosen physical activity with regard to patient characteristics.

Method

Patients with hip or knee osteoarthritis from a previous randomised controlled trial, where they received individualised patient-centred counselling about physical activity and registered self-selected sessions of physical activity in a 7-day diary, were included. Sessions lasting more than 10 min and rated at least light effort were categorized, and differences were evaluated.

Results

Of the 94 patients included, 72.3 % were female, 72.0 % had knee osteoarthritis and mean age was 62.0 (SD 8.2) years. Women and men who preferred walking, walked on average > 4 times/week and 3–4 times/week, respectively. Everyday activities and cycling were performed 2–3 times/week by both women and men. The proportions of individuals maintaining the same activity after one and two years were 50 % for walking and 2 % for strength training. Men more often choose different activities and after two years they performed everyday activities and cycling to the same extent as walking. Individuals who chose walking were significantly older, of female gender and had lower muscle strength in the affected leg.

Conclusion

Walking is the form of physical activity patients with osteoarthritis most often choose, perform and maintain. Knowledge about preferred activities among patients is crucial for maintaining physical activity in the long term.

目的评价髋关节或膝关节骨性关节炎患者在进行个体化体育活动干预后1年和2年选择和维持何种形式和类型的体育活动，并进一步评价在选择最多的体育活动时患者特征是否存在差异。方法纳入来自先前随机对照试验的髋关节或膝关节骨关节炎患者，在该试验中，他们接受了以患者为中心的个体化体育活动咨询，并在7天的日记中登记了自我选择的体育活动会话。持续时间超过10分钟且至少被评为轻度努力的会话被分类，并评估差异。结果94例患者中，72.3%为女性，72.0%患有膝关节骨性关节炎，平均年龄62.0岁（SD 8.2）。喜欢步行的女性和男性平均每周分别步行4次和3-4次。女性和男性每周进行2-3次日常活动和骑自行车。在1年和2年后保持相同运动的个体比例是50%的步行和2%的力量训练。男性更经常选择不同的活动，两年后，他们每天都进行活动，骑自行车的程度与走路的程度相同。选择步行的人明显是年龄较大的女性，受影响的腿部肌肉力量较弱。结论步行是骨关节炎患者最常选择、进行和维持的体育活动形式。了解患者喜欢的运动对长期保持身体活动至关重要。

{"title":"Walking is the form of physical activity people with osteoarthritis in the hip or knee choose and maintain after two years","authors":"R. Bendrik , M. Peterson , K. Bröms , M. Emtner , A. Hed Ekman , L.V. Kallings , B. Sundström","doi":"10.1016/j.ocarto.2025.100681","DOIUrl":"10.1016/j.ocarto.2025.100681","url":null,"abstract":"<div><h3>Objective</h3><div>To evaluate which form and type of physical activity individuals with hip or knee osteoarthritis choose and maintain one and two years after an individualised intervention for physical activity and further to evaluate whether there were differences in the most chosen physical activity with regard to patient characteristics.</div></div><div><h3>Method</h3><div>Patients with hip or knee osteoarthritis from a previous randomised controlled trial, where they received individualised patient-centred counselling about physical activity and registered self-selected sessions of physical activity in a 7-day diary, were included. Sessions lasting more than 10 min and rated at least light effort were categorized, and differences were evaluated.</div></div><div><h3>Results</h3><div>Of the 94 patients included, 72.3 % were female, 72.0 % had knee osteoarthritis and mean age was 62.0 (SD 8.2) years. Women and men who preferred walking, walked on average > 4 times/week and 3–4 times/week, respectively. Everyday activities and cycling were performed 2–3 times/week by both women and men. The proportions of individuals maintaining the same activity after one and two years were 50 % for walking and 2 % for strength training. Men more often choose different activities and after two years they performed everyday activities and cycling to the same extent as walking. Individuals who chose walking were significantly older, of female gender and had lower muscle strength in the affected leg.</div></div><div><h3>Conclusion</h3><div>Walking is the form of physical activity patients with osteoarthritis most often choose, perform and maintain. Knowledge about preferred activities among patients is crucial for maintaining physical activity in the long term.</div></div>","PeriodicalId":74377,"journal":{"name":"Osteoarthritis and cartilage open","volume":"7 4","pages":"Article 100681"},"PeriodicalIF":2.8,"publicationDate":"2025-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145105129","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

Biochemical biomarkers of knee osteoarthritis progression: Results from the FNIH biomarkers consortium progress OA study 膝关节骨关节炎进展的生化生物标志物：来自FNIH生物标志物联盟进展OA研究的结果

IF 2.8

Osteoarthritis and cartilage open

Pub Date : 2025-09-05 DOI: 10.1016/j.ocarto.2025.100677

Jamie E. Collins , Douglas Robinson , Nigel Arden , Anne Christine Bay-Jensen , Leticia A. Deveza , Morten Karsdal , Christoph Ladel , Thomas A. Perry , Christopher J. Swearingen , David J. Hunter , Virginia B. Kraus

Objective

The Foundation for National Institutes of Health (FNIH) OA Biomarkers Consortium aims to identify and qualify biomarkers to support drug development in knee osteoarthritis (OA). The PROGRESS OA study aims to externally validate prognostic biomarkers identified in the earlier Phase I study.

Design

PROGRESS OA included data from the control arms of several completed randomized controlled trials (RCTs) for knee OA. The primary outcome was medial or lateral joint space width loss (JSWL) ≥0.7 mm. Secondary outcomes included medial or lateral JSWL combined with symptomatic progression. Nine biochemical biomarkers identified in Phase I were included here. Logistic regression with elastic net selection examined associations between baseline biomarkers and outcomes over 12–36 months, separately for subgroups with available serum, urine, and both serum and urine biomarkers.

Results

In total, the study included 827 participants across three RCTs, 159 (19 %) with JSWL≥0.7 mm. In 681 participants with both serum and urine biospecimens, the combination of serum hyaluronan (HA), urinary C2C-HUSA, body mass index (BMI), and Kellgren-Lawrence grade (KLG) yielded AUC 0.627 (95 % CI: 0.573, 0.681) for predicting JSWL≥0.7 mm, compared to AUC 0.612 (95 % CI: 0.557, 0.667) for BMI and KLG alone. Serum (HA) and urinary C2C-HUSA were consistently selected as predictors of disease progression in elastic net models across the subgroups.

Conclusions

Biomarker associations were consistent with Phase I findings, but predictive performance remained modest. Future work in the FNIH OA Biomarkers consortium project will focus on evaluating short term changes in biomarkers to assess their potential for monitoring treatment efficacy.

美国国立卫生研究院（FNIH） OA生物标志物联盟基金会旨在鉴定和鉴定生物标志物，以支持膝关节骨关节炎（OA）的药物开发。PROGRESS OA研究旨在外部验证早期I期研究中确定的预后生物标志物。DesignPROGRESS OA纳入了几个已完成的膝关节OA随机对照试验（rct）的对照组数据。主要终点为内侧或外侧关节间隙宽度损失(JSWL)≥0.7 mm。次要结局包括内侧或外侧JSWL合并症状进展。在I期鉴定的9个生化生物标志物包括在这里。使用弹性网选择的Logistic回归检查了基线生物标志物与12-36个月预后之间的关系，分别用于血清、尿液和血清和尿液生物标志物可用的亚组。结果本研究共纳入3个rct的827名受试者，其中159名（19%）JSWL≥0.7 mm。在681名具有血清和尿液生物标本的参与者中，血清透明质酸（HA）、尿C2C-HUSA、体重指数（BMI）和kell格林-劳伦斯分级（KLG）联合预测JSWL≥0.7 mm的AUC为0.627 (95% CI: 0.573, 0.681)，而BMI和KLG单独预测JSWL≥0.7 mm的AUC为0.612 （95% CI: 0.557, 0.667）。在弹性网模型中，血清（HA）和尿C2C-HUSA被一致选择作为疾病进展的预测因子。结论：生物标志物相关性与I期研究结果一致，但预测性能仍然不高。FNIH OA生物标志物联盟项目的未来工作将侧重于评估生物标志物的短期变化，以评估其监测治疗疗效的潜力。

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引用次数: 0

Guideline-informed care for osteoarthritis: Support needs of community pharmacists and healthcare professionals in Nigeria, West-Africa 骨关节炎的指南知情护理：支持西非尼日利亚社区药剂师和卫生保健专业人员的需求

IF 2.8

Osteoarthritis and cartilage open

Pub Date : 2025-09-04 DOI: 10.1016/j.ocarto.2025.100678

Oladapo Adetunji , Ibidunni Alonge , Ebunoluwa Ayinmode , Tolulope Owoyemi , Adebimpe Ogunbanjo , Simon White , Adewale Adebajo , Christian Mallen , Krysia Dziedzic , Opeyemi O. Babatunde

Objective

The study examined the context, training needs, and extent to which community pharmacists in Nigeria have the knowledge, resources, and capability to manage OA in line with evidence-based recommendations.

Methods

Focus group discussions (n = 2) were conducted. Discussions explored current practice, the support needs, and perceptions of a new OA care model where pharmacists could be trained to screen, educate, and refer patients. Data was analyzed thematically, including stakeholder workshops to aid interpretation.

Results

Data from two focus groups with 22 healthcare professionals revealed five key themes. Community pharmacies were the first point of call for most patients. Care pathway and navigation onwards were influenced by patient affordability. Radiological examinations and blood tests underpinned diagnosis and care predominantly involved pharmacological approaches. There was no local care pathway agreed/established for health professionals, and multidisciplinary team collaboration/care for OA was limited. Participants expressed the need for professional education and the development of national guidelines to inform osteoarthritis management in primary care.

Conclusions

Nigeria's OA care pathway is fragmented, involves overuse of medication, and has limited access to non-pharmaceutical treatments. A unified, evidence-based approach with adequate training and multidisciplinary collaboration is essential for effective primary care and reducing health inequalities.

目的：本研究调查了尼日利亚社区药剂师根据循证建议管理OA的背景、培训需求和知识、资源和能力。方法进行焦点小组讨论（n = 2）。讨论探讨了当前的实践，支持需求，以及对一种新的OA护理模式的看法，在这种模式下，药剂师可以接受培训，以筛查、教育和转诊患者。数据按主题分析，包括利益相关者研讨会，以帮助解释。结果来自22名医疗保健专业人员的两个焦点小组的数据揭示了五个关键主题。社区药房是大多数患者的第一选择。护理路径和后续导航受患者负担能力的影响。放射学检查和血液检查是诊断和护理的基础，主要涉及药理学方法。没有为卫生专业人员商定/建立的当地护理途径，OA的多学科团队协作/护理有限。与会者表示有必要进行专业教育和制定国家指南，以告知初级保健中的骨关节炎管理。结论尼日利亚OA的护理途径是碎片化的，涉及药物的过度使用，非药物治疗的可及性有限。对于有效的初级保健和减少卫生不平等现象来说，统一的循证办法、适当的培训和多学科合作至关重要。

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引用次数: 0

Prevalence, incidence, and progression of hip osteoarthritis in a young military population: The ADVANCE cohort study 年轻军人髋关节骨关节炎的患病率、发病率和进展：ADVANCE队列研究

IF 2.8

Osteoarthritis and cartilage open

Pub Date : 2025-09-02 DOI: 10.1016/j.ocarto.2025.100675

F.C.E. Watson , O. O'Sullivan , A. Bennett , R. Agricola , S. Schofield , D. Hanff , C. Boos , P. Cullinan , N. Fear , H. Kemp , A.M.J. Bull

Objective

Prevalence of hip osteoarthritis (OA) is rarely reported in young populations (e.g., military). We will report the prevalence of hip OA in a young military cohort and investigate the relationship between injury and progression/incidence.

Design

ADVANCE is a prospective cohort study comparing physical and psychosocial outcomes in 1145 men who served in Afghanistan including 579 men with combat injury (Exposed) who were frequency-matched to 566 controls (Unexposed). The Exposed group was sub-divided into hip injured (Exp-H), lower limb amputation (Exp-A) and other (Exp-NA). Kellgren-Lawrence (KL) scores of pelvic radiographs and Non-Arthritic Hip Score (NAHS) questionnaires were collected across two waves (Baseline and Follow-up). Prevalence at Baseline (KL ≥ 2), progression (KL ≥ 1 at Baseline, KL ≥ 2 at Follow-up) and incidence (KL0 at Baseline, KL ≥ 2 at Follow-up) at Follow-up were reported and compared between groups for KL and NAHS.

Results

Baseline prevalence of radiographic hip OA was 8.5 % and 4.4 % in the Exposed and Unexposed groups, respectively. Exp-A and Exp-H groups had 3.88 (95%CI:2.27–6.63) and 7.18 (95%CI:3.44–14.98 times increased risk for radiographic hip OA than Unexposed. Exp-A and Exp-H had a 2.15 (95%CI:1.22–3.80) and 3.28 (95%CI:1.42–7.59) times increased radiographic progression risk, compared to Unexposed. Risk of NAHS Progression and Incidence were not significantly different between groups.

Conclusion

Radiographic hip OA prevalence is higher in a young military population than in a similarly aged general population. Combat injury alone may not increase hip OA prevalence; but hip and lower limb loss injuries do. Progression risk is highest in those with hip or limb loss injuries.

目的髋关节骨关节炎（OA）的患病率在年轻人群（如军人）中很少报道。我们将报道一个年轻军人队列中髋关节骨关节炎的患病率，并调查损伤与进展/发病率之间的关系。DesignADVANCE是一项前瞻性队列研究，比较了在阿富汗服役的1145名男性的身体和心理社会结果，其中579名男性有战斗损伤（暴露），566名对照（未暴露）。暴露组又分为髋部损伤组（Exp-H）、下肢截肢组（Exp-A）和其他组（Exp-NA）。骨盆x线片Kellgren-Lawrence （KL）评分和非关节炎髋关节评分（NAHS）问卷分为基线和随访两组。报告基线时的患病率（KL≥2）、进展（基线时KL≥1，随访时KL≥2）和随访时的发病率（基线时KL0，随访时KL≥2），并比较KL和NAHS组之间的差异。结果暴露组和未暴露组髋关节骨性关节炎基线患病率分别为8.5%和4.4%。Exp-A组和Exp-H组髋关节骨性关节炎的风险分别是未暴露组的3.88倍（95%CI:2.27 ~ 6.63）和7.18倍（95%CI:3.44 ~ 14.98）。与未暴露组相比，Exp-A和Exp-H组的影像学进展风险分别增加2.15倍（95%CI: 1.22-3.80）和3.28倍（95%CI: 1.42-7.59）。两组间NAHS进展风险及发病率无显著差异。结论年轻军人髋部骨性关节炎的放射学患病率高于同龄普通人群。单纯的战斗损伤可能不会增加髋关节骨关节炎的患病率；但髋部和下肢的损伤会。进展风险最高的是髋关节或肢体损伤。

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引用次数: 0

Longitudinal associations between bilateral versus unilateral knee osteoarthritis and physical performance measures 双侧与单侧膝关节骨性关节炎与体能指标之间的纵向关联

IF 2.8

Osteoarthritis and cartilage open

Pub Date : 2025-09-02 DOI: 10.1016/j.ocarto.2025.100676

Jennifer S. Hanberg , Faith Selzer , Elena Losina , Jeffrey N. Katz , Jamie E. Collins

Background

Bilateral knee osteoarthritis (KOA) is common, but evidence for the effect of bilateral versus unilateral KOA on functional outcomes is conflicting. We aimed to examine the association between bilateral versus unilateral KOA and physical performance measures over two years.

Methods

Our cohort included adults with symptomatic, radiographic KOA. Study assessments at baseline, 12 and 24 months included the 30-s chair sit-to-stand task (CST) and 40-m walk (40 MW). We defined bilateral KOA as Kellgren-Lawrence grade ≥2 and Knee Osteoarthritis Outcome Pain Scale ≥17/100 in both knees. We used linear mixed models to (1) assess the cross-sectional association between the presence of bilateral versus unilateral KOA at each timepoint and performance measures, and (2) assess the association between bilateral versus unilateral KOA at baseline and longitudinal changes in performance measures. Models were adjusted for clinical and demographic covariates.

Results

101 participants were included. At baseline, 43/101 (43 %) had bilateral KOA. In adjusted models, bilateral, versus unilateral, KOA was associated with 1.0 fewer stands on the CST (95 % CI: 2.2–0.1), and a 0.03 m/s slower 40 MW (95 % CI: 0.10–0.04). Average 2-year change in CST was −0.6 stands in those with baseline bilateral KOA and −0.7 in those with unilateral KOA (between-group difference, 0.1 stands (95 % CI: 1.7–1.8)). The baseline bilateral KOA group had greater worsening in 40 MW time (between-group difference −0.10 m/s (95 % CI: -0.20–0.00)).

Conclusions

We did not find clinically significant associations between bilateral vs unilateral KOA and performance on two physical performance tasks over two years of follow-up in this cohort study.

背景：双侧膝骨关节炎（KOA）很常见，但双侧与单侧膝骨关节炎对功能结局的影响证据是相互矛盾的。我们的目的是研究两年内双侧与单侧KOA与身体表现测量之间的关系。方法我们的队列包括有症状的影像学KOA的成年人。基线、12和24个月的研究评估包括30秒的椅子坐到站立任务（CST）和40米步行（40兆瓦）。我们将双侧KOA定义为Kellgren-Lawrence分级≥2，双膝骨关节炎结局疼痛量表≥17/100。我们使用线性混合模型来(1)评估每个时间点双侧与单侧KOA的存在与绩效指标之间的横断面关联，以及(2)评估基线双侧与单侧KOA之间的关联以及绩效指标的纵向变化。根据临床和人口统计学协变量对模型进行调整。结果共纳入101例受试者。在基线时，43/101（43%）有双侧KOA。在调整后的模型中，双侧与单侧相比，KOA与CST上的站立减少1.0 （95% CI: 2.2-0.1）和0.03 m/s慢40 MW （95% CI: 0.10-0.04）相关。基线双侧KOA患者的2年平均CST变化为- 0.6分，单侧KOA患者的2年平均CST变化为- 0.7分（组间差异为0.1分（95% CI: 1.7-1.8））。基线双侧KOA组在40 MW时间内恶化更严重（组间差异- 0.10 m/s (95% CI: -0.20-0.00)）。结论：在这项队列研究中，我们在两年的随访中没有发现双侧与单侧KOA与两项体力活动任务的表现之间有临床意义的关联。

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引用次数: 0

Preoperative neuropathic-like pain and central sensitisation are risk factors for chronic pain after total knee arthroplasty: A systematic review and meta-analysis 术前神经性疼痛和中枢致敏是全膝关节置换术后慢性疼痛的危险因素：一项系统回顾和荟萃分析

IF 2.8

Osteoarthritis and cartilage open

Pub Date : 2025-08-29 DOI: 10.1016/j.ocarto.2025.100674

Felipe F. Gonzalez , Alessandro Barone , Rithik Palaniappan , Raffaella Russo , Giorgio Gasparini , Leonardo Metsavaht , Jorge Chahla , Filippo Familiari

Objective

To investigate the effects of preoperative neuropathic-like pain and central sensitisation on clinical outcomes after total knee arthroplasty (TKA).

Design

This systematic review and meta-analysis followed PRISMA guidelines and was prospectively registered. Studies were included if they assessed preoperative neuropathic-like pain or central sensitisation before TKA and clinical outcomes after surgery, such as pain, function, or psychological status. Cross-sectional studies and case reports were excluded. Two authors independently screened, extracted data and rated articles' quality using a quality assessment tool. A meta-analysis was performed for studies reporting comparable methods and outcomes.

Results

From 6061 identified records, 15 studies met the inclusion criteria (total sample: 2385 individuals; follow-up periods: less than 1 year to 5 years). Most studies exhibited low/moderate risk of bias, primarily due to small sample sizes. The risk ratio of chronic pain (VAS ≥3 after at least 3 months) was 2.75 (CI: 1.78; 4.26) for patients with neuropathic-like pain (PainDETECT score ≥13). Seven out of eleven studies identified neuropathic-like pain and central sensitisation as risk factors for clinical outcomes such as decreased self-reported function, satisfaction, and anxiety (p < 0.05). Studies that adjusted for covariates showed mixed results, with some losing statistical significance.

Conclusion

The presence of neuropathic-like pain and central sensitisation in candidates for TKA is a risk factor for postoperative chronic pain. Evidence for decreased function, satisfaction, and psychological conditions is inconsistent. Screening and managing neuropathic-like pain and central sensitisation preoperatively could possibly improve clinical outcomes. Further research with standardized methods is needed.

Prospero id

CRD42024622693.

目的探讨术前神经性疼痛和中枢致敏对全膝关节置换术（TKA）临床疗效的影响。本系统评价和荟萃分析遵循PRISMA指南，并进行前瞻性注册。如果研究在TKA前评估术前神经性疼痛或中枢致敏，以及手术后的临床结果，如疼痛、功能或心理状态，则纳入研究。横断面研究和病例报告被排除在外。两位作者独立筛选、提取数据并使用质量评估工具对文章质量进行评级。对报告可比较方法和结果的研究进行荟萃分析。结果6061份纳入记录中，有15项研究符合纳入标准（总样本：2385人，随访时间：少于1年至5年）。大多数研究显示低/中等偏倚风险，主要是由于样本量小。神经性疼痛（PainDETECT评分≥13）患者慢性疼痛（至少3个月后VAS≥3）的风险比为2.75 （CI: 1.78; 4.26）。11项研究中有7项确定神经性样疼痛和中枢致敏是临床结果的危险因素，如自我报告功能、满意度和焦虑下降（p < 0.05）。对协变量进行调整后的研究结果喜忧参半，有些研究失去了统计学意义。结论神经性疼痛和中枢致敏是TKA患者术后慢性疼痛的危险因素。功能、满意度和心理状况下降的证据并不一致。术前筛查和处理神经性疼痛和中枢致敏可能会改善临床结果。需要采用标准化方法进行进一步研究。普洛斯彼罗idCRD42024622693。

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引用次数: 0