Osteoarthritis year in review 2022: rehabilitation

Holden, Melanie; Nicolson, P.J.; Thomas, Martin J.; Corp, Nadia; Hinman, Rana S; Bennell, Kim L

doi:10.1016/j.joca.2022.10.004

Cited by 22 publications

(14 citation statements)

References 81 publications

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“…Thus, patients with higher pain intensity may exhibit gait adaptations in order to lower knee dynamic loading parameters. 45 - 47 As medial knee joint loading can be reduced with load-modifying interventions such as bracing, taping or footwear, 48 it can be speculated that such interventions may be beneficial for those with neuropathic-like pain symptoms. Specifically, KAM impulse was found to have greater sensitivity to the effects of biomechanical intervention than peak force.…”

Section: Discussionmentioning

confidence: 99%

Neuropathic-like pain in knee osteoarthritis: exploring differences in knee loading and inflammation. A cross-sectional study

DAINESE,

DE MITS,

WITTOEK

et al. 2024

Eur J Phys Rehabil Med

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BACKGROUND A subgroup of patients with knee osteoarthritis (OA) reports symptoms attributable to a neuropathic cause. Little to no attention has been invested on investigating differences in knee loading and inflammation in these patients. AIM To explore differences in inflammation and knee loading in patients with knee OA categorized based on the presence of neuropathic-like pain. DESIGN Cross-sectional study. SETTING Ghent University Hospital, Ghent, Belgium. POPULATION Knee OA patients. METHODS cross-sectional analysis of data from 96 patients (mean age 64.18±7.11 years) with primary knee OA participating in a randomized controlled trial. Participants were divided into three groups (unlikely, possible and indication of neuropathic-like pain) according to the modified painDETECT questionnaire (mPDQ). Data on demographics, symptoms and physical function were obtained by questionnaires. Effusion/synovitis and bone marrow lesions (BMLs) were measured using magnetic resonance imaging. Knee loading variables (knee adduction moment [KAM], KAM impulse, and knee flexion moment [KFM]) were assessed by 3D-motion analysis. One-way analysis of covariance (ANCOVA), Chi-square test and curve analyses were used to analyze continuous, categorical and loading variables respectively. Multinomial logistic regression was used to identify predictors for neuropathic-like pain. RESULTS Patients with indication of neuropathic-like pain exhibited higher KAM impulse compared to those with no indication of neuropathic-like pain (standard mean difference (SMD): -0.036 Nm normalized to body weight and height per second, 95% CI: -0.071, -0.001) along with greater pain intensity (SMD: 3.87 units, 95% CI: 1.90, 5.84), stiffness (SMD: 1.34 units, 95% CI: 0.19, 2.48) and worse physical function (SMD: 13.98 units 95% CI: 7.52, 20.44). Curve analysis showed no significant differences in KFM and KAM between groups. Effusion/synovitis and BMLs did not differ significantly between groups. The best predictors for indication of neuropathic-like pain were KAM impulse, Hoffa and sex. CONCLUSIONS Knee OA patients with indication of neuropathic-like pain exhibited higher dynamic medial loading, greater pain severity and worse physical function, while inflammatory markers were not significantly different across mPDQ groups. Future longitudinal studies are warranted to strengthen the evidence and establish mechanisms to explain associations between neuropathic-like pain and knee loading. CLINICAL REHABILITATION IMPACT Knee loading is a modifiable factor and patients with neuropathic-like pain may benefit from offloading interventions.

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Section: Discussionmentioning

confidence: 99%

Neuropathic-like pain in knee osteoarthritis: exploring differences in knee loading and inflammation. A cross-sectional study

DAINESE,

DE MITS,

WITTOEK

et al. 2024

Eur J Phys Rehabil Med

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“…In particular, small diverse samples, rather than large scale robust studies that can enable definitive answers to important genetic and epigenetic correlates of osteoarthritis and what should its prevention look like, fail however to often situate the condition in the context of the local overall joint environment and forces acting or failing to act optimally on the joint. 17 Other reported perspectives include genetic based therapies and explanatory factors, [18][19][20] aspects of biomaterial development to treat osteoarthritis, 21,22 such as collagen chondro protection 23,24 and various lubricants 25 but few specifically account for the origin of the disease that is clearly quite diverse, 1 and may include vulnerability to excess stress as well as abnormal stress reactions that might be remediable, but may not be addressed by focal solutions or those that are not actionable or clearly understood. 26 In addition, biological cell based therapies that do not account for the overall environment of the damaged joint are also likely to prove suboptimal at best in clinical terms, no matter how carefully these are construed in the lab or tested on non-human samples.…”

Section: General Findingsmentioning

confidence: 99%

Osteoarthritis 2050 projections and its multiple mitigation challenges

Marks

2023

MOJGG

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Osteoarthritis is increasingly being shown to be an immense costly public health problem among the older population that is not readily reversed. This brief examines 2023 data to establish what is being advanced to minimize the projected osteoarthritis burden and why this topic remains of great import. Using the key word: Older adults and Osteoarthritis the PUBMED, PubMed Central, and Google Scholar were explored for current 2023 articles of relevance. These data, while not all encompassing, reveal there is an urgent need to go beyond downstream surgical and narcotic remedies for ameliorating osteoarthritis pain and towards upstream preventive approaches, including the parallel role of health literacy and exercise interventions and their adherence. However, multiple challenges clearly prevail in this latter regard that warrant ongoing attention.

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“…Эти методы играют важную роль в лечении ОА, что четко обозначено в российских и международных рекомендациях по ведению таких больных [12][13][14]. Имеется серьезная доказательная база, подтверждающая эффективность нефармакологических подходов и методов медицинской реабилитации при ОА [15,16]. В частности, J. Tong и соавт.…”

Section: лечение наиболее распространенных бкмсunclassified

Combined use of non-steroidal anti-inflammatory drugs and symptomatic slow-acting drugs in musculoskeletal diseases

Karateev¹,

Лила²,

Parfenov

et al. 2023

Sovremennaâ revmatologiâ

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Musculoskeletal diseases, such as osteoarthritis (OA), nonspecific back pain (NBP), and periarticular soft tissue pathology (PSTP – tendinitis, enthesitis, bursitis, etc.) are one of the most common reasons for visiting general practitioners. The treatment of this pathology is based on the complex use of drugs and non-drug methods for maximum pain control and lost function restoration. Considering the common pathogenesis of musculoskeletal pain in OA, NBP, and PSTP, it is advisable to base the therapy of these diseases on a single algorithm. Of course, when prescribing treatment, one should take into account "red flags" (symptoms of life threatening diseases), features of the clinical course, patient's psycho-emotional condition, and comorbid diseases.Development of a unified tactic for the treatment of musculoskeletal pain will significantly reduce the time spent on a diagnostic search and the choice of adequate therapy, which will facilitate the work of a general practitioner. Thus, non-drug approaches (patient education, kinesiotherapy, psychotherapeutic methods, etc.), non-steroidal anti-inflammatory drugs (NSAIDs) and symptomatic slow-acting drugs (SYSADOA) seem to be the most rational approach in the debut of the treatment of OA, NBP and PSTP. Among NSAIDs, celecoxib seems to be one of the optimal drugs in terms of efficacy and safety, and among SYSADOAs – diacerein. There is evidence that the combined use of these drugs may increase their analgesic and anti-inflammatory potential.

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Osteoarthritis year in review 2022: rehabilitation

Cited by 22 publications

References 81 publications

Neuropathic-like pain in knee osteoarthritis: exploring differences in knee loading and inflammation. A cross-sectional study

Neuropathic-like pain in knee osteoarthritis: exploring differences in knee loading and inflammation. A cross-sectional study

Osteoarthritis 2050 projections and its multiple mitigation challenges

Combined use of non-steroidal anti-inflammatory drugs and symptomatic slow-acting drugs in musculoskeletal diseases

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