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Osteoarthritis affects a significant portion of U.S. adults, and knee osteoarthritis contributes to 80% of disease burden. Previous data have shown that non‐White patient populations often report worse symptoms and less favorable outcomes following arthroplasty, a definitive treatment for knee osteoarthritis. There is a lack of demographics data on race/ethnicity, as well as socioeconomic status (SES) and social determinants of health (SDOH), in knee osteoarthritis treatment guidelines and knee arthroplasty research. In addition, there is underrepresentation of non‐White patient populations in the existing treatment guidelines for knee osteoarthritis. Over the past decade, orthobiologics have emerged as an alternative to surgical intervention. Our hypothesis is that there would be a similar lack of reporting of demographics data and underrepresentation of non‐White populations in studies pertaining to orthobiologics, including evaluating differences in outcomes. This study reviewed U.S.‐based research in orthobiologics as a treatment option for knee osteoarthritis. We identified a lack of demographics reporting in terms of race/ethnicity, and none of the studies reported SES or SDOH. Non‐White populations were underrepresented; White patients contributed to 80% or more of all study populations that reported race/ethnicity. None studied the correlation between symptoms and outcome measures, and the race/ethnicity, SES, and SDOH of the patients. Based on a review of existing literature, we strongly advocate for ongoing research encompassing patients of all races/ethnicities, SES, and SDOH, and an exploration into potential variations in symptoms and outcomes among distinct population subgroups. Furthermore, SES barriers may influence health care delivery on orthobiologics for disadvantaged populations.
Osteoarthritis affects a significant portion of U.S. adults, and knee osteoarthritis contributes to 80% of disease burden. Previous data have shown that non‐White patient populations often report worse symptoms and less favorable outcomes following arthroplasty, a definitive treatment for knee osteoarthritis. There is a lack of demographics data on race/ethnicity, as well as socioeconomic status (SES) and social determinants of health (SDOH), in knee osteoarthritis treatment guidelines and knee arthroplasty research. In addition, there is underrepresentation of non‐White patient populations in the existing treatment guidelines for knee osteoarthritis. Over the past decade, orthobiologics have emerged as an alternative to surgical intervention. Our hypothesis is that there would be a similar lack of reporting of demographics data and underrepresentation of non‐White populations in studies pertaining to orthobiologics, including evaluating differences in outcomes. This study reviewed U.S.‐based research in orthobiologics as a treatment option for knee osteoarthritis. We identified a lack of demographics reporting in terms of race/ethnicity, and none of the studies reported SES or SDOH. Non‐White populations were underrepresented; White patients contributed to 80% or more of all study populations that reported race/ethnicity. None studied the correlation between symptoms and outcome measures, and the race/ethnicity, SES, and SDOH of the patients. Based on a review of existing literature, we strongly advocate for ongoing research encompassing patients of all races/ethnicities, SES, and SDOH, and an exploration into potential variations in symptoms and outcomes among distinct population subgroups. Furthermore, SES barriers may influence health care delivery on orthobiologics for disadvantaged populations.
Objectives To compare the efficacy of the various wavelengths of low-level light therapy (LLLT) in alleviating knee pain, dysfunction, and stiffness in patients with knee osteoarthritis (KOA), and to compare the effectiveness of LLLT versus sham treatment in reducing knee pain, dysfunction, and stiffness. Methods PubMed, Web of Science, EMBASE, and Cochrane Library were searched from inception to 12 December 2023. Randomized controlled trials that assessed the effects of different wavelengths of LLLT on alleviating pain of patients with KOA were included. A conventional meta-analysis and network meta-analysis were preformed, and standardized mean differences (SMD) with 95% confidence interval (CI) were calculated. Results Thirteen studies involving 673 participants with KOA met inclusion criteria. Overall, LLLT was superior to sham LLLT for relieving pain (SMD = 0.96, 95% CI 0.31–1.61) but not for improving function (SMD = 0.21, 95% CI − 0.11 to 0.53) or stiffness (SMD = 0.07, 95% CI − 0.25 to 0.39). Surface under the cumulative ranking curve (SUCRA) value ranking showed the most effective wavelength of LLLT in reducing KOA pain was 904–905 nm (SUCRA, 86.90%), followed by multi-wavelengths (MWL) (SUCRA, 56.43%) and 785–850 nm (SUCRA, 54.97%). Compared to sham LLLT, L2 (SMD = 1.42, 95% CI = 0.31–2.53) and L1 (SMD = 0.82; 95% CI = 0.11–1.50) showed a significant reduction in KOA pain. However, MWL (SMD = 0.83; 95% CI = − 0.06 to 1.72) showed similar KOA pain reduction compared to sham LLLT. The certainty of evidence showed that the quality of evidence regarding the effectiveness of overall LLLT versus sham, and 904–905 nm versus sham were low, while the quality of evidence for MWL versus sham, and 785–850 nm versus sham was very low. Conclusion While the 904–905 nm wavelength showed potential benefits in reducing KOA pain, the overall quality of the evidence was low. LLLT with 904–905 nm or 785–850 nm wavelengths yielded significantly better reduction in KOA pain compared to sham LLLT, but further high-quality research is warranted to validate these findings.
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