Osteoarthritis: an update with relevance for clinical practice

Bijlsma, J. W. J.; Bérenbaum, Francis; Lafeber, Floris P. J. G.

doi:10.1016/s0140-6736(11)60243-2

Cited by 1,901 publications

(1,557 citation statements)

References 127 publications

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“…The second most common non-CTD musculoskeletal manifestation was OA with a prevalence of 3%, similar to previously figures [22]. The average age for OA in SCD was younger at 36 years compared to >50 years in non-SCD population [23,24]. There were also high proportions of patients with hyperuricemia (16.3% of SCD patients) but little clinical correlation to the development of gout (1.2% of SCD patients).…”

Section: Discussionsupporting

confidence: 82%

Increased Prevalence of Autoimmunity and Connective Tissue Diseases in Sickle Cell Disease

Igbineweka¹,

Darbari²,

Drašar³

et al. 2016

J Gen Pract

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Connective tissue disease (CTD) and sickle cell disease (SCD) are diverse group of disorders; however, both of these diseases are characterized by underlying chronic inflammation. CTD is perceived to have a higher incidence and to affect the disease severity in SCD. Objectives:We seek to describe prevalence of autoimmunity and CTD and itsimpact on SCD disease severity as this is not well described in the literature. Methods:We retrospectively reviewed the medical records of 722 patients with SCD, seen over an 11 year period followed at a tertiary care hospital in London, UK. During the last 2 years of the study, number of hospitalizations and length of hospital stay were compared in patients with SCD with and without CTD. Results:In the study cohort, hemoglobin SS was the most common genotype (n = 451; 62%) and 411 (57%) were female. Twenty-three patients (3.1% had documented evidence of CTD, with rheumatoid arthritis (n = 14; 2%) and systemic lupus erythematosus (n = 2; 0.3%) being the most common. Antinuclear antibody was present in 108 (15%) of the patients and anti-smooth muscle antibody was present in 60 (8%). The mean number of hospitalizations (1.9 ± 2.7 vs. 1.5 ± 2.7) and mean length of hospital stay (6 days ± 4.1 vs. 7 days ± 11.4) were not different between those with or without autoimmunity and/or CTD. Avascular necrosis was the most common non-CTD musculoskeletal complication, affecting 72 (10%) patients. Conclusion:Our study suggests that positive autoimmune serology and CTD were more common in SCD compared to non-SCD population of similar ethnic background; however, presence of CTD does not appear to affect the SCD severity. The high frequency of CTD and overlapping of clinical symptoms suggest a need for diagnostic vigilance in diagnosing CTD in patients with SCD.

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Section: Discussionsupporting

confidence: 82%

Increased Prevalence of Autoimmunity and Connective Tissue Diseases in Sickle Cell Disease

Igbineweka¹,

Darbari²,

Drašar³

et al. 2016

J Gen Pract

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“…Unfortunately, despite a large body of research, there is no commonly accepted system for classifying OA phenotypes 41. As specific disease history and etiology may influence disease progression and outcome of treatment, in the absence of an existing, robust classification system, the working group developed a simple physician‐reported measure of joint history that broadly categorizes OA etiologies (Table 2).…”

Section: Resultsmentioning

confidence: 99%

Defining an International Standard Set of Outcome Measures for Patients With Hip or Knee Osteoarthritis: Consensus of the International Consortium for Health Outcomes Measurement Hip and Knee Osteoarthritis Working Group

Rolfson

Wissig²,

Maasakkers³

et al. 2016

Arthritis Care & Research

125

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ObjectiveTo define a minimum Standard Set of outcome measures and case‐mix factors for monitoring, comparing, and improving health care for patients with clinically diagnosed hip or knee osteoarthritis (OA), with a focus on defining the outcomes that matter most to patients.MethodsAn international working group of patients, arthroplasty register experts, orthopedic surgeons, primary care physicians, rheumatologists, and physiotherapists representing 10 countries was assembled to review existing literature and practices for assessing outcomes of pharmacologic and nonpharmacologic OA therapies, including surgery. A series of 8 teleconferences, incorporating a modified Delphi process, were held to reach consensus.ResultsThe working group reached consensus on a concise set of outcome measures to evaluate patients’ joint pain, physical functioning, health‐related quality of life, work status, mortality, reoperations, readmissions, and overall satisfaction with treatment result. To support analysis of these outcome measures, pertinent baseline characteristics and risk factor metrics were defined. Annual outcome measurement is recommended for all patients.ConclusionWe have defined a Standard Set of outcome measures for monitoring the care of people with clinically diagnosed hip or knee OA that is appropriate for use across all treatment and care settings. We believe this Standard Set provides meaningful, comparable, and easy to interpret measures ready to implement in clinics and/or registries globally. We view this set as an initial step that, when combined with cost data, will facilitate value‐based health care improvements in the treatment of hip and knee OA.

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“…Pathological changes include localized loss of articular cartilage and new bone formation in places of destructive bone loss at joint margins [1]. The most common location for OA is the knee joint, followed by the feet and hips, and it becomes more common with age and women are more affected than men [2]. The treatment focuses on the reduction of pain and stiffness, and the maintenance or improvement of join function; further aims of treatments are the delay of the progression of joint damage and improving the patient’s quality of life [3].…”

Section: Introductionmentioning

confidence: 99%

Pulsatile dry cupping in patients with osteoarthritis of the knee – a randomized controlled exploratory trial

Teut

Kaiser

Ortiz

et al. 2012

BMC Complement Altern Med

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IntroductionCupping is used in various traditional medicine forms to relieve pain in musculoskeletal diseases. The aim of this study was to investigate the effectiveness of cupping in relieving the symptoms of knee osteoarthritis (OA).MethodsIn a two-group, randomized controlled exploratory pilot study patients with a clinically and radiological confirmed knee OA (Kellgren-Lawrence Grading Scale: 2-4) and a pain intensity > 40 mm on a 100 mm visual analogue scale (VAS) were included. 40 Patients were randomized to either 8 sessions of pulsatile dry cupping within 4 weeks or no intervention (control). Paracetamol was allowed on demand for both groups. Outcomes were the Western Ontario and McMaster Universities Osteoarthritis (WOMAC) score, the pain intensity on a VAS (0 mm = no pain to 100 mm = maximum intensity) and Quality of Life (SF-36) 4 and 12 weeks after randomization. Use of Paracetamol was documented within the 4-week treatment period. Analyses were performed by analysis of covariance adjusting for the baseline value for each outcome.Results21 patients were allocated to the cupping group (5 male; mean age 68 ± SD 7.2) and 19 to the control group (8 male; 69 ± 6.8). After 4 weeks the WOMAC global score improved significantly more in the cupping group with a mean of 27.7 (95% confidence interval 22.1; 33.3) compared to 42.2 (36.3; 48.1) in the control group (p = 0.001). After 12 weeks the WOMAC global score were still significantly different in favor for cupping (31.0 (24.9; 37.2) vs. 40.8 (34.4; 47.3) p = 0.032), however the WOMAC subscores for pain and stiffness were not significant anymore. Significantly better outcomes in the cupping group were also observed for pain intensity on VAS and for the SF-36 Physical Component Scale compared to the control group after 4 and 12 weeks. No significant difference was observed for the SF-36 Mental Component Scale and the total number of consumed Paracetamol tablets between both groups (mean 9.1, SD ± 20.0 vs. 11.5 ± 15.9).ConclusionIn this exploratory study dry cupping with a pulsatile cupping device relieved symptoms of knee OA compared to no intervention. Further studies comparing cupping with active treatments are needed.Trial registrationClinicaltrials.gov Identifier: NCT01057043

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Osteoarthritis: an update with relevance for clinical practice

Cited by 1,901 publications

References 127 publications

Increased Prevalence of Autoimmunity and Connective Tissue Diseases in Sickle Cell Disease

Increased Prevalence of Autoimmunity and Connective Tissue Diseases in Sickle Cell Disease

Defining an International Standard Set of Outcome Measures for Patients With Hip or Knee Osteoarthritis: Consensus of the International Consortium for Health Outcomes Measurement Hip and Knee Osteoarthritis Working Group

Pulsatile dry cupping in patients with osteoarthritis of the knee – a randomized controlled exploratory trial

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