Study of 500 patients with limb joint osteoarthritis. I. Analysis by age, sex, and distribution of symptomatic joint sites.

Cushnaghan, J; Dieppe, Paul

doi:10.1136/ard.50.1.8

Cited by 288 publications

(152 citation statements)

References 15 publications

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“…Several epidemiologic studies have shown an association between OA of the hand and OA of the knee in community-based study populations, suggesting that hand OA is often part of a more generalized OA (22)(23)(24). Hand OA has a significant heredity, indicating the presence of a genetic risk factor (13,15).…”

Section: Discussionmentioning

confidence: 99%

Association of radiographic hand osteoarthritis with radiographic knee osteoarthritis after meniscectomy

Englund¹,

Paradowski²,

Lohmander³

2004

Arthritis & Rheumatism

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Objective. To evaluate the association between radiographic hand osteoarthritis (OA), a disease with marked heredity, and radiographic knee OA in patients treated with meniscectomy.Methods. We retrospectively identified 170 patients (mean age 54 years [range 33-87 years], 23% women) who had undergone isolated meniscectomy an average of 20 years earlier (range 17-22 years). Patients with cruciate ligament injury were excluded. All subjects were examined by standardized knee and hand radiography. Individual joints were considered to have OA when displaying radiographic features corresponding to a Kellgren/Lawrence (K/L) grade >2. Hand OA was considered present if at least 1 of the following criteria was fulfilled: the presence of radiographic OA (K/L grade >2) in at least 1 interphalangeal joint in each hand symmetrically, or in at least 2 distal or proximal interphalangeal joints in the same hand in a pattern consistent with primary OA (in the same row or ray), or in the first carpometacarpal joint bilaterally. The association between radiographic hand OA and radiographic knee OA was evaluated using logistic regression.Results. Radiographic hand OA was present in 57 patients (34%) and radiographic knee OA was identified in 105 patients (62%), within 94 index knees (55%) and 47 contralateral knees (28%). In a multivariate model, radiographic hand OA was associated with an increased likelihood of radiographic OA in the index knee (odds ratio [OR] 3.0, 95% confidence interval [95% CI] 1.2-7.5) and in the nonoperated contralateral knee (OR 3.5, 95% CI 1.0-12.2).Conclusion. The presence of radiographic hand OA is associated with an increased frequency of radiographic knee OA after meniscectomy. This finding confirms and extends that of a single previous study showing an interaction between hereditary and environmental risk factors for OA, a common and genetically complex disease. Accordingly, the development of OA following a meniscal tear and the resulting meniscal surgery should not be regarded to be of secondary origin only.

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Section: Discussionmentioning

confidence: 99%

Association of radiographic hand osteoarthritis with radiographic knee osteoarthritis after meniscectomy

Englund¹,

Paradowski²,

Lohmander³

2004

Arthritis & Rheumatism

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“…Several studies have shown an association between OA of the hand and OA of the knee, suggesting that hand OA is often part of a more generalized OA (Cushnaghan and Dieppe 1991, Hirsch et al 1996. Hand OA has a signifi cant heredity, indicating the presence of a genetic risk factor (Stecher 1941, Spector et al 1996 (Figure 10).…”

Section: Knee Oa After Meniscal Injury Is Not Secondary Oa Onlymentioning

confidence: 99%

Meniscal tear - a feature of osteoarthritis

Englund¹

2004

SORT

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Meniscectomy is recognized as an important risk factor for the development of knee osteoarthritis (OA), a disease that traditionally has been considered as a simple "wear and tear" phenomenon. However, despite numerous reports, little evidence has been presented that a limited meniscal resection, compared with a more extensive resection, reduces the risk of OA by preserving meniscal function. Why? This thesis provides one possible answer to that question.Patients, who had undergone isolated meniscal resection in 1973, 1978, or between 1983 and 1985 at Lund University Hospital, Sweden, were reviewed clinically and radiographically 15-22 years after the surgical procedure.Of the subjects (n = 317) almost 50% had developed radiographic OA in their operated knee, but just over half of these patients were symptomatic. An additional 20% of the patients had knee symptoms, but did not have radiographic knee OA. These results confi rm a limited correlation between radiographic features of the disorder and symptoms.A degenerative type of meniscal tear and obesity were the factors most strongly associated with both radiographic knee OA and symptomatic radiographic knee OA.Partial meniscal resection induced less radiographic changes related to knee OA compared with total meniscectomy, but the patient-relevant outcomes remained essentially the same.If radiographic hand OA was present there was an increased likelihood of the patient also having knee OA following meniscectomy. This fi nding was independent of age, and therefore an inherited susceptibility to the disease contributes to the risk of knee OA after meniscal tear. Genetic and environmental risk factors interact in OA development.A degenerative meniscal lesion is often associated with early-stage knee OA, a disorder also involving the meniscal tissue. The tear may thus represent the fi rst "signal" feature of OA. The challenge for the health professional is to discriminate between symptoms caused by a meniscal tear and those caused by OA. Meniscal resection may not benefi t the patient with early-stage knee OA. The intervention merely removes evidence of the disorder, while the OA joint degradation proceeds.

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“…Studies of cadavers have revealed that full-thickness cartilage defects occur ϳ20 times more often in the knee than in the ankle (2,3). Symptomatic OA with radiographic changes occurs ϳ8-9.4 times more frequently in the knee than in the ankle in patients seeking treatment (4,5). Therefore, several researchers have focused on comparing the cartilages from these 2 joints to determine whether they possess histologic, biochemical, biomechanical, and/or metabolic differences (6)(7)(8)(9)(10).…”

mentioning

confidence: 99%

Differential acoustic properties of early cartilage lesions in living human knee and ankle joints

Hattori¹,

Takakura²,

Ishimura³

et al. 2005

Arthritis & Rheumatism

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Objective. Although numerous studies have been performed to determine whether there are histologic, biochemical, biomechanical, and metabolic differences between knee and ankle cartilage, none have investigated the presence of such differences in living human cartilage. We previously developed an ultrasonic evaluation system for articular cartilage that analyzes the A-mode echogram using wavelet transformation. The current study was undertaken to determine whether the acoustic properties of living human cartilage differ between knee and ankle joints.Methods. Twenty-eight patients were subjected to ultrasonic evaluation under arthroscopy. After arthroscopic grading, the cartilage was measured using an ultrasonic probe. Two quantitative parameters were used, i.e., the maximum magnitude and the echo duration at the 95% interval of the maximum magnitude.Results. In intact cartilage, the maximum magnitude and echo duration did not differ between the knee and the ankle. In lesional cartilage, in contrast, the maximum magnitude was higher, and the echo duration was shorter, in the ankle than in the knee. These differences were statistically significant.Conclusion. Ultrasound findings could be used to judge the degree of early cartilage degeneration in vivo on the basis of objective data such as the maximum magnitude and echo duration. Because we were unable to quantitatively analyze the biochemical and biomechanical properties of the cartilage in this study, our biochemical and biomechanical findings are based only on qualitative assessment. Nevertheless, the results indicate that this ultrasonic evaluation system may be useful for elucidating the processes of articular cartilage degeneration in osteoarthritis.Osteoarthritis (OA), also referred to as degenerative joint disease, is one of the most prevalent chronic conditions, although not all joints are equally affected by the disease (1). Studies of cadavers have revealed that full-thickness cartilage defects occur ϳ20 times more often in the knee than in the ankle (2,3). Symptomatic OA with radiographic changes occurs ϳ8-9.4 times more frequently in the knee than in the ankle in patients seeking treatment (4,5). Therefore, several researchers have focused on comparing the cartilages from these 2 joints to determine whether they possess histologic, biochemical, biomechanical, and/or metabolic differences (6-10). There has been a great deal of effort, in studies using cartilage from cadavers, to elucidate the differences between these 2 joints. Indeed, such studies may help us to understand the different susceptibilities of these 2 joints and the pathogenesis of OA in general. However, none of these investigations have been conducted with living human cartilage.We previously developed a novel system for evaluating articular cartilage, in which the acoustic properties of articular cartilage are measured by introducing an ultrasound probe into the knee joint under arthroscopy (11,12). The analysis system is based on wavelet transformation of the reflex echogram from arti...

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Study of 500 patients with limb joint osteoarthritis. I. Analysis by age, sex, and distribution of symptomatic joint sites.

Abstract: Five hundred subjects with symptomatic limb joint osteoarthritis, who had been referred to a rheumatologist, were enrolled into a continuing study.

Cited by 288 publications

References 15 publications

Association of radiographic hand osteoarthritis with radiographic knee osteoarthritis after meniscectomy

Association of radiographic hand osteoarthritis with radiographic knee osteoarthritis after meniscectomy

Meniscal tear - a feature of osteoarthritis

Differential acoustic properties of early cartilage lesions in living human knee and ankle joints

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