PM&R最新文献

{"title":"Geographic variations in ACGME PGY-2 PM&R residency program salaries compared to cost of living.","authors":"Jimmy Wen, Shannon Dwyer, Megan Kou, Apple Zhu, Arsh Alam, Naomi Pai, Jennifer S Addleman, Joshua Levin","doi":"10.1002/pmrj.70154","DOIUrl":"https://doi.org/10.1002/pmrj.70154","url":null,"abstract":"","PeriodicalId":20354,"journal":{"name":"PM&R","volume":" ","pages":""},"PeriodicalIF":2.8,"publicationDate":"2026-05-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147864196","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Hypovitaminosis D in acute inpatient cancer rehabilitation: Prevalence, predictors, and practical implications.","authors":"Jegy M Tennison, Minxing Chen, Areeba Hafeez, Ananya Krishnan, Sefia Khan, Rony Dev, Sonal Admane, Eduardo Bruera","doi":"10.1002/pmrj.70151","DOIUrl":"https://doi.org/10.1002/pmrj.70151","url":null,"abstract":"<p><strong>Background: </strong>Hypovitaminosis D is associated with adverse health outcomes, including increased mortality in patients with cancer. Although vitamin D insufficiency (23%-72%) and deficiency (20%-71%) are common among patients admitted to inpatient rehabilitation, their prevalence and predictors in cancer-specific inpatient rehabilitation populations remain uncharacterized.</p><p><strong>Objective: </strong>To determine the prevalence of hypovitaminosis D in adults with cancer admitted to acute inpatient rehabilitation and to identify demographic, clinical, laboratory, and functional predictors.</p><p><strong>Design: </strong>Retrospective observational cohort study.</p><p><strong>Setting: </strong>An inpatient rehabilitation service within a tertiary cancer hospital.</p><p><strong>Patients: </strong>Consecutive adults with a cancer diagnosis admitted for acute inpatient rehabilitation between December 1, 2023, and May 24, 2024.</p><p><strong>Interventions: </strong>Not applicable.</p><p><strong>Main outcome measure(s): </strong>The primary outcome was the prevalence of hypovitaminosis D (25-hydroxyvitamin D ≤ 29 ng/mL). Secondary outcomes included predictors of hypovitaminosis D and evaluation of the timing and frequency of vitamin D supplementation upon index hospital admission, upon admission to inpatient rehabilitation, and at 3 and 6 months post discharge.</p><p><strong>Results: </strong>Of 126 patients, 78 (62%) had hypovitaminosis D. Significant predictors included relatively younger age (median 66.0 vs 71.5 years; effect size, 5.5 with 95% confidence interval [CI], 1.60-9.40, p = .006) and presence of neurogenic bladder or bowel (16.7% vs 2.4%; odds ratio, 0.12 with 95% CI, 0.003-0.924, p = .019). At hospital admission, 29% (n = 36) were receiving supplementation, and 40% (n = 51) initiated supplementation during inpatient rehabilitation. At 3 and 6 months post discharge, 48% (n = 61) and 39% (n = 49), respectively, had records of continued supplementation. Vitamin D supplementation was generally well tolerated during inpatient rehabilitation, with only minor side effects that were managed in three patients.</p><p><strong>Conclusions: </strong>Hypovitaminosis D was highly prevalent among adult patients with cancer undergoing inpatient rehabilitation. Identified predictors, including relatively younger age and neurogenic bladder or bowel, may help guide targeted screening.</p>","PeriodicalId":20354,"journal":{"name":"PM&R","volume":" ","pages":""},"PeriodicalIF":2.8,"publicationDate":"2026-05-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147864364","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Predictors of successful viscosupplementation in osteoarthritis of the knee.","authors":"Anish Rana, Garret Waterstradt, Kenneth Dale King, Samia Lopa, Maya N Hatch, Jennifer Paul, Nathan Barford","doi":"10.1002/pmrj.70148","DOIUrl":"https://doi.org/10.1002/pmrj.70148","url":null,"abstract":"<p><strong>Background: </strong>Knee osteoarthritis (OA) is a common cause of disability among older adults. Common treatments include intra-articular corticosteroids (IACS) and viscosupplementation (VS). However, many insurance carriers either decline to cover VS or require prior IACS failure. Limited data exist on whether IACS response can guide VS use.</p><p><strong>Objective: </strong>To determine whether response to IACS predicts subsequent response to VS, and whether age, gender, body mass index (BMI), and OA severity are associated with VS outcomes.</p><p><strong>Design: </strong>Retrospective cohort study.</p><p><strong>Setting: </strong>Outpatient physical medicine and rehabilitation clinics at a tertiary-care academic medical center.</p><p><strong>Participants: </strong>Four hundred sixty three adult patients (≥18 years) with primary knee OA who received both IACS and VS injections.</p><p><strong>Interventions: </strong>Primary independent variable was response to IACS. Additional variables were age, gender, BMI, and OA severity.</p><p><strong>Main outcome measures: </strong>Primary outcome was pain relief following VS, categorized as favorable (>33% relief) or unfavorable (≤ 33% relief ).</p><p><strong>Results: </strong>The favorable response rate to VS among IACS nonresponders was 55% (95% confidence interval [CI]: 48%-62%) compared to 72% (95% CI: 67%-76%) in IACS responders (p < .001). IACS response was associated with higher odds of VS response (odds ratio [OR] = 2.10, 95% CI: 1.41-3.12, p < .001), which remained significant after adjusting for age, gender, BMI, and OA severity (OR = 2.25, 95% CI: 1.54-3.28, p <.001). BMI and age were not independently associated with VS response; however, both demonstrated a nonsignificant trend toward lower odds of response (BMI: OR = 0.88 per 5 kg/m², 95% CI: 0.77-1.01, p = .08; age: OR = 0.95 per 5 years, 95% CI: 0.87-1.04, p = .24). No significant associations were observed for gender or OA severity.</p><p><strong>Conclusions: </strong>Response to IACS predicts subsequent response to VS in patients with knee OA. These findings may help guide treatment selection, though prospective studies are needed.</p>","PeriodicalId":20354,"journal":{"name":"PM&R","volume":" ","pages":""},"PeriodicalIF":2.8,"publicationDate":"2026-05-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147841967","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Assessment of adverse events and safety associated with intra-articular platelet-rich plasma injections compared to other injectates for knee osteoarthritis: A systematic review and meta-analysis.","authors":"Hirotaka F Nakagawa, James Kim, Judy Rabinowitz, Walter I Sussman","doi":"10.1002/pmrj.70141","DOIUrl":"https://doi.org/10.1002/pmrj.70141","url":null,"abstract":"<p><strong>Objective: </strong>To evaluate adverse events (AEs) associated with intra-articular platelet-rich plasma (IA-PRP) injections for knee osteoarthritis (KOA) and compare their rates with those of intra-articular corticosteroids (IA-CS), hyaluronic acid (IA-HA), and normal saline (IA-NS).</p><p><strong>Literature survey: </strong>A systematic search of PubMed, Embase, and Cochrane Library databases identified randomized controlled trials (RCTs) published after 2015. Studies were included if they reported AEs related to IA-PRP injections for KOA and provided comparator data for IA-CS, IA-HA, or IA-NS.</p><p><strong>Methodology: </strong>Data on AEs were extracted and categorized into mild knee pain and swelling, severe knee pain requiring withdrawal, knee stiffness, other musculoskeletal (MSK) events, non-MSK events, and severe AEs. A random-effects meta-analysis was performed to calculate odds ratios (OR) with 95% confidence intervals (CI) for AE rates in IA-PRP versus comparator groups. Subgroup analysis was conducted to evaluate the effects of leukocyte concentration on AE rates.</p><p><strong>Synthesis: </strong>Thirty-two RCTs published articles, involving 1268 IA-PRP-treated knees, met inclusion criteria. AEs were reported in 18.7% of IA-PRP cases, with mild knee pain and swelling being the most common (10.6%). Compared to IA-HA, IA-PRP had significantly higher rates of mild knee pain and swelling (p < .001). Subgroup analysis revealed that this difference was significant only for leukocyte-rich IA-PRP (p < .05), whereas leukocyte-poor IA-PRP showed no significant difference compared to IA-HA (p = .51). Knee stiffness was more frequent in IA-PRP versus IA-NS (p = .031). There were no significant differences in other AE categories, and no severe AEs were reported across any groups.</p><p><strong>Conclusions: </strong>IA-PRP injections are associated with mild, transient AEs such as knee pain and swelling, particularly with leukocyte-rich PRP formulations. These symptoms typically resolve without intervention. Leukocyte-poor IA-PRP showed a similar safety profile to IA-HA. No severe AEs were observed, supporting the overall safety of IA-PRP for KOA. Clinicians should counsel patients on the likelihood of mild postprocedure symptoms, especially with high leukocyte formulations, while considering IA-PRP as a treatment option.</p>","PeriodicalId":20354,"journal":{"name":"PM&R","volume":" ","pages":""},"PeriodicalIF":2.8,"publicationDate":"2026-05-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147841934","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Factors associated with low anaerobic threshold and its impact on sleep quality and health-related quality of life in individuals with long COVID.","authors":"Chia-Huei Lin, Chia-Ying Lai, Chih-Ya Chang, Ta-Chung Chao, Chieh-Yi Song, Cheng-Chiang Chang, Wen-Yuan Chang, Chien-Yao Huang, Jyun-Wei Jhuang, Shang-Lin Chiang","doi":"10.1002/pmrj.70133","DOIUrl":"https://doi.org/10.1002/pmrj.70133","url":null,"abstract":"<p><strong>Introduction: </strong>Anaerobic threshold (AT), a crucial indicator of submaximal exercise capacity and cardiorespiratory function, has been reported to be impaired in individuals with long COVID. However, the predictors of reduced AT during exercise in this population and its impacts on patient-reported outcomes, including sleep quality and health-related quality of life (HRQL), remain unknown. This study aims to identify factors associated with low AT and examine its relationship with patient-reported outcomes.</p><p><strong>Objective: </strong>To investigate the predictors of low AT and compare patient-reported outcomes (sleep quality and HRQL) between individuals with normal and low AT among those with long COVID.</p><p><strong>Design: </strong>Cross-sectional study.</p><p><strong>Setting: </strong>Post-COVID integrated outpatient clinic at a medical center in northern Taiwan.</p><p><strong>Patients (or participants): </strong>Eligible patients aged 20-80 years with long COVID were recruited.</p><p><strong>Interventions: </strong>Not applicable.</p><p><strong>Main outcome measure(s): </strong>AT, peak oxygen consumption (peak VO₂), and patient-reported outcomes, including sleep quality and HRQL, assessed using the Taiwanese version of the World Health Organization Quality of Life-BREF and Pittsburgh Sleep Quality Index.</p><p><strong>Results: </strong>Factors associated with low AT included younger age (odds ratio [OR] = 0.904, 95% confidence interval [CI]: 0.867-0.942, p < .001) and lower peak VO₂ (OR = 0.737, 95% CI: 0.659-0.842, p < .001). Participants with low AT exhibited impaired patient-reported outcomes including poorer sleep quality (p = .008), and lower HRQL scores across all domains, as compared to those with normal AT. After adjustment for significant covariates, only the psychological domain of HRQL remained statistically significant (adjusted p = .035).</p><p><strong>Conclusions: </strong>Low AT in individuals with long COVID was associated with younger age and lower peak VO₂. Its independent impact on sleep quality and HRQL appears limited, suggesting that patient-reported outcomes may be influenced by multiple interacting factors and warrant further investigation.</p>","PeriodicalId":20354,"journal":{"name":"PM&R","volume":" ","pages":""},"PeriodicalIF":2.8,"publicationDate":"2026-05-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147841974","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Adipose-derived and bone marrow aspirate concentrate injections for osteoarthritis: A scoping review.","authors":"Leonardo P Oliveira, Aaron Lear, Joseph Elphingstone, Derek Stokes, Rachel Chamberlain, Timothy Tiu, David Price, Megan Agnew, Stephanie Kliethermes, Sarah Sund, Leslie A Christensen, Shane Shapiro, Kenneth Mautner","doi":"10.1002/pmrj.70147","DOIUrl":"https://doi.org/10.1002/pmrj.70147","url":null,"abstract":"<p><strong>Background: </strong>Osteoarthritis is a leading cause of disability worldwide, and cell-based treatments including adipose-derived and bone marrow aspirate have been sought by the lay and medical community as treatment options.</p><p><strong>Objective: </strong>To perform a scoping review of published literature on cell-based injections allowed by the U.S. Food and Drug Administration for the treatment of osteoarthritis to synthesize existing evidence and identify research gaps for future evaluation.</p><p><strong>Methods: </strong>A comprehensive search of five databases was executed from inception through January 2, 2025. Studies that met the inclusion criteria were original research studies written in English on Food and Drug Administration-allowed cell-based treatments in adults with osteoarthritis of any joint.</p><p><strong>Results: </strong>The database search yielded 4257 unique records. After screening, 84 studies met the inclusion criteria, encompassing 9996 patients and a total of 10,508 procedures. The primary research study designs were cohort studies (n = 62), focused on treatment of knee osteoarthritis (n = 63), and described bone marrow aspirate (n = 42) and adipose-derived (n = 42) treatments. Postprocedure monitoring ranged from 6 weeks to 5 years, with most studies ≤1 year (n = 59). Patient-reported outcomes were reported in 83 of 84 studies; few provided imaging outcomes including magnetic resonance imaging (n = 9) or radiographs (n = 2).</p><p><strong>Conclusion: </strong>This review identified limited randomized controlled trials, limited studies outside the knee, limited description of cell-based treatments, and treatment protocols, along with inconsistent patient-reported outcomes limited to 1 year in most studies. We propose establishing reporting guidelines in research on cell-based therapies.</p>","PeriodicalId":20354,"journal":{"name":"PM&R","volume":" ","pages":""},"PeriodicalIF":2.8,"publicationDate":"2026-05-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147819784","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Intercostal nerve injury after rib fractures: A case series correlating electrodiagnostic testing with imaging, ultrasound, and surgical findings.","authors":"Matthew Sherrier, Dane Daley, Evert Eriksson","doi":"10.1002/pmrj.70134","DOIUrl":"https://doi.org/10.1002/pmrj.70134","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Intercostal nerve injury can occur after rib fractures, resulting in denervation of the abdominal musculature. Loss of innervation to the rectus abdominis and intercostal muscles can cause atrophy and subsequent eventration, pain, and cosmetic issues. Intercostal electrodiagnostic testing can diagnose and localize intercostal nerve damage after rib fractures at levels T7 and below.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Objective: &lt;/strong&gt;To characterize rib fracture patterns associated with intercostal nerve injury and evaluate the diagnostic and surgical utility of preoperative nerve conduction study/electromyography (NCS/EMG) findings.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;Eight patients with NCS/EMG-diagnosed intercostal nerve injury following rib fractures were included in the study. A total of 17 levels with intercostal nerve damage were identified on electrodiagnostic testing. Descriptive rib fracture characteristics were obtained from preoperative chest computed tomography by a single chest wall surgeon and analyzed for displacement, degree of rib separation, fracture location, and presence of intercostal muscle, lung, and retroperitoneal hernias. Preoperative electrodiagnostic testing results were correlated with computed tomography rib fracture characteristics, ultrasound measurements of rectus abdominis cross sectional thickness, and direct intraoperative intercostal nerve evaluation using an intraoperative nerve stimulator.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;At the level of NCS/EMG-diagnosed intercostal nerve injury, 50% ribs were displaced and 50% were nondisplaced. Two levels demonstrated evidence of intercostal hernia, one with lung hernia and one with retroperitoneal hernia. The average degree of separation of rib fractures was 1.45 cm with two ribs demonstrating 0 cm of separation. With regard to rib fracture location, 29% were posterior, 41% posterolateral, and 23% lateral. Seven of eight patients (total of 15 nerves) underwent surgical intervention in the form of neurolysis versus intercostal nerve reconstruction with allograft nerve tissue. Direct intraoperative intercostal nerve stimulation correlated with the presence of intercostal nerve injury identified on preoperative NCS/EMG findings in 12 of 15 cases (80%). Two intercostal nerves were not explored secondary to significant intercostal trauma. A single level discrepancy was identified between preoperative NCS/EMG and intraoperative findings in one case. Ultrasound measurements demonstrated an average rectus abdominis transverse cross-sectional thickness of 0.66 cm on the affected side, compared with 1.04 cm on the nonaffected side (p = .01) and demonstrated a decrease in cross-sectional thickness as represented as a percentage of the contralateral, nonaffected side when measured against time from rib fracture (R&lt;sup&gt;2&lt;/sup&gt; = 0.432).&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;The present case series describes the rib fracture characteristics, ultrasound assessment, and interoper","PeriodicalId":20354,"journal":{"name":"PM&R","volume":" ","pages":""},"PeriodicalIF":2.8,"publicationDate":"2026-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147779253","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prolotherapy versus epidural steroid injections for lumbar pain with associated leg pain: A pragmatic randomized controlled trial.","authors":"Osnat Wende, Kenneth Dean Reeves, Guy Vishnevsky, An-Lin Cheng, David Rabago","doi":"10.1002/pmrj.70136","DOIUrl":"https://doi.org/10.1002/pmrj.70136","url":null,"abstract":"<p><strong>Background: </strong>Chronic low back pain with associated leg pain (CLBP-L) (whether referred or radiating) is a common, debilitating, and expensive condition. Epidural steroid injections (ESI) are commonly used, although effectiveness is often limited. Dextrose prolotherapy injections (DPT) are a potential alternative treatment to address the biomechanical and neurological causes of CLBP-L.</p><p><strong>Objective: </strong>To assess the effectiveness of DPT compared with ESI for CLBP-L.</p><p><strong>Design: </strong>Pragmatic unblinded, randomized controlled trial.</p><p><strong>Setting: </strong>Outpatient pain clinic; ESIs were performed in an operating room, DPT in a clinic procedure room.</p><p><strong>Participants: </strong>Adults aged between 18 and 90 years with at least 12 weeks of CLBP-L, and at least 6 on a 0-10 point leg pain severity numerical rating scale (NRS).</p><p><strong>Interventions: </strong>Up to three monthly injections for ESI participants; up to five monthly treatments for DPT participants.</p><p><strong>Main outcome measures: </strong>Least square mean (LSM) analysis of NRS 0-10 point pain scale (primary) and Oswestry Disability Index (secondary) at 1, 3, 6, and 12 months after treatment completion, using intention to treat analysis.</p><p><strong>Results: </strong>One hundred twelve participants were enrolled; eight withdrew from the study before receiving therapy; 104 participants (53% female; 58 <math> <semantics><mrow><mo>±</mo></mrow> <annotation>$$ pm $$</annotation></semantics> </math> 15 years old; body mass index 28 ± 5 kg/m², with 19 <math> <semantics><mrow><mo>±</mo></mrow> <annotation>$$ pm $$</annotation></semantics> </math> 23 months CLBP-L) were randomized (55 DPT, 49 ESI) and analyzed. No baseline differences existed between groups. DPT outperformed ESI in LSM pain scores at 6 (5.1 ± 0.7 vs. 7.2 ± 0.75 points; p < .001) and 12 m(5.2 ± 0.7 vs. 6.9 ± 0.7 points; p = .001) months. Function score LSMs also favored the DPT group at 6 (33 ± 5 vs. 45 ± 4.5 points; p < .001) and 12  (34 ± 4.5 vs. 42 ± 5 points; p = .012) months. There were no adverse events.</p><p><strong>Conclusions: </strong>For participants with CLBP-L, DPT resulted in statistically significant and clinically meaningful improvement of pain and function compared with ESI at 1 year after treatment completion. DPT may be an appropriate alternative for patients with CLBP-L.</p><p><strong>Clinical trials: </strong>NCT01934868, registered on August 30, 2013.</p>","PeriodicalId":20354,"journal":{"name":"PM&R","volume":" ","pages":""},"PeriodicalIF":2.8,"publicationDate":"2026-04-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147779256","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Relaxin-2 as a modifiable hormonal pathway in knee osteoarthritis: Dose dependent effects on chondrocyte phenotype.","authors":"Nicole B Katz, Adam M Khay, Kandarp M Dave, Ellen Casey, Fabrisia Ambrosio, Hirotaka Iijima","doi":"10.1002/pmrj.70150","DOIUrl":"https://doi.org/10.1002/pmrj.70150","url":null,"abstract":"<p><strong>Background: </strong>Postmenopausal female individuals are disproportionately affected by knee osteoarthritis (KOA), experiencing earlier onset and more severe pathology compared to their male counterparts. Despite this clinical disparity, the molecular mechanisms underlying female-specific vulnerability remain poorly defined.</p><p><strong>Objective: </strong>To evaluate the mechanistic role of relaxin-2 in postmenopausal KOA.</p><p><strong>Design: </strong>This was a translational research study that evaluated relaxin-2 using an in vitro postmenopausal human KOA chondrocyte culture model and in silico network medicine simulation.</p><p><strong>Setting: </strong>Research laboratory.</p><p><strong>Specimens: </strong>KOA chondrocytes isolated from a 67-year-old postmenopausal female human donor.</p><p><strong>Interventions: </strong>Female KOA chondrocytes were treated with varying relaxin-2 concentrations (control: 0 pg/mL, low: 0.496 pg/mL, medium: 49.6 pg/mL, and high: 4960 pg/mL; n = 5-7/group), with doses based on previously reported physiologic serum levels for pre- and postmenopausal female individuals.</p><p><strong>Main outcome measure(s): </strong>Effects were evaluated by immunofluorescence analysis of chondrogenicity markers (type II collagen [Col2], aggrecan [ACAN]), fibrotic markers (type I collagen [Col1], type III collagen [Col3]), extracellular matrix degradation markers (matrix metalloproteinase-13 [MMP-13], A Disintegrin And Metalloproteinase with Thrombospondin Motifs 4 [ADAMTS4]), and mitochondrial integrity and function markers (translocase of the outer mitochondrial membrane 20 [TOMM20], Succinate Dehydrogenase Subunit A [SDHA], Peroxisome Proliferator-Activated Receptor Gamma Coactivator 1-alpha [PGC-1α]).</p><p><strong>Results: </strong>Relaxin-2 increased Col2 at low and medium concentrations (p < .05), with the Col2/Col1 ratio highest at the low dose relaxin-2. MMP-13 expression was greatest for the medium compared to the control (p = .73), low (p = .002), and high relaxin-2 concentrations (p = .005), whereas ACAN and ADAMTS4 showed no differences across concentrations (p > .05). In silico analysis revealed that postmenopausal female individuals exhibit a fibrotic transcriptomic signature and that mitochondrial function is regulated by relaxin-2 in fibrotic chondrocytes. Computational analyses were validated experimentally, with TOMM20 and SDHA elevated at all relaxin-2 concentrations (p < .05), whereas PGC-1α was reduced at high concentration (p < .05).</p><p><strong>Conclusions: </strong>These findings demonstrate that relaxin-2 reprograms fibrotic osteoarthritic chondrocytes toward a healthier, less fibrotic state by restoring mitochondrial function.</p>","PeriodicalId":20354,"journal":{"name":"PM&R","volume":" ","pages":""},"PeriodicalIF":2.8,"publicationDate":"2026-04-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147779347","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Rehabilitation and surgical management after biceps tendon rupture in the only functional upper limb of a multilimb amputee with osseointegration.","authors":"Nicholas Robinson, Eda Shi, Deion Ellis, Danielle Melton","doi":"10.1002/pmrj.70132","DOIUrl":"https://doi.org/10.1002/pmrj.70132","url":null,"abstract":"","PeriodicalId":20354,"journal":{"name":"PM&R","volume":" ","pages":""},"PeriodicalIF":2.8,"publicationDate":"2026-04-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147779341","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}