Osteoarthritis and cartilage open最新文献

{"title":"Referral, enrollment, and health care use in a comprehensive patient-centered management program for osteoarthritis of the hip and knee","authors":"Trevor A. Lentz ,&nbsp;Preston Roundy ,&nbsp;Emily Poehlein ,&nbsp;Cynthia L. Green ,&nbsp;Richard C. Mather III ,&nbsp;William Jiranek","doi":"10.1016/j.ocarto.2024.100532","DOIUrl":"10.1016/j.ocarto.2024.100532","url":null,"abstract":"<div><h3>Objective</h3><div>Osteoarthritis management programs (OAMPs) have become a more common way to deliver patient-centered care. However, there is limited information on real-world use of these programs to guide implementation, payment policy, accessibility, and scaling in the United States. This paper describes 5-year use metrics for the Duke Joint Health Program, an OAMP embedded within a US academic health system.</div></div><div><h3>Method</h3><div>This analysis includes patients referred into the Program between October 2017 and April 2022. We generated descriptive statistics of referral and enrollment totals, demographics and patient-reported measures of enrollees, retention and healthcare use metrics (e.g., office visit frequency), and data capture rates for patient-reported outcomes.</div></div><div><h3>Results</h3><div>During the study period, 6863 patients were referred to the program and 4162 (61 ​%) enrolled. We observed statistically significant differences between those who did and did not enroll by age (mean difference ​± ​SE: 2.49 ​± ​2.8 years), sex (70.0 ​% vs 67.7 ​% female), race (65.1 ​% vs 55.3 ​% Caucasian/White), employment status (50.0 ​% vs 40.2 ​% retired), and insurance type (53.5 ​% vs 47.0 ​% Medicare). The median (Q1, Q3) number of visits was 2 (1, 4) and ranged from 1 to 67. The median (Q1, Q3) number of days from first to last program visit was 23 (0, 84) days. Questionnaire completion rates were 72 ​% at baseline, 46 ​% at 6 weeks, 39 ​% at 3 months, and 40 ​% at 6 and 12 months.</div></div><div><h3>Conclusion</h3><div>Findings can guide the planning, development, and implementation of future OAMPs and inform policies to ensure programs are accessible and equitable.</div></div>","PeriodicalId":74377,"journal":{"name":"Osteoarthritis and cartilage open","volume":"6 4","pages":"Article 100532"},"PeriodicalIF":0.0,"publicationDate":"2024-10-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142538758","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical benefit of physical rehabilitation after total hip and knee arthroplasty: A pragmatic, randomized, controlled trial (The DRAW1 trial)","authors":"T. Mark-Christensen ,&nbsp;K. Thorborg ,&nbsp;T. Kallemose ,&nbsp;T. Bandholm","doi":"10.1016/j.ocarto.2024.100530","DOIUrl":"10.1016/j.ocarto.2024.100530","url":null,"abstract":"<div><h3>Importance</h3><div>Comparative effectiveness trials have not shown superiority of one type of physical rehabilitation over another following total hip (THA) and knee (TKA) arthroplasty. We therefore ask the fundamental effectiveness question: Does physical rehabilitation “work” better than no physical rehabilitation?</div></div><div><h3>Objective</h3><div>To compare the effectiveness of a 6-week program of physical rehabilitation (home-based telerehabilitation, or home-based rehabilitation) to no physical rehabilitation following THA and TKA.</div></div><div><h3>Design</h3><div>3-arm,randomized, controlled, superiority trial with blinded outcome assessments. 377 patients (210 THA/167 TKA) were screened for eligibility before the targeted sample size of 168 patients was reached. Outcome measures were assessed at baseline, at the end of intervention (6 weeks), and 3 and 12 months postoperatively. The primary outcome was the Hip disability and Osteoarthritis Outcome Score (HOOS)/Knee injury and Osteoarthritis Outcome Score (KOOS)-subscale: function in daily living. Secondary outcomes included: HOOS/KOOS-subscales: pain, symptoms, and quality of life, patient global assessment, analgesics, walking aids, 30-s chair stand test, 4 ​× ​10 ​m fast-paced walk test, exercise adherence, and satisfaction.</div></div><div><h3>Results</h3><div>Comparing physical rehabilitation (home-based telerehabilitation, and home-based rehabilitation) to no physical rehabilitation, the mean group-differences for the primary outcome were 3.3 (95%CI: −1.9 to 8.6; p ​= ​0.10) points at 6 weeks, and 1.9 (95%CI: −3.7 to 7.6; p ​= ​0.25) and 2.6 (95%CI: −4.4 to 9.6; p ​= ​0.23) points at the 3- and 12-months follow-ups, respectively.</div></div><div><h3>Conclusion</h3><div>Physical rehabilitation was not superior to the no physical rehabilitation comparator following THA or TKA in terms of self-reported function or any of the secondary outcomes.</div></div><div><h3>Trial registration</h3><div>NCT03750448 (November 23, 2018), URL: <span><span>https://clinicaltrials.gov/ct2/show/NCT03750448</span><svg><path></path></svg></span>.</div></div>","PeriodicalId":74377,"journal":{"name":"Osteoarthritis and cartilage open","volume":"6 4","pages":"Article 100530"},"PeriodicalIF":0.0,"publicationDate":"2024-10-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142528278","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Depression predicts decreased lumbar bone mineral density: A scoping review of chronic psychological stress and spinal tissue pathology","authors":"Mary A. Bucklin ,&nbsp;Eric C. Gehrke ,&nbsp;Jennifer C. Westrick ,&nbsp;Michael Gottlieb ,&nbsp;John T. Martin","doi":"10.1016/j.ocarto.2024.100529","DOIUrl":"10.1016/j.ocarto.2024.100529","url":null,"abstract":"<div><h3>Objective</h3><div>Chronic low back pain (cLBP) is a complex disease with biological, psychological, and social components and the complex interactions of these components are poorly understood. Chronic psychological stress (CPS) (anxiety, depression, etc.) and pathological changes in spinal tissue (osteoporosis, disc degeneration, etc.) are frequently and independently associated with cLBP, yet their explicit relationship has not been collectively reviewed. The objective of this scoping review is to investigate the current state of research on how CPS may impact spinal tissue pathology.</div></div><div><h3>Design</h3><div>Five steps were utilized to conduct this scoping review: 1) identify a research objective and establish a search strategy, 2) identify research articles, 3) select research articles that meet search criteria, 4) extract data, 5) summarize and report results.</div></div><div><h3>Results</h3><div>We identified N ​= ​56 articles relating CPS to spinal pathology. Of those that identified a relationship between CPS and spine pathology (N ​= ​39), most (N ​= ​24) described decreased lumbar vertebral bone mineral density (BMD) between depression and control groups. Animal studies (N ​= ​8) were limited to mice and confirmed a causal relationship between CPS and lower vertebral BMD. Only a few additional human studies (N ​= ​9) documented relationships between other various forms of CPS and spinal tissue pathologies.</div></div><div><h3>Conclusion</h3><div>This scoping review documents evidence of a relationship between CPS and decreased spine health in humans as well as a causal relationship between the initiation of CPS and decreased BMD in animals. As few studies evaluated disease in other spinal anatomy in relationship to CPS, future work in this area is warranted. Further exploration of CPS beyond depression is warranted as well.</div></div>","PeriodicalId":74377,"journal":{"name":"Osteoarthritis and cartilage open","volume":"6 4","pages":"Article 100529"},"PeriodicalIF":0.0,"publicationDate":"2024-10-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142571628","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association between type III collagen degradation and local tissue damage of a single joint","authors":"Christian S. Thudium ,&nbsp;Sten Rasmussen ,&nbsp;Morten A. Karsdal ,&nbsp;Anne-Christine Bay-Jensen","doi":"10.1016/j.ocarto.2024.100527","DOIUrl":"10.1016/j.ocarto.2024.100527","url":null,"abstract":"<div><h3>Objective</h3><div>The development of disease-modifying drugs is limited by OA's heterogeneity and the challenge of defining clinical endpoints. Serological biomarkers are considered potential surrogate endpoints, but their contribution from single joints to systemic levels in OA patients is unclear. In this exploratory study we longitudinally assessed systemic biomarker levels' response to tissue damage and healing before and after surgery in patients undergoing knee or hip joint replacement revision for aseptic failure. Patients with chronic pain associated with a prior hip or knee arthroplasty, but not receiving revision surgery were included as control.</div></div><div><h3>Method</h3><div>The serological biomarker of MMP mediated type III collagen degradation C3M, associated with synovial tissue degradation, was measured at baseline before revision surgery, after revision surgery and at a 6-month follow-up in 48 patients with aseptic loosening of a knee or hip prosthesis and in 18 patients with chronic pain from a hip or knee prosthesis. Longitudinal changes in biomarkers were modeled using linear mixed models.</div></div><div><h3>Results</h3><div>No differences between the aseptic loosening and chronic pain groups were observed at baseline. Revision surgery in the aseptic loosening group led to a swift increase in C3M, which normalized within 2–3 months. No changes in biomarker level were observed in chronic pain patients over three months.</div></div><div><h3>Conclusion</h3><div>These findings suggest that tissue damage in a single joint significantly impacts systemic biomarker levels and underscores the relevance of systemic biomarkers in assessing local tissue remodeling.</div></div>","PeriodicalId":74377,"journal":{"name":"Osteoarthritis and cartilage open","volume":"6 4","pages":"Article 100527"},"PeriodicalIF":0.0,"publicationDate":"2024-10-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142528350","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"TNFα has differential effects on the transcriptome profile of selected populations in murine cartilage","authors":"Ernesto Canalis ,&nbsp;Lauren Schilling ,&nbsp;Emily Denker","doi":"10.1016/j.ocarto.2024.100528","DOIUrl":"10.1016/j.ocarto.2024.100528","url":null,"abstract":"<div><h3>Objective</h3><div>To further our understanding of the role of tumor necrosis factor (TNF)α on the inflammatory response in chondrocytes.</div></div><div><h3>Design</h3><div>We explored the effects of TNFα on the transcriptome of epiphyseal chondrocytes from newborn C57BL/6 mice at the total and single cell (sc) resolution.</div></div><div><h3>Results</h3><div>Gene set enrichment analysis of total RNA-Seq from TNFα-treated chondrocytes revealed enhanced response to biotic stimulus, defense and immune response and cytokine signaling and suppressed cartilage and skeletal morphogenesis and development. scRNA-Seq analyzed 14,239 ​cells and 24,320 genes and distinguished 16 ​cell clusters. The more prevalent ones were constituted by limb bud and chondrogenic cells and fibroblasts comprising ∼73 ​% of the cell population. Genes expressed by joint fibroblasts were detected in 5 clusters comprising ∼45 ​% of the cells isolated. Pseudotime trajectory finding revealed an association between fibroblast and chondrogenic clusters which was not modified by TNFα. TNFα decreased the total cells recovered by 18.5 ​% and the chondrogenic, limb bud and mesenchymal clusters by 32 ​%, 27 ​% and 7 ​%, respectively. TNFα had profound effects on the insulin-like growth factor (IGF) axis decreasing <em>Igf1</em>, <em>Igf2</em> and <em>Igfbp4</em> and inducing <em>Igfbp3</em> and <em>Igfbp5</em>, explaining an inhibition of collagen biosynthesis, cartilage and skeletal morphogenesis. Ingenuity Pathway Analysis of scRNA-Seq data revealed that TNFα enhanced the osteoarthritis, rheumatoid arthritis, pathogen induced cytokine storm and interleukin 6 signaling pathways and suppressed fibroblast growth factor signaling.</div></div><div><h3>Conclusions</h3><div>Epiphyseal chondrocytes are constituted by diverse cell populations distinctly regulated by TNFα to promote inflammation and suppression of matrix biosynthesis and growth.</div></div>","PeriodicalId":74377,"journal":{"name":"Osteoarthritis and cartilage open","volume":"6 4","pages":"Article 100528"},"PeriodicalIF":0.0,"publicationDate":"2024-10-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142442295","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Walking recovers cartilage compressive strain in vivo","authors":"Shu-Jin Kust ,&nbsp;Kyle D. Meadows ,&nbsp;Dana Voinier ,&nbsp;JiYeon A. Hong ,&nbsp;Dawn M. Elliott ,&nbsp;Daniel K. White ,&nbsp;Axel C. Moore","doi":"10.1016/j.ocarto.2024.100526","DOIUrl":"10.1016/j.ocarto.2024.100526","url":null,"abstract":"<div><h3>Background</h3><div>Articular cartilage is a fiber reinforced hydrated solid that serves a largely mechanical role of supporting load and enabling low friction joint articulation. Daily activities that load cartilage, lead to fluid exudation and compressive axial strain. To date, the only mechanism shown to recover this cartilage strain in vivo is unloading (e.g., lying supine). Based on recent work in cartilage explants, we hypothesized that loaded joint activity (walking) would also be capable of strain recovery in cartilage.</div></div><div><h3>Methods</h3><div>Eight asymptomatic young adults performed a fixed series of tasks, each of which was followed by magnetic resonance imaging to track changes in their knee cartilage thickness. The order of tasks was as follows: 1) stand for 30 ​min, 2) walk for 10 ​min, 3) stand for 30 ​min, and 4) lie supine for 50 ​min. The change in cartilage thickness was used to compute the axial cartilage strain.</div></div><div><h3>Results</h3><div>Standing produced an average axial strain of −5.1 ​% (compressive) in the tibiofemoral knee cartilage, while lying supine led to strain recovery. In agreement with our hypothesis, walking also led to cartilage strain recovery. Interestingly, the recovery rate during walking (0.19 ​% strain/min) was nearly 3-fold faster than lying supine (0.07 ​% strain/min).</div></div><div><h3>Conclusions</h3><div>This study represents the first in vivo demonstration that joint activity is capable of recovering compressive strain in cartilage. These findings indicate that joint activities such as walking may play a key role in maintaining and recovering cartilage strain, with implications for maintaining cartilage health and preventing or delaying cartilage degeneration.</div></div>","PeriodicalId":74377,"journal":{"name":"Osteoarthritis and cartilage open","volume":"6 4","pages":"Article 100526"},"PeriodicalIF":0.0,"publicationDate":"2024-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142538757","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effect of a multidisciplinary lifestyle intervention on body composition in people with osteoarthritis: Secondary analysis of the “Plants for Joints” randomized controlled trial","authors":"C.A. Wagenaar ,&nbsp;W. Walrabenstein ,&nbsp;C.S. de Jonge ,&nbsp;M. Bisschops ,&nbsp;M. van der Leeden ,&nbsp;M. van der Esch ,&nbsp;P.J.M. Weijs ,&nbsp;M.A. Troelstra ,&nbsp;M.A. Korteweg ,&nbsp;A.J. Nederveen ,&nbsp;D. van Schaardenburg","doi":"10.1016/j.ocarto.2024.100524","DOIUrl":"10.1016/j.ocarto.2024.100524","url":null,"abstract":"<div><h3>Objective</h3><div>The Plants for Joints (PFJ) intervention significantly improved pain, stiffness, and physical function, and metabolic outcomes, in people with metabolic syndrome-associated osteoarthritis (MSOA). This secondary analysis investigated its effects on body composition.</div></div><div><h3>Method</h3><div>In the randomized PFJ study, people with MSOA followed a 16-week intervention based on a whole-food plant-based diet, physical activity, and stress management, or usual care. For this secondary analysis, fat mass, muscle mass, and bone mineral density were measured using dual-energy X-ray absorptiometry (DEXA) for all participants. Additionally, in a subgroup (<em>n</em> ​= ​32), hepatocellular lipid (HCL) content and composition of visceral adipose tissue (VAT) were measured using magnetic resonance spectroscopy (MRS). An intention-to-treat analysis with a linear-mixed model adjusted for baseline values was used to analyse between-group differences.</div></div><div><h3>Results</h3><div>Of 66 people randomized, 64 (97%) completed the study. The PFJ group experienced significant weight loss (−5.2 ​kg; 95% CI –6.9, −3.6) compared to controls, primarily from fat mass reduction (−3.9 ​kg; 95% CI –5.3 to −2.5). No significant differences were found in lean mass, muscle strength, or bone mineral density between groups. In the subgroup who underwent MRI scans, the PFJ group had a greater reduction in HCL (−6.5%; 95% CI –9.9, 3.0) compared to controls, with no observed differences in VAT composition.</div></div><div><h3>Conclusion</h3><div>The PFJ multidisciplinary intervention positively impacted clinical and metabolic outcomes, and appears to significantly reduce body fat, including liver fat, while preserving muscle mass and strength.</div></div>","PeriodicalId":74377,"journal":{"name":"Osteoarthritis and cartilage open","volume":"6 4","pages":"Article 100524"},"PeriodicalIF":0.0,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142416503","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Postnatal deletion of Phlpp1 in chondrocytes delays post-traumatic osteoarthritis in male mice","authors":"Samantha R. Weaver ,&nbsp;Katherine M. Arnold ,&nbsp;Eduardo Peralta-Herrera ,&nbsp;Manuela Oviedo ,&nbsp;Elizabeth L. Zars ,&nbsp;Elizabeth W. Bradley ,&nbsp;Jennifer J. Westendorf","doi":"10.1016/j.ocarto.2024.100525","DOIUrl":"10.1016/j.ocarto.2024.100525","url":null,"abstract":"<div><h3>Objective</h3><div>Osteoarthritis is a chronic, debilitating disease that causes long-term pain and immobility. Germline deletion of Phlpp1 or administration of small molecules that inhibit Phlpp1 prevents post-traumatic osteoarthritis (PTOA) in mice. However, the chondrocyte-intrinsic role of Phlpp1 in PTOA progression is unknown. The objective of this study was to determine how postnatal, chondrocyte-directed deletion of Phlpp1 affects PTOA progression in the presence or absence of Phlpp inhibitors.</div></div><div><h3>Design</h3><div>Phlpp1^fl/fl; Agc-Cre^ERT2 and Agc-Cre^ERT2 mice were injected with tamoxifen at 12 weeks of age to generate Phlpp1-CKO_AgcERT and control (AgcERT) groups. Male mice underwent surgery to destabilize the medial meniscus (DMM) at 17 weeks of age. A separate cohort of male Phlpp1-CKO_AgcERT mice were administered an intra-articular injection of NSC117079, a Phlpp1/2 inhibitor, or saline seven weeks after DMM surgery. Activity and mechanical allodynia were monitored throughout the experiment and cartilage damage was evaluated 12 weeks post-surgery.</div></div><div><h3>Results</h3><div>Phlpp1-CKO_AgcERT mice had less cartilage damage than AgcERT littermates 12 weeks after DMM surgery but exhibited no differences in activity. Prg4 expression was also higher in articular chondrocytes of Phlpp1-CKO_AgcERT mice. Intra-articular administration of NSC117079 to Phlpp1-CKO_AgcERT mice improved cartilage structure, subchondral bone sclerosis, and mechanical allodynia at 12 weeks post-DMM.</div></div><div><h3>Conclusions</h3><div>Postnatal deletion of Phlpp1 in chondrocytes attenuates DMM-induced cartilage damage and subchondral bone sclerosis but does not prevent pain-related behaviors. Intra-articular injection of Phlpp inhibitors delays mechanical allodynia in Phlpp1-CKO_AgcERT mice. These data indicate that Phlpp1 in chondrocytes affects articular cartilage structure after injury, but pain-related behaviors are controlled by Phlpp1 or Phlpp2 in other cell types.</div></div>","PeriodicalId":74377,"journal":{"name":"Osteoarthritis and cartilage open","volume":"7 1","pages":"Article 100525"},"PeriodicalIF":0.0,"publicationDate":"2024-09-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11732534/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142985687","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Associations between changes in leg extensor muscle power and physical function after supervised exercise in patients with hip osteoarthritis. Secondary analysis from the hip booster trial","authors":"Troels Kjeldsen ,&nbsp;Ulrik Dalgas ,&nbsp;Søren T. Skou ,&nbsp;Frederik N. Foldager ,&nbsp;Bo M. Bibby ,&nbsp;Inger Mechlenburg","doi":"10.1016/j.ocarto.2024.100523","DOIUrl":"10.1016/j.ocarto.2024.100523","url":null,"abstract":"<div><h3>Objective</h3><p>To investigate associations between changes in leg extensor muscle power of the affected limb (ΔLEP) and changes in physical function after 12 weeks of progressive resistance training (PRT) or neuromuscular exercise (NEMEX) in patients with hip osteoarthritis.</p></div><div><h3>Design</h3><p>Secondary analyses of a randomized controlled trial. From 160 participants enrolled in the clinical trial and cluster randomized to PRT (n ​= ​82) or NEMEX (n ​= ​78), a total of 147 (92%) had complete follow-up data and were included in the analyses. Simple linear and multivariate linear regression models estimated the crude and adjusted associations between ΔLEP normalized to body weight (watt/kg) and changes in performance-based and patient-reported measures of physical function.</p></div><div><h3>Results</h3><p>Adjusted estimates [95% confidence intervals] showed associations between ΔLEP (watt/kg) and changes in 30-s chair stand test (β: 2.34 [1.33; 3.35], R²: 0.13), 9-step timed stair climb test (β: −1.47 [-2.09; −0.85], R²: 0.38), 40-m fast paced walking test (β: −2.20 [-3.30; −1.11], R²: 0.09), Activities of Daily Life function (β: 8.63 [3.16; 14.10], R²: 0.23) and Sport and Recreation function (β: 10.57 [2.32; 18.82], R²: 0.21) subscales from the Hip disability and Osteoarthritis Outcomes Score. Group allocation to PRT did not lead to greater regression coefficients than in NEMEX.</p></div><div><h3>Conclusions</h3><p>Changes in leg extensor muscle power after supervised exercise are consistently associated with changes in physical function across performance-based and patient-reported measures in patients with hip osteoarthritis. These associations seem to be independent of allocation to PRT or NEMEX.</p></div>","PeriodicalId":74377,"journal":{"name":"Osteoarthritis and cartilage open","volume":"6 4","pages":"Article 100523"},"PeriodicalIF":0.0,"publicationDate":"2024-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2665913124000906/pdfft?md5=95c386dcd34f5c693f37480cb6ac5883&pid=1-s2.0-S2665913124000906-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142238687","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Efficacy and safety of an oral complementary medicine combination in people with symptomatic knee osteoarthritis: Protocol for the double-blind, randomized, placebo-controlled ATLAS trial","authors":"Arashi Shahid ,&nbsp;Xiaoqian Liu ,&nbsp;Karen Bracken ,&nbsp;Robin Christensen ,&nbsp;Leticia Alle Deveza ,&nbsp;Simone Collins ,&nbsp;Joanna Harnett ,&nbsp;David J. Hunter ,&nbsp;Andrew J. McLachlan ,&nbsp;Sarah Robbins ,&nbsp;Jocelyn L. Bowden","doi":"10.1016/j.ocarto.2024.100522","DOIUrl":"10.1016/j.ocarto.2024.100522","url":null,"abstract":"<div><h3>Objective</h3><p>To investigate the efficacy and safety of an oral complementary medicine combination formulation relative to placebo, on changes in pain intensity from baseline to week 12, in people with knee osteoarthritis (OA).</p></div><div><h3>Design</h3><p>A placebo-controlled, double-blind, two-arm, superiority, phase II, Randomized Controlled Trial (RCT) (ACTRN12623000380695). We will recruit 82 participants (∼41 per arm), aged ≥40 years, with a clinical diagnosis of symptomatic knee OA and radiographic change on x-ray (Kellgren-Lawrence Grade ≥2). Participants will be randomly allocated to receive either a complementary medicine formulation containing a daily dose of <em>Boswellia serrata</em> extract (Boswellin® Super, 250 ​mg/day), pine bark extract (Fenoprolic™ 70 Organic 100 ​mg/day), curcumin (500 ​mg/day), piperine (5 ​mg/day), and methylsulfonylmethane (MSM, 1500 ​mg/day), or placebo, for 12-weeks. The primary endpoint will be change from baseline in average knee pain intensity at 12-weeks (visual analogue scale). Secondary endpoints will include change in knee pain from baseline to 12-weeks in the Knee Injury and Osteoarthritis Outcome Score (KOOS), global assessment of disease activity, global rating of change, and health-related quality of life (AQoL-8D).</p></div><div><h3>Ethics and dissemination</h3><p>This protocol has been approved by the University of Sydney Human Research Ethics Committee (#2021/877). Dissemination will occur through lay summaries, infographics, conference abstracts, oral presentations, theses, and scientific publications.</p></div><div><h3>Conclusion</h3><p>This RCT will provide credible evidence about the efficacy and safety of this complementary medicine combination and inform updates to international clinical practice standards on the use of complementary medicines in the management of symptomatic knee OA.</p></div>","PeriodicalId":74377,"journal":{"name":"Osteoarthritis and cartilage open","volume":"6 4","pages":"Article 100522"},"PeriodicalIF":0.0,"publicationDate":"2024-09-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S266591312400089X/pdfft?md5=d1c5734d318abefb68d2c1e222b0edd0&pid=1-s2.0-S266591312400089X-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142228889","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}