Osteoarthritis and cartilage open最新文献

{"title":"Measurement of expectations regarding exercise therapy of patients with hip and knee osteoarthritis: A scoping review","authors":"A.P.M. Konings-Pijnappels ,&nbsp;M.C. van der Steen ,&nbsp;H. Seetsen-van Schelven ,&nbsp;I. Hoogendoorn ,&nbsp;T.P.M. Vliet Vlieland ,&nbsp;R.P.A. Janssen","doi":"10.1016/j.ocarto.2025.100617","DOIUrl":"10.1016/j.ocarto.2025.100617","url":null,"abstract":"<div><h3>Objective</h3><div>While exercise therapy generally yields positive outcomes in patients with hip or knee osteoarthritis (HOA or KOA), individual results vary. Expectations may influence treatment results, but research on this topic is scarce. Therefore, this study aimed to describe methods to assess pre-treatment expectations of patients with HOA or KOA with respect to exercise therapy.</div></div><div><h3>Design</h3><div>Scoping review, with the Pubmed, Embase, CINAHL and Cochrane databases searched for original clinical studies of any design reporting a method or instrument to assess expectations of exercise therapy in patients with HOA or KOA. Data extraction from selected studies concerned study characteristics and the method or instrument used, as well as their content, categorized into expectations of structure, process or outcomes of exercise therapy treatment.</div></div><div><h3>Results</h3><div>Twenty-nine studies met the inclusion criteria. Twenty-three different methods used to address expectations were identified, 3 of which had a qualitative nature (interviews) and 20 concerned questionnaires. There was a large variation in number of items and measurement scales in the identified methods. Nine methods addressed expectations of outcomes of treatment, 7 addressed both outcomes and the process/structure of treatment. One instrument was found to measure willingness to receive exercise rather than expectations. For the remaining 6 instruments no content nor aspects measured were reported.</div></div><div><h3>Conclusion</h3><div>In the literature, apart from interviews, mainly quantitative methods have been used to measure expectations with regard to exercise therapy in patients with HOA or KOA. Most of their content concerned the outcomes of care, rather than its structure and/or process.</div></div>","PeriodicalId":74377,"journal":{"name":"Osteoarthritis and cartilage open","volume":"7 3","pages":"Article 100617"},"PeriodicalIF":0.0,"publicationDate":"2025-04-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143942264","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Potential sources of pain in symptomatic degenerative meniscal tear: A narrative review","authors":"Love Tsai ,&nbsp;Elizabeth Matzkin ,&nbsp;Morgan H. Jones ,&nbsp;Rachel E. Miller ,&nbsp;Jeffrey N. Katz","doi":"10.1016/j.ocarto.2025.100616","DOIUrl":"10.1016/j.ocarto.2025.100616","url":null,"abstract":"<div><h3>Importance</h3><div>Although degenerative meniscal tear is relatively prevalent in older persons, the sources of the accompanying pain and mechanical symptoms—such as knee clicking, locking, and popping—are unclear, making targeted treatment difficult. We conducted a narrative literature review to synthesize research surrounding sources of symptomatic degenerative meniscal tear.</div></div><div><h3>Observations</h3><div>We identified five mechanisms of symptom generation in patients with degenerative meniscal tear: obstruction, abnormal load bearing, inflammation, neoinnervation, and central sensitization. We confirmed clinical observations that degenerative meniscal tear often occurs concomitantly with knee osteoarthritis, which adds complexity to symptom attribution.</div></div><div><h3>Conclusions and relevance</h3><div>Degenerative meniscal tear may lead to pain or mechanical symptoms through a variety of pathways. In identifying the diversity in pathways and corresponding physiological changes leading to symptomatic degenerative meniscal tear, this review may help clinicians contextualize the condition and target therapies for their patients.</div></div>","PeriodicalId":74377,"journal":{"name":"Osteoarthritis and cartilage open","volume":"7 3","pages":"Article 100616"},"PeriodicalIF":0.0,"publicationDate":"2025-04-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144072150","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The current and changing role of glucagon-like peptide-1 receptor agonists in knee osteoarthritis","authors":"Anne D. Holleman,&nbsp;Jeffrey N. Katz","doi":"10.1016/j.ocarto.2025.100611","DOIUrl":"10.1016/j.ocarto.2025.100611","url":null,"abstract":"","PeriodicalId":74377,"journal":{"name":"Osteoarthritis and cartilage open","volume":"7 3","pages":"Article 100611"},"PeriodicalIF":0.0,"publicationDate":"2025-04-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143928336","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effects of high impact exercise on systemic cytokines in women with mild knee osteoarthritis: A 12-month RCT","authors":"Ville-Markus Konola ,&nbsp;Juhani Multanen ,&nbsp;Johanna K. Ihalainen ,&nbsp;Jukka E. Hintikka ,&nbsp;Timo Jämsä ,&nbsp;Hannu Kautiainen ,&nbsp;Miika T. Nieminen ,&nbsp;Satu Pekkala ,&nbsp;Maarit Valtonen ,&nbsp;Ari Heinonen","doi":"10.1016/j.ocarto.2025.100609","DOIUrl":"10.1016/j.ocarto.2025.100609","url":null,"abstract":"<div><h3>Objective</h3><div>This study investigated the effects of a high-impact exercise regimen compared with a reference group on systemic cytokine levels in patients with mild knee osteoarthritis (OA). Furthermore, associations between cytokines and magnetic resonance imaging (MRI) transverse relaxation time (T2) mapping and metabolic equivalent task hours (MET-hours) during leisure-time physical activity (LTPA) were assessed.</div></div><div><h3>Method</h3><div>In this secondary analysis, 73 postmenopausal women aged 50–65 years with mild knee OA were randomized to a 12-month high-impact aerobic/step aerobics training group (n ​= ​35) or a non-training reference group (n ​= ​38). The serum cytokine levels, including interleukin-1 alpha (IL-1α), IL-2, IL-4, IL-5, IL-6, IL-10, IL-13, IL-17, interferon-gamma (IFN-γ), and tumor necrosis factor alpha (TNF-α), were determined via multiplex cytokine assays. The cartilage structure of the medial tibial condyle was assessed by MRI T2 mapping. The primary outcome was between-group differences in cytokine level changes.</div></div><div><h3>Results</h3><div>After a 12-month follow-up, no significant differences in cytokine level changes were found between the groups. In the intervention group, 12-month changes in TNF-α levels were associated with changes in medial tibial condyle T2. In the reference group, 12-month changes in IL-10 levels were associated with changes in medial tibial condyle T2 and the number of weekly LTPA MET-hours.</div></div><div><h3>Conclusion</h3><div>A progressive high-impact exercise regimen did not affect systemic cytokine levels compared to the reference group and could therefore offer a possible mode of exercise for postmenopausal women with mild knee OA.</div></div><div><h3>Trial registration number</h3><div>ISRCTN58314639.</div></div>","PeriodicalId":74377,"journal":{"name":"Osteoarthritis and cartilage open","volume":"7 2","pages":"Article 100609"},"PeriodicalIF":0.0,"publicationDate":"2025-04-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143843899","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Stromal cell-based injection therapies for the treatment of knee osteoarthritis: A systematic review of level I randomized controlled trials","authors":"Jaydeep Dhillon ,&nbsp;James A. Maguire ,&nbsp;Matthew J. Kraeutler","doi":"10.1016/j.ocarto.2025.100608","DOIUrl":"10.1016/j.ocarto.2025.100608","url":null,"abstract":"<div><h3>Objective</h3><div>To systematically review randomized controlled trials (RCTs) to compare clinical outcomes of stromal cell-based injection therapies versus other non-operative treatment modalities for the treatment of knee osteoarthritis (OA).</div></div><div><h3>Method</h3><div>A systematic review was performed by searching PubMed, Cochrane Library, and EMBASE to locate RCTs, published since 2019, comparing stromal cell-based injection therapies versus other non-operative modalities for the treatment of knee OA. The search terms used were: <em>knee AND osteoarthritis AND injection AND randomized</em>.</div></div><div><h3>Results</h3><div>Seventeen studies (all Level I evidence) were included in this review with 972 patients undergoing treatment with stromal cell-based therapy (Intervention Group) and 651 patients in the control group (Control Group). Among the 17 studies, 7 used autologous adipose-derived mesenchymal stromal cells (MSCs) (ADMSCs), 2 studies used allogeneic ADMSCs, 4 used autologous bone marrow-derived MSCs (BMMSCs), 1 used allogeneic BMMSCs, 1 used allogeneic placental MSCs, 1 used umbilical cord-derived MSCs (UCMSCs), and 1 study used autologous ADMSCs, BMMSCs, or allogeneic UCMSCs. All but 3 studies reported significantly better clinical or radiological outcomes in the Intervention Group at final follow-up. A total of 5 and 3 studies reported adverse events occurring in the Intervention and the Control groups, respectively, but they were all self-limiting.</div></div><div><h3>Conclusions</h3><div>Patients undergoing treatment of knee OA with MSCs might be expected to experience improvements in clinical and radiological outcomes in comparison to other non-operative modalities. Additional studies with mid-to long-term outcomes are needed to better determine the efficacy and safety of MSCs for the treatment of knee OA.</div></div>","PeriodicalId":74377,"journal":{"name":"Osteoarthritis and cartilage open","volume":"7 2","pages":"Article 100608"},"PeriodicalIF":0.0,"publicationDate":"2025-04-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143848494","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Reliability of digitally instructed self-reported 30-second chair stand test for lower extremity function","authors":"Leif E. Dahlberg ,&nbsp;Oscar Karlsson ,&nbsp;Paulina Sirard ,&nbsp;L Stefan Lohmander ,&nbsp;Ali Kiadaliri","doi":"10.1016/j.ocarto.2025.100613","DOIUrl":"10.1016/j.ocarto.2025.100613","url":null,"abstract":"<div><h3>Objective</h3><div>The 30-s Chair Stand Test (30s CST), a valid and reliable test evaluating lower extremity physical function, has been integrated into a digital eHealth program. We aimed to evaluate the agreement (inter-rater reliability) between digital self-assessment and in-person physiotherapist assessment as well as intra-rater test-retest reliability of digital self-assessment among persons with hip or knee osteoarthritis.</div></div><div><h3>Design</h3><div>Eligible participants with hip or knee osteoarthritis were identified from the digital treatment database. The 30s CST was performed through a digital self-assessment and in-person physiotherapist assessment. The inter-rater reliability study was conducted at a physiotherapy clinic and for the intra-rater test-retest reliability, the participants performed the digitally self-assessment test twice in their home.</div></div><div><h3>Results</h3><div>The inter-rater reliability one-day study, included 18 participants (mean age 67 years and 89 ​% females) and one physiotherapist. The intra-rater test-retest, separated by 10–14 days, included 54 participants (mean age 69 years, 78 ​% females). There were, on average, 1.5 (95 ​% CI 0.6 to 2.4) more self-reported sit-to-stand repetitions for the digital self-assessment compared with in-person physiotherapist assessment. The digital self-assessment of 30s CST showed low to excellent inter-rater reliability with an intraclass correlation coefficient (ICC) of 0.87 (95 ​% CI 0.47 to 0.96) and good to excellent intra-rater test-retest reliability, ICC 0.88 (95 ​% CI 0.79 to 0.93). Bland-Altman plots suggested good levels of inter- and intra-rater reliability.</div></div><div><h3>Conclusion</h3><div>Results suggest that the 30s CST can be measured digitally as a self-administered and self-reported measurement of lower extremity physical function in older adults with hip and/or knee osteoarthritis.</div></div>","PeriodicalId":74377,"journal":{"name":"Osteoarthritis and cartilage open","volume":"7 2","pages":"Article 100613"},"PeriodicalIF":0.0,"publicationDate":"2025-04-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143864014","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Extracellular vesicles in osteoarthritis synovial fluid contain both transmembrane and intravesical TNF-α","authors":"Xin Zhang ,&nbsp;Virginia Byers Kraus","doi":"10.1016/j.ocarto.2025.100612","DOIUrl":"10.1016/j.ocarto.2025.100612","url":null,"abstract":"<div><h3>Objective</h3><div>We previously identified extracellular vesicles (EVs) as a key source of TNF-α in the plasma of both knee osteoarthritis (OA) patients and healthy individuals. Building on these findings, this study aimed to evaluate the presence of surface-bound transmembrane TNF-α (TM-TNF-α) and intravesical TNF-α in EVs from OA synovial fluid (SF).</div></div><div><h3>Methods</h3><div>Using high-resolution flow cytometry, we rigorously quantified the percentages and integrated mean fluorescence intensity (iMFI) of surface-bound, intravesical, and total TNF-α forms in EVs isolated from SF of 25 knee OA patients. CZ CELLxGENE and OA joint tissue-derived single-cell and single-nuclei RNA sequencing data were used to analyze <em>TNF</em> gene expression.</div></div><div><h3>Results</h3><div><em>TNF</em> is expressed across multiple cell types. In OA joints it is predominantly expressed by synoviocytes, with TNF-α present in the SF EV pool. TM-TNF-α was consistently detected on SF EVs using three distinct TNF-α antibodies, although its frequency and iMFI were significantly lower than the corresponding intravesical TNF-α (Friedman test with Benjamini-Hochberg correction, FDR &lt;0.05). The average percentages (and range) of EVs expressing TNF-α, as detected by the three anti-TNF-α antibodies, were 2.57 ​% (0.09–37.08 ​%) for TM-TNF-α⁺, 8.62 ​% (0.38–43.64 ​%) for intravesical TNF-α⁺, and 14.42 ​% (0.71–44.32 ​%) for total EV TNF-α⁺. Interestingly, TM-TNF-α frequencies on SF EVs were similar to those observed on various immune cell subsets in peripheral blood.</div></div><div><h3>Conclusions</h3><div>While intravesical TNF-α may evade TNF-α inhibitors, TNF-α carried by EVs retains pathogenic potential, either by activating pro-inflammatory pathways via TM-TNF-α receptor engagement on target cells, or through the transfer of TNF-α cargo to recipient cells.</div></div>","PeriodicalId":74377,"journal":{"name":"Osteoarthritis and cartilage open","volume":"7 2","pages":"Article 100612"},"PeriodicalIF":0.0,"publicationDate":"2025-04-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143835239","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The effects of combining electrical stimulation of the calf and thigh muscles on WOMAC pain in knee osteoarthritis: A double-blind, randomised, sham-controlled trial","authors":"Samuel Briggs-Price ,&nbsp;George Mills ,&nbsp;Linzy Houchen-Wolloff ,&nbsp;Enya Daynes ,&nbsp;Charlotte Gerlis ,&nbsp;Lorna E. Latimer ,&nbsp;Colin Esler ,&nbsp;Darren Targett ,&nbsp;Sally J. Singh","doi":"10.1016/j.ocarto.2025.100607","DOIUrl":"10.1016/j.ocarto.2025.100607","url":null,"abstract":"<div><h3>Objective</h3><div>To explore the effectiveness of a NMES device in improving pain and function for individuals with KOA.</div></div><div><h3>Method</h3><div>This was a randomised, sham-controlled, superiority trial recruiting individuals with symptomatic KOA, with both participants and outcome assessors blinded to the treatment allocation. Participants were randomised to receive either self-administered NMES, consisting of quadriceps (5 times a week) and footplate stimulation (7 times a week), or a sham device for 8 weeks. The primary outcome was the change in Western Ontario and McMaster Universities Arthritis Index (WOMAC) pain domain at week 8.</div></div><div><h3>Results</h3><div>179 participants were randomised; 50.8 ​% female, mean (SD) age 66.9 (8.7) years. 164 attended the follow up visit. No difference in the WOMAC pain domain was seen between groups (−0.7; 95 ​% CI: −1.5, 0.1; P ​= ​0.10), though within group improvements were reported in both groups (NMES: −1.5; 95 ​% CI: −2.0, 0.8; P ​&lt; ​0.01, sham: −0.8; 95 ​% CI: −1.4, 0.2; P ​&lt; ​0.01). There were no differences in strength, exercise and functional capacity, swelling, health related quality of life or anxiety and depression between groups. Sub-group analysis for NMES compliance or recruitment source did not change response in primary outcome.</div></div><div><h3>Conclusion</h3><div>Use of an NMES device on the quadriceps and plantar flexors did not enhance pain relief or improve function over the sham control in people with KOA.</div></div>","PeriodicalId":74377,"journal":{"name":"Osteoarthritis and cartilage open","volume":"7 2","pages":"Article 100607"},"PeriodicalIF":0.0,"publicationDate":"2025-04-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143816343","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Online osteoarthritis training programme for community-based clinicians: Mixed methods cohort study","authors":"Ben Darlow ,&nbsp;Melanie Brown ,&nbsp;Alison Pask ,&nbsp;Andrew M. Briggs ,&nbsp;Ben Hudson ,&nbsp;Eileen McKinlay ,&nbsp;Gareth Frew ,&nbsp;J. Haxby Abbott ,&nbsp;Jane Clark ,&nbsp;Loren Vincent ,&nbsp;Rawiri Keenan ,&nbsp;Rebecca Grainger ,&nbsp;Sarah Dean ,&nbsp;Shirley Simmonds ,&nbsp;James Stanley","doi":"10.1016/j.ocarto.2025.100610","DOIUrl":"10.1016/j.ocarto.2025.100610","url":null,"abstract":"<div><h3>Background</h3><div>Core osteoarthritis interventions are ideally delivered in community-based settings. However, many community-based clinicians lack confidence and/or competence to effectively deliver high-quality, culturally-safe, evidence-based osteoarthritis care.</div></div><div><h3>Objective</h3><div>Assess changes in community-based dietitians', pharmacists', and physiotherapists’ knowledge and confidence to treat people with knee osteoarthritis after completing online KneeCAPS training, and explore perceptions of usefulness, what clinicians learned, and how this influenced their ability to provide osteoarthritis care.</div></div><div><h3>Design</h3><div>Mixed methods cohort study with quantitative measures and qualitative free-text and focus group interviews.</div></div><div><h3>Results</h3><div>158 clinicians completed baseline measures, of which 121 completed all required training modules and 68 provided 3-month follow-up; 17 participated in focus groups. Osteoarthritis Knowledge Scale scores (mean change 6.7; 95 % CI 5.1, 8.3) and Confidence in Osteoarthritis Skills scores (mean change 11.8; 95 % CI 9.4, 14.3) increased across the cohort. Clinicians considered the training was thorough, helpful, and clinically applicable. Clinicians reported increased confidence to manage osteoarthritis, and gaining knowledge and skills to help patients. Three themes reflected areas of learning or professional growth: the importance of culturally-safe relationship-building to engage all patients in care; helpful ways to think about osteoarthritis based on best evidence; and the focus and structure of consultations to support sustainable health behaviours. An integrative theme reflected new awareness of the impact of language and communication on patient relationships and outcomes.</div></div><div><h3>Conclusion</h3><div>KneeCAPS osteoarthritis training improved knowledge about and confidence in skills to manage knee osteoarthritis, particularly regarding culturally-safe relationships, paradigms for making sense of OA, supporting behaviour change, and communication to support participation.</div></div>","PeriodicalId":74377,"journal":{"name":"Osteoarthritis and cartilage open","volume":"7 2","pages":"Article 100610"},"PeriodicalIF":0.0,"publicationDate":"2025-04-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143825622","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Twelve-month efficacy of carboxymethyl-chitosan in refractory knee osteoarthritis: A randomized controlled trial (PIONEER)","authors":"Philippe Van Overschelde ,&nbsp;Pieter Vansintjan ,&nbsp;Nicolas Portelange ,&nbsp;Mickaël Chausson ,&nbsp;Wim Weyenberg","doi":"10.1016/j.ocarto.2025.100605","DOIUrl":"10.1016/j.ocarto.2025.100605","url":null,"abstract":"<div><h3>Objectives</h3><div>The 12-month efficacy and safety of a novel bioresorbable fluid implant based on CM-chitosan for intra-articular injection was evaluated in knee osteoarthritis (OA) patients with predictive factors of failure to viscosupplementation.</div></div><div><h3>Design</h3><div>This pilot single-blind randomized controlled study was conducted in 104 patients with at least one of the following OA phenotypes: tricompartmental OA, patellofemoral involvement, K&amp;L grade III or IV and/or body mass index &gt;30 ​kg/m². Non-inferiority and superiority of CM-chitosan (KioMedine^VSone) in reducing pain were evaluated compared Hylan G-F 20 (Synvisc-One). Efficacy was evaluated using the WOMAC scores, OMERACT-OARSI responder rates, TKA eligibility and events, patient and physician satisfaction.</div></div><div><h3>Results</h3><div>At 6 months post-injection, mean WOMAC pain reduction vs. baseline was 69.4 ​± ​25.5 ​% for the CM-chitosan group and 66.3 ​± ​26.15 ​% for the Hylan G-F 20 group (non-inferiority p ​= ​0.096; 95 ​% CI -16.94 ​%, 7.02 ​%). At 12 months, significant symptomatic improvement in both groups, with clinically important differences in WOMAC pain reduction in favor of CM-chitosan, were observed, including in the subgroups of patients with patellofemoral OA (Δ 11.5 ​%), obese patients (Δ 21.7 ​%) and patients eligible for TKA at baseline (Δ 13.5 ​%). CM-chitosan showed a high response rate (93.8 ​%), as well as high patient (93.8 ​%) and investigator (90.6 ​%) satisfaction. No new safety signals were identified.</div></div><div><h3>Conclusions</h3><div>In this difficult-to-treat population, CM-chitosan was non-inferior to Hylan G-F 20, but did show clinically important, though not statistically significant, differences in pain reduction at 12 months. CM-chitosan was effective in improving OA symptoms and physical function for 12 months.</div></div>","PeriodicalId":74377,"journal":{"name":"Osteoarthritis and cartilage open","volume":"7 2","pages":"Article 100605"},"PeriodicalIF":0.0,"publicationDate":"2025-04-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143807546","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}