Osteoarthritis and cartilage open最新文献

{"title":"Low-level laser therapy in osteoarthritic pain: A narrative review with an approach to integrated clinical use","authors":"S.N. Hennessy ,&nbsp;G.D. Corcoran","doi":"10.1016/j.ocarto.2025.100685","DOIUrl":"10.1016/j.ocarto.2025.100685","url":null,"abstract":"<div><h3>Objective</h3><div>The authors examine how Low-level laser therapy (LLLT) can be used in osteoarthritis (OA) management. LLLT has not, as yet, been widely integrated into OA management, either as a stand-alone modality or in conjunction with standard treatments.</div></div><div><h3>Methods</h3><div>A narrative review of meta-analyses and trials using LLLT in OA treatment was undertaken to establish how it may be used optimally in OA management. Pubmed, Google Scholar and Cochrane databases were interrogated to identify analyses and trials.</div></div><div><h3>Results</h3><div>Meta-analysis and trial results are variable, but improvements of up to 14.23 ​mm are noted in VAS scores following use in knee osteoarthritis (Standardised Mean Difference (SMD) 95 ​% CI: 7.31:21.14), 13.7 ​mm in spinal disease (SMD 95 ​% CI: 9.72; 17.42) and 19.86 ​mm (SMD 95 ​% CI: 10.04:29.68) in cervical disease. Positive effects on function were documented, as was a reduction in use of analgesic medication. Integration of LLLT into OA management programmes produced additional improvements. The side-effect profile is excellent. Issues of trial size, comparability, dosing, and assessment of response, mean that further studies are required.</div></div><div><h3>Conclusions</h3><div>We conclude that LLLT is useful in the management of OA pain, with benefits for stiffness and function. Use as an integral part of an OA management and rehabilitation plan appears to give additional benefits. LLLT has an excellent side effect profile and may reduce need for analgesic medication, making it a potentially valuable adjunct in OA pain management, especially at a time when adverse effects of pharmacological treatment are of increasing concern.</div></div>","PeriodicalId":74377,"journal":{"name":"Osteoarthritis and cartilage open","volume":"7 4","pages":"Article 100685"},"PeriodicalIF":2.8,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145158710","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":"Cross-sectional associations of radiographic multiple joint osteoarthritis and symptoms, laboratory values and the gut microbiota: A multimodal study in humans and pet dogs","authors":"Amanda E. Nelson ,&nbsp;Liubov Arbeeva ,&nbsp;Kelly Johnson ,&nbsp;Serena Savage-Guin ,&nbsp;Tessa Walker ,&nbsp;Masataka Enomoto ,&nbsp;Christina Stevens ,&nbsp;Milja Koskinen ,&nbsp;Tracey Cole ,&nbsp;Savannah Aker ,&nbsp;Connor Thonen-Fleck ,&nbsp;M. Andrea Azcarate-Peril ,&nbsp;Richard F. Loeser ,&nbsp;Jordan B. Renner ,&nbsp;Yvonne M. Golightly ,&nbsp;B. Duncan X. Lascelles","doi":"10.1016/j.ocarto.2025.100682","DOIUrl":"10.1016/j.ocarto.2025.100682","url":null,"abstract":"<div><h3>Objective</h3><div>To describe the frequency of multiple joint osteoarthritis (MJOA) and symptoms, and associations with fecal microbial diversity and composition, in cohorts of humans and dogs.</div></div><div><h3>Design</h3><div>Human participants enrolled in the community-based Johnston County Health Study (JoCoHS), and an independent cohort of pet dogs, were included. Questionnaires, functional assessments, standardized multiple joint radiographs, and pain assessments, blood and fecal samples were obtained. Microbiome analysis was done by 16S rRNA amplicon sequencing. MJOA was defined as ≥3 unique joint sites involved; symptom burden was based on self-reported/proxy measures of pain. Descriptive statistics and Spearman correlations with Benjamini-Hochberg correction were used to determine relationships among lab tests, pain, and microbiome diversity measures.</div></div><div><h3>Results</h3><div>Human participants (n ​= ​100, 63 ​% women, mean age 56 years, mean body mass index 34 ​kg/m²) and 115 pet dogs (40 ​% spayed females, 57 ​% neutered males, mean age 8 years, mean weight 27 ​kg) were included; 20 ​% had radiographic MJOA (rMJOA). Microbial α-diversity did not differ between participants with or without rMJOA. However, lower levels of the <em>Christensenellaceae R-7 group</em> and <em>Lachnoclostridium</em> in humans, and the butyrate-producing bacterium, <em>Faecalibacterium</em> in dogs, were moderately correlated with greater pain severity, as were higher levels of <em>Escherichia-Shigella</em> in dogs. <em>Faecalibacterium</em> was more abundant in humans without rMJOA.</div></div><div><h3>Conclusions</h3><div>These two cohorts demonstrated remarkably similar frequencies of rMJOA (∼20 ​%), supporting the use of dogs to model naturally occurring MJOA. Taxa potentially related to rMJOA and pain were identified in this preliminary analysis, providing new insights into links between dysbiosis and MJOA.</div></div>","PeriodicalId":74377,"journal":{"name":"Osteoarthritis and cartilage open","volume":"7 4","pages":"Article 100682"},"PeriodicalIF":2.8,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145158746","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":"Development and validation of a generalisable survival model to predict osteoarthritis progression","authors":"H.H.T. Li ,&nbsp;L.C. Chan ,&nbsp;P.K. Chan ,&nbsp;C. Wen","doi":"10.1016/j.ocarto.2025.100688","DOIUrl":"10.1016/j.ocarto.2025.100688","url":null,"abstract":"<div><h3>Objective</h3><div>To develop and validate a transfer-learning survival model to predict progression end-stage knee osteoarthritis (esKOA) or receive knee replacement (KR).</div></div><div><h3>Method</h3><div>A DeepSurv model was trained on the Osteoarthritis Initiative (OAI) dataset with baseline clinical variables, including age, sex, BMI, comorbidities, smoking status, prior knee injury and surgery, pain medication use, use of walking aids, and activity level (9560 knees). A generalisable model was then developed by fine-tuning the OAI-derived model with data from the Multicenter Osteoarthritis Study (MOST) Centre 1 (3002 knees). This model was validated on an independent dataset from MOST Centre 2 (2972 knees). Model performance was evaluated using the concordance index from 1000 bootstrap resamples. SHapley Additive exPlanations (SHAP) were employed to assess changes in feature importance after fine-tuning.</div></div><div><h3>Results</h3><div>The OAI-derived model performed well within OAI (C-index ​= ​0.75) but fairly on MOST Centre 1 (C-index ​= ​0.61, <em>p</em> ​&lt; ​0.0001), indicating domain shift or cross-cohort variation. Similarly, a model trained only on MOST Centre 1 data performed moderately within MOST (C-index ​= ​0.63) but did not generalise to OAI (C-index ​= ​0.60, <em>p</em> ​&lt; ​0.0001). After transfer learning, the generalised model maintained performance on OAI (C-index ​= ​0.69) and improved on MOST Centre 1 (C-index ​= ​0.64, <em>p</em> ​&lt; ​0.0001) and MOST Centre 2 (C-index ​= ​0.67, <em>p</em> ​&lt; ​0.0001). SHAP analysis revealed that heart attack history, diabetes, smoking, and BMI became more influential predictors in the fine-tuned model.</div></div><div><h3>Conclusion</h3><div>Transfer learning enabled the development of a generalised model for knee OA prognosis that performs consistently across cohorts. By adapting to population-specific risk patterns, this approach enhances model generalisability and reduces bias from ethnic or demographic overrepresentation in training datasets.</div></div>","PeriodicalId":74377,"journal":{"name":"Osteoarthritis and cartilage open","volume":"7 4","pages":"Article 100688"},"PeriodicalIF":2.8,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145220169","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":"Changes in knee pain and walking speed following primary, unilateral total knee arthroplasty and their association: A systematic review and meta-analysis","authors":"Nico Faber ,&nbsp;Matej Skrobot ,&nbsp;Georg N. Duda,&nbsp;Nicholas M. Brisson","doi":"10.1016/j.ocarto.2025.100694","DOIUrl":"10.1016/j.ocarto.2025.100694","url":null,"abstract":"<div><h3>Objective</h3><div>To quantify changes in knee pain and walking speed following primary, unilateral total knee arthroplasty (TKA) for knee osteoarthritis, and to examine their relationship during recovery. Walking speed is a key indicator of functional recovery and long-term health, but whether pain relief translates into improved mobility remains unclear.</div></div><div><h3>Design</h3><div>A systematic review and meta-analysis was conducted following PRISMA guidelines. PubMed was searched to September 2025 for studies reporting pre- and post-TKA values of knee pain (WOMAC-pain or KOOS-pain) and self-selected walking speed in adults undergoing primary, unilateral TKA. Pooled changes were calculated using inverse-variance weighted random-effects models. Meta-regression explored associations between pain and walking speed, adjusting for covariates.</div></div><div><h3>Results</h3><div>Eighteen studies (n ​= ​819; 64.1 ​% female; age 65.1 ​± ​8.3 years; body mass index 28.4 ​± ​5.9 ​kg/m²) were included. Knee pain significantly decreased by 27–36 points (WOMAC-pain) and 19–40 points (KOOS-pain), exceeding minimal clinically important differences. Walking speed increased by +0.12 ​m/s at 3 months and +0.18 ​m/s at 12 months, both exceeding the +0.1 ​m/s threshold for clinically relevant change. No significant change in speed occurred before 3 months, and a non-significant decline appeared beyond 12 months. Meta-regression revealed greater knee pain (β ​= ​−0.005, p ​&lt; ​0.001) and use of WOMAC-pain (vs. KOOS-pain) (β ​= ​−0.224, p ​&lt; ​0.001) predicted slower walking speed (R² ​= ​0.48, p ​&lt; ​0.001).</div></div><div><h3>Conclusions</h3><div>TKA yields substantial pain relief and improved walking speeds by 3–12 months. However, mobility gains are not sustained beyond one year and are influenced by pain. Postoperative care should support both symptoms and mobility to improve long-term outcomes.</div></div>","PeriodicalId":74377,"journal":{"name":"Osteoarthritis and cartilage open","volume":"7 4","pages":"Article 100694"},"PeriodicalIF":2.8,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145319948","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":"Prevalence, incidence, and progression of hip osteoarthritis in a young military population: The ADVANCE cohort study","authors":"F.C.E. Watson ,&nbsp;O. O'Sullivan ,&nbsp;A. Bennett ,&nbsp;R. Agricola ,&nbsp;S. Schofield ,&nbsp;D. Hanff ,&nbsp;C. Boos ,&nbsp;P. Cullinan ,&nbsp;N. Fear ,&nbsp;H. Kemp ,&nbsp;A.M.J. Bull","doi":"10.1016/j.ocarto.2025.100675","DOIUrl":"10.1016/j.ocarto.2025.100675","url":null,"abstract":"<div><h3>Objective</h3><div>Prevalence of hip osteoarthritis (OA) is rarely reported in young populations (e.g., military). We will report the prevalence of hip OA in a young military cohort and investigate the relationship between injury and progression/incidence.</div></div><div><h3>Design</h3><div>ADVANCE is a prospective cohort study comparing physical and psychosocial outcomes in 1145 men who served in Afghanistan including 579 men with combat injury (Exposed) who were frequency-matched to 566 controls (Unexposed). The Exposed group was sub-divided into hip injured (Exp-H), lower limb amputation (Exp-A) and other (Exp-NA). Kellgren-Lawrence (KL) scores of pelvic radiographs and Non-Arthritic Hip Score (NAHS) questionnaires were collected across two waves (Baseline and Follow-up). Prevalence at Baseline (KL ​≥ ​2), progression (KL ​≥ ​1 ​at Baseline, KL ​≥ ​2 ​at Follow-up) and incidence (KL0 at Baseline, KL ​≥ ​2 ​at Follow-up) at Follow-up were reported and compared between groups for KL and NAHS.</div></div><div><h3>Results</h3><div>Baseline prevalence of radiographic hip OA was 8.5 ​% and 4.4 ​% in the Exposed and Unexposed groups, respectively. Exp-A and Exp-H groups had 3.88 (95%CI:2.27–6.63) and 7.18 (95%CI:3.44–14.98 times increased risk for radiographic hip OA than Unexposed. Exp-A and Exp-H had a 2.15 (95%CI:1.22–3.80) and 3.28 (95%CI:1.42–7.59) times increased radiographic progression risk, compared to Unexposed. Risk of NAHS Progression and Incidence were not significantly different between groups.</div></div><div><h3>Conclusion</h3><div>Radiographic hip OA prevalence is higher in a young military population than in a similarly aged general population. Combat injury alone may not increase hip OA prevalence; but hip and lower limb loss injuries do. Progression risk is highest in those with hip or limb loss injuries.</div></div>","PeriodicalId":74377,"journal":{"name":"Osteoarthritis and cartilage open","volume":"7 4","pages":"Article 100675"},"PeriodicalIF":2.8,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145004507","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":"Walking is the form of physical activity people with osteoarthritis in the hip or knee choose and maintain after two years","authors":"R. Bendrik ,&nbsp;M. Peterson ,&nbsp;K. Bröms ,&nbsp;M. Emtner ,&nbsp;A. Hed Ekman ,&nbsp;L.V. Kallings ,&nbsp;B. Sundström","doi":"10.1016/j.ocarto.2025.100681","DOIUrl":"10.1016/j.ocarto.2025.100681","url":null,"abstract":"<div><h3>Objective</h3><div>To evaluate which form and type of physical activity individuals with hip or knee osteoarthritis choose and maintain one and two years after an individualised intervention for physical activity and further to evaluate whether there were differences in the most chosen physical activity with regard to patient characteristics.</div></div><div><h3>Method</h3><div>Patients with hip or knee osteoarthritis from a previous randomised controlled trial, where they received individualised patient-centred counselling about physical activity and registered self-selected sessions of physical activity in a 7-day diary, were included. Sessions lasting more than 10 ​min and rated at least light effort were categorized, and differences were evaluated.</div></div><div><h3>Results</h3><div>Of the 94 patients included, 72.3 ​% were female, 72.0 ​% had knee osteoarthritis and mean age was 62.0 (SD 8.2) years. Women and men who preferred walking, walked on average ​&gt; ​4 times/week and 3–4 times/week, respectively. Everyday activities and cycling were performed 2–3 times/week by both women and men. The proportions of individuals maintaining the same activity after one and two years were 50 ​% for walking and 2 ​% for strength training. Men more often choose different activities and after two years they performed everyday activities and cycling to the same extent as walking. Individuals who chose walking were significantly older, of female gender and had lower muscle strength in the affected leg.</div></div><div><h3>Conclusion</h3><div>Walking is the form of physical activity patients with osteoarthritis most often choose, perform and maintain. Knowledge about preferred activities among patients is crucial for maintaining physical activity in the long term.</div></div>","PeriodicalId":74377,"journal":{"name":"Osteoarthritis and cartilage open","volume":"7 4","pages":"Article 100681"},"PeriodicalIF":2.8,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145105129","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":"Corrigendum to “The PIKASO trial (Preventing Injured Knees from Osteoarthritis: Severity Outcomes): Rationale and design features for a randomized controlled trial” [Osteoarthr Cartil Open 7 (2025) 100563]","authors":"Cale A. Jacobs ,&nbsp;Morgan H. Jones ,&nbsp;Jamie E. Collins ,&nbsp;Lily M. Waddell ,&nbsp;Xiaojuan Li ,&nbsp;Carl S. Winalski ,&nbsp;Brian Pietrosimone ,&nbsp;Virginia Byers Kraus ,&nbsp;Miguel Otero ,&nbsp;Elizabeth Wellsandt ,&nbsp;Laura C. Schmitt ,&nbsp;Kurt P. Spindler ,&nbsp;Donald D. Anderson ,&nbsp;Scott A. Rodeo ,&nbsp;Robert A. Magnussen ,&nbsp;Brian R. Wolf ,&nbsp;Joe M. Hart ,&nbsp;Austin V. Stone ,&nbsp;Caitlin E. Conley ,&nbsp;Yvonne M. Golightly ,&nbsp;Elena Losina","doi":"10.1016/j.ocarto.2025.100665","DOIUrl":"10.1016/j.ocarto.2025.100665","url":null,"abstract":"","PeriodicalId":74377,"journal":{"name":"Osteoarthritis and cartilage open","volume":"7 4","pages":"Article 100665"},"PeriodicalIF":2.8,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144892330","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":"Preoperative neuropathic-like pain and central sensitisation are risk factors for chronic pain after total knee arthroplasty: A systematic review and meta-analysis","authors":"Felipe F. Gonzalez ,&nbsp;Alessandro Barone ,&nbsp;Rithik Palaniappan ,&nbsp;Raffaella Russo ,&nbsp;Giorgio Gasparini ,&nbsp;Leonardo Metsavaht ,&nbsp;Jorge Chahla ,&nbsp;Filippo Familiari","doi":"10.1016/j.ocarto.2025.100674","DOIUrl":"10.1016/j.ocarto.2025.100674","url":null,"abstract":"<div><h3>Objective</h3><div>To investigate the effects of preoperative neuropathic-like pain and central sensitisation on clinical outcomes after total knee arthroplasty (TKA).</div></div><div><h3>Design</h3><div>This systematic review and meta-analysis followed PRISMA guidelines and was prospectively registered. Studies were included if they assessed preoperative neuropathic-like pain or central sensitisation before TKA and clinical outcomes after surgery, such as pain, function, or psychological status. Cross-sectional studies and case reports were excluded. Two authors independently screened, extracted data and rated articles' quality using a quality assessment tool. A meta-analysis was performed for studies reporting comparable methods and outcomes.</div></div><div><h3>Results</h3><div>From 6061 identified records, 15 studies met the inclusion criteria (total sample: 2385 individuals; follow-up periods: less than 1 year to 5 years). Most studies exhibited low/moderate risk of bias, primarily due to small sample sizes. The risk ratio of chronic pain (VAS ≥3 after at least 3 months) was 2.75 (CI: 1.78; 4.26) for patients with neuropathic-like pain (PainDETECT score ≥13). Seven out of eleven studies identified neuropathic-like pain and central sensitisation as risk factors for clinical outcomes such as decreased self-reported function, satisfaction, and anxiety (p ​&lt; ​0.05). Studies that adjusted for covariates showed mixed results, with some losing statistical significance.</div></div><div><h3>Conclusion</h3><div>The presence of neuropathic-like pain and central sensitisation in candidates for TKA is a risk factor for postoperative chronic pain. Evidence for decreased function, satisfaction, and psychological conditions is inconsistent. Screening and managing neuropathic-like pain and central sensitisation preoperatively could possibly improve clinical outcomes. Further research with standardized methods is needed.</div></div><div><h3>Prospero id</h3><div>CRD42024622693.</div></div>","PeriodicalId":74377,"journal":{"name":"Osteoarthritis and cartilage open","volume":"7 4","pages":"Article 100674"},"PeriodicalIF":2.8,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145019372","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":"Guideline-informed care for osteoarthritis: Support needs of community pharmacists and healthcare professionals in Nigeria, West-Africa","authors":"Oladapo Adetunji ,&nbsp;Ibidunni Alonge ,&nbsp;Ebunoluwa Ayinmode ,&nbsp;Tolulope Owoyemi ,&nbsp;Adebimpe Ogunbanjo ,&nbsp;Simon White ,&nbsp;Adewale Adebajo ,&nbsp;Christian Mallen ,&nbsp;Krysia Dziedzic ,&nbsp;Opeyemi O. Babatunde","doi":"10.1016/j.ocarto.2025.100678","DOIUrl":"10.1016/j.ocarto.2025.100678","url":null,"abstract":"<div><h3>Objective</h3><div>The study examined the context, training needs, and extent to which community pharmacists in Nigeria have the knowledge, resources, and capability to manage OA in line with evidence-based recommendations.</div></div><div><h3>Methods</h3><div>Focus group discussions (n ​= ​2) were conducted. Discussions explored current practice, the support needs, and perceptions of a new OA care model where pharmacists could be trained to screen, educate, and refer patients. Data was analyzed thematically, including stakeholder workshops to aid interpretation.</div></div><div><h3>Results</h3><div>Data from two focus groups with 22 healthcare professionals revealed five key themes. Community pharmacies were the first point of call for most patients. Care pathway and navigation onwards were influenced by patient affordability. Radiological examinations and blood tests underpinned diagnosis and care predominantly involved pharmacological approaches. There was no local care pathway agreed/established for health professionals, and multidisciplinary team collaboration/care for OA was limited. Participants expressed the need for professional education and the development of national guidelines to inform osteoarthritis management in primary care.</div></div><div><h3>Conclusions</h3><div>Nigeria's OA care pathway is fragmented, involves overuse of medication, and has limited access to non-pharmaceutical treatments. A unified, evidence-based approach with adequate training and multidisciplinary collaboration is essential for effective primary care and reducing health inequalities.</div></div>","PeriodicalId":74377,"journal":{"name":"Osteoarthritis and cartilage open","volume":"7 4","pages":"Article 100678"},"PeriodicalIF":2.8,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145049661","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":"Minimal important change of the knee injury and osteoarthritis outcome score in patients with mild to moderate knee osteoarthritis – using three different anchor-based methods","authors":"Henriette Killingrød Lundquist ,&nbsp;Britt Elin Øiestad ,&nbsp;Joseph Sexton ,&nbsp;May Arna Risberg ,&nbsp;Nina Østerås","doi":"10.1016/j.ocarto.2025.100699","DOIUrl":"10.1016/j.ocarto.2025.100699","url":null,"abstract":"<div><h3>Objective</h3><div>To estimate Minimal Important Change (MIC) for improvement in the Knee injury and Osteoarthritis Outcome Score (KOOS) in patients with mild to moderate knee osteoarthritis (OA), using three recommended anchor-based methods, and examine how methodological choices influence these estimates.</div></div><div><h3>Design</h3><div>Secondary analysis of a three-arm randomized controlled trial. KOOS and a Global Rating of Change (GROC) scale were collected at baseline and 4-month follow-up. MIC values were estimated using predictive modeling, Mean Change, and Receiver Operating Characteristic (ROC) methods. Sensitivity analyses assessed the impact of different anchor cut-offs.</div></div><div><h3>Results</h3><div>Data were available for 131 patients undergoing non-surgical treatment (mean age 57.4 years, 50 ​% female). At follow-up, 19 ​% reported important improvement. Using the predictive modeling method, which allows adjustment for the low proportion of patients reporting important improvement, MICs were 11.3 (Pain), 12.1(Symptoms), 10.2 (ADL), 15.5 (Sport/Rec) and 13.2 (QoL). The Mean Change method yielded comparable MICs (range 10.6–16.1), but due to its reliance on a small subgroup, it is generally considered less robust and showed wider CIs in our sample. ROC-based MICs ranged from −0.4 to 12.5 and were associated with wide CIs, and high misclassification rates. Sensitivity analyses showed lower MICs with broader improvement definitions were used.</div></div><div><h3>Conclusion</h3><div>MIC estimates for KOOS varied considerably by method. Predictive modeling yielded the most precise MIC estimates and should be considered for future research, particularly when the proportion of improved patients deviates from 50 ​%. These results also highlight the importance of methodological transparency for interpreting PROMs in non-surgical knee OA treatment.</div></div>","PeriodicalId":74377,"journal":{"name":"Osteoarthritis and cartilage open","volume":"7 4","pages":"Article 100699"},"PeriodicalIF":2.8,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145465342","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}