Arthritis care & research
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Arthritis care & research · Sep 2019
Timing of Abatacept Before Elective Arthroplasty and Risk of Postoperative Outcomes.
Guidelines recommend withholding biologic therapies before hip and knee arthroplasty, yet evidence to inform optimal timing is limited. The aim of this study was to determine whether withholding abatacept infusions is associated with lower risk of adverse postoperative outcomes. ⋯ Compared to continuing intravenous abatacept, withholding abatacept for ≥4 weeks (one dosing interval) before surgery was not associated with a lower risk of hospitalized infection, nonurinary hospitalized infection, PJI, or 30-day readmission.
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Arthritis care & research · Aug 2019
Prevalence of Radiographic and Magnetic Resonance Imaging Features of Patellofemoral Osteoarthritis in Young and Middle-Aged Adults With Persistent Patellofemoral Pain.
To describe the prevalence of radiographic features of patellofemoral (PF) osteoarthritis (OA) in adults with persistent PF pain, to describe the prevalence of magnetic resonance imaging (MRI)-defined PF OA and compare it to that in age- and sex-matched controls, and to explore the prevalence of radiographic and MRI-defined PF OA across age, sex, and body mass index (BMI) groups. ⋯ Features of radiographic and MRI-defined PF OA were evident in 20-30% of adults ages 26-50 years with persistent PF pain, with greater prevalence observed in those who were older, or female, or who had a higher BMI. MRI-defined PF OA was more prevalent in individuals with PF pain than in pain-free controls, especially when defined as a full-thickness cartilage lesion with BML.
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Arthritis care & research · Jul 2019
Biopsy-Proven Small-Fiber Neuropathy in Primary Sjögren's Syndrome: Neuropathic Pain Characteristics, Autoantibody Findings, and Histopathologic Features.
Painful small-fiber neuropathies (SFNs) in primary Sjögren's syndrome (SS) may present as pure or mixed with concurrent large-fiber involvement. SFN can be diagnosed by punch skin biopsy results that identify decreased intra-epidermal nerve-fiber density (IENFD) of unmyelinated nerves. ⋯ SS SFN had an increased frequency among male patients, a decreased frequency of multiple antibodies, frequent treatment with opioid analgesics, and the presence of nonstocking-and-glove pain. Distinguishing between DRG versus axonal injury is significant, especially given that mechanisms targeting the DRG may result in irreversible neuronal cell death. Altogether, these findings highlight clinical, autoantibody, and pathologic features that can help to define mechanisms and treatment strategies.
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Arthritis care & research · Jun 2019
Role of Hip Injury and Giving Way in Pain Exacerbation in Hip Osteoarthritis: An Internet-Based Case-Crossover Study.
To evaluate the association between hip injury/giving way and hip pain exacerbations in patients with symptomatic hip osteoarthritis (OA). ⋯ Hip injury and episodes of the hip giving way were significantly related to pain exacerbation in patients with symptomatic hip OA. Methods to prevent exposure to injury may help to reduce the burden of pain in patients with hip OA.
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Arthritis care & research · Jun 2019
Effects of Osteoarthritis Pain, and Concurrent Insomnia and Depression on Health Care Use in a Primary Care Population of Older Adults.
To examine independent and combined effects of pain with concurrent insomnia and depression symptoms on the use of health care services in older adults with osteoarthritis (OA). ⋯ Pain is the main driver for health care use in patients with OA. In addition to pain, insomnia plus depression jointly increased diverse types of health care use, and these combined effects increased greatly with increasing severity of insomnia and depression. These findings indicate the important role that concurrent symptomatic conditions may play in increasing use of health care services.