Osteoarthritis and cartilage
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Osteoarthr. Cartil. · May 2014
Multicenter StudyAssociation between fixation technique and revision risk in total hip arthroplasty patients younger than 55 years of age. Results from the Nordic Arthroplasty Register Association.
To evaluate implant survival following primary total hip replacement (THR) in younger patients. To describe the diversity in use of cup-stem implant combinations. ⋯ Uncemented implants perform better in relation to long-term risk of aseptic loosening, whereas both uncemented and hybrid rather than cemented implants in patients younger than 55 years had more short-term revisions because problems due to dislocation, periprosthetic fracture and infection has not yet been completely solved. The vast majority of cup-stem combinations were used in very few operations.
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Osteoarthr. Cartil. · May 2014
Multicenter StudyImpact of physician specialty on classification of physician-perceived patient severity for patients with osteoarthritis.
Physicians often classify patients' osteoarthritis (OA) severity subjectively. As treatment decisions are influenced by severity classifications, it is important to understand the factors that influence physicians' OA severity ratings. This research sought to empirically identify physician and patient characteristics that lead to a patient being perceived as having more severe OA. ⋯ Patient age, BMI, presence and severity of symptoms and health care use significantly impacted physicians' OA severity ratings, but radiographic changes appeared to be given greater weight among orthopedic surgeons and rheumatologists than PCPs when assessing patient severity. Whether these differences translate into different treatment recommendations for similar patients is unknown, and warrants study.
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Osteoarthr. Cartil. · May 2014
Crepitus is a first indication of patellofemoral osteoarthritis (and not of tibiofemoral osteoarthritis).
The patellofemoral joint (PFJ) is important in early detection of knee osteoarthritis (OA). Little is known about the relationship between specific clinical findings and PFJ Magnetic resonance Imaging (MRI) features. The objective was to examine the relationship between (early) clinical findings and PFJ MRI features in females (45-60 years) without knee OA (PFJ or tibiofemoral joint (TFJ) OA) based on a recently suggested MRI definition. ⋯ Crepitus and history of patellar pain are clinical findings that indicate PFJ lesions seen on MRI. These tests could help to indicate signs of PFJOA. Follow-up data needs to confirm whether these tests have an additional diagnostic value for early knee OA in PFJ or TFJ.
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Osteoarthr. Cartil. · Apr 2014
GDF5 reduces MMP13 expression in human chondrocytes via DKK1 mediated canonical Wnt signaling inhibition.
Growth differentiation factor 5 (GDF5) is important for joint formation and associated with osteoarthritis (OA). Its role for the homeostasis of cartilage extracellular matrix (ECM) is, however, unknown. The canonical Wnt signaling pathway is also implemented in OA and activation of the pathway has detrimental effects on the cartilage ECM. The objective of this study was to investigate the effect of GDF5 stimulation on the Wnt signaling pathway and on the expression of known modulators of cartilage ECM. ⋯ Herein, we provide evidence of a previously unknown link between GDF5 signaling and canonical Wnt signaling that may contribute to the understanding of the molecular mechanisms of OA.
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Osteoarthr. Cartil. · Mar 2014
Sensitivity and associations with pain and body weight of an MRI definition of knee osteoarthritis compared with radiographic Kellgren and Lawrence criteria: a population-based study in middle-aged females.
Is a magnetic resonance imaging (MRI) definition for tibiofemoral osteoarthritis [(TFOAMRI) (definite osteophyte and full-thickness cartilage loss (or a combination of these factors with other MRI osteoarthritis (OA) features)] more sensitive to detect structural OA compared with the Kellgren & Lawrence (K&L) grading? And which definition shows the strongest association with (1) knee pain at baseline, (2) persistent knee pain during 2-year follow-up, (3) new onset of knee pain ±2 years later, and (4) body mass index (BMI). ⋯ TFOAMRI detects more cases of knee OA than K&L ≥ 2. Together with a better content validity and at least equal construct validity, we conclude that the TFOAMRI definition for knee OA is more sensitive in detecting structural knee OA.