Osteoarthritis and cartilage
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In the last decades, many researchers aimed to identify causal genetic variants by means of candidate gene analyses, genome wide linkage and association studies to elucidate underlying mechanisms of osteoarthritis (OA). Although several consistent genetic variants were identified the successes are limited. This review has a focus on studies published until mid 2011 and on data presented at the Osteoarthritis Research Society International 2011 (OARSI) in San Diego and that aim to elucidate the primary molecular and cellular events commencing OA onset in humans by applying genetic study designs.
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This review highlights seminal publications of rehabilitation interventions and outcomes in osteoarthritis (OA) of the hip or knee. ⋯ Interventions of manual therapy for hip and knee OA provided limited evidence of effectiveness. These studies are of limited quality due to lack of blinding and disclosure of co-intervention. Tele-rehabilitation may be a viable option to improve access to rehabilitation post joint replacement for those in rural and remote areas. Data continue to support the need to include performance measures as well as patient-reported outcomes in evaluating outcomes in OA. Additionally, measures of participation should be considered as core outcomes.
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This study used 'think aloud' to explore issues around using a standardised questionnaire to assess persistent pain after joint replacement. Twenty participants with moderate-extreme persistent pain in their replaced hip or knee completed the Chronic Pain Grade (CPG) while 'thinking aloud'. ⋯ Completion of the CPG by patients was influenced by four issues: challenges with the question wording or response options on the CPG items; the fluctuating nature of pain and functional limitations; the need to account for co-morbidities and pain elsewhere; and adjustment to pain. These issues reflect those that have arisen previously in patients with musculoskeletal pain, and need to be considered when assessing persistent joint pain, both before and after joint replacement.
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Osteoarthr. Cartil. · Dec 2011
Review Meta AnalysisPre-operative interventions (non-surgical and non-pharmacological) for patients with hip or knee osteoarthritis awaiting joint replacement surgery--a systematic review and meta-analysis.
To determine if pre-operative interventions for hip and knee osteoarthritis provide benefit before and after joint replacement. ⋯ Low to moderate evidence from mostly small RCTs demonstrated that pre-operative interventions, particularly exercise, reduce pain for patients with hip and knee osteoarthritis prior to joint replacement, and exercise with education programs may improve activity after hip replacement.