Search

Background. Increasing evidence highlights potential associations between varus thrust and health domains associated with knee osteoarthritis (OA). Objective. The aim of this study was to investigate the association between varus thrust and 2 subcategories--'pain and stiffness' and 'activities of daily living (ADI.)'--of the Japanese Knee Osteoarthritis Measure (JKOM). Design. This was a cross-sectional study. Methods. In total, 296 outpatients with knee OA visiting orthopedic clinics were enrolled. The inclusion criteria were age [greater than or equal to]50 years, medial knee OA and Kellgren-Lawrence (K/L) grade [greater than or equal to] 1 in one or both knees, and the ability to walk independently. Standard posterior-anterior knee radiographs were measured for vims alignment. Participants were video recorded while walking and were evaluated for the presence or absence of varus thrust. Pain and stiffness of the knee joint and ADL were evaluated using the JKOM. Multivariate regressions (outcomes: pain and stiffness and ADL; predictor variable: varus thrust) were performed. Results. Varus thrust was present in 46 (16.2%) of 284 patients. Multivariate regression analyses demonstrated that varus thrust is independently associated with pain and stiffness, adjusted for age, sex, body mass index, K/L grade, and varus alignment ([beta] = 17, P =.005). However, the association between varus thrust and ADL was not significant ([beta]=.11, P =.058). Based on sensitivity analyses, including participants of K/I. grade 1 had little influence on this analysis. Limitations. Only 16.2% of participants had a varus thrust. Moreover, a cause-effect relationship between varus thrust and pain and stiffness remains unknown due to the crosssectional design of this study. Conclusions. Varus thrust was associated with pain and stiffness in patients with medial knee OA. However, the association between varus thrust and ADL did not reach significance., Knee osteoarthritis (OA) is the most common joint disease and an important cause of pain and disability among older adults. (1,2) In a 2009 study by Yoshimura et al, (3) [...]

Regenerative rehabilitation is a promising field aimed at harnessing the regenerative potential of stem cell therapeutics to maximize functional recovery. Here, we outline recent advancements in the field of regenerative rehabilitation for treating knee osteoarthritis (KOA) and we highlight sex-specific considerations to promote knowledge translation to the clinic. A systematic review suggests that sexual dimorphism in the efficacy of regenerative rehabilitation approaches for the treatment of KOA may be partly attributed to the functional decline of female mesenchymal stem cells (MSCs) over the lifespan, particularly after menopause. These declines are likely to be accompanied by poor clinical outcomes. While evidence is far from adequate, physical therapeutics have emerged as a means to promote estrogen signaling in MSCs, potentially reversing menopause-related MSC dysfunction. This study calls for actions to dissect the effects of menopause, together with physical therapeutics, on stem cell therapeutics towards the development of effective regenerative rehabilitation approaches.

Knee osteoarthritis (OA) has been suggested to increase the risk of falls. Low back pain (LBP) is a potential risk factor for falls in people with knee OA, but this issue has not been addressed adequately in previous studies. The objective of this study was to investigate the relationship between LBP and falls in people with knee OA in a 12‐month period. Participants with knee OA (Kellgren/Lawrence [K/L] grade ≥1) completed questionnaires for LBP and falls that occurred in the preceding 12 months. Binary and ordinal logistic regression analyses were performed to assess the relationship between LBP or moderate‐to‐severe LBP (numeric rating scale ≥4 points) and any fall (≥1 fall) or recurrent falls (≥2 falls) after adjustment for age, sex, K/L grade, knee pain severity, and quadriceps strength. Sensitivity analyses were performed excluding people with sciatica, nonchronic LBP, K/L grade 1, and those receiving pain medications. We included 189 participants (ages 61–90 years, 78.3% women) in this study. Of these participants, 41 (21.6%) reported falls in the preceding 12 months. People with any LBP (n = 101) and those with moderate‐to‐severe LBP (n = 45) had 2.7‐ and 3.7‐times higher odds of recurrent falls, respectively. Sensitivity analyses revealed a strong correlation between moderate‐to‐severe LBP and recurrent falls. Thorough investigation of LBP as a risk factor for recurrent falls in people with knee OA may provide a novel insight into the pathomechanics of recurrent falls in this population.

To test the hypothesis that varus thrust visualized during gait is associated with a higher prevalence of low back pain (LBP) in individuals with knee osteoarthritis (OA). Individuals with knee OA(Kellgren/Lawrence grade ≥1) underwent a gait observation to assess varus thrust. The participants identified LBPand its severity using questionnaires. Logistic regression analyses were performed to examine the association between varus thrust and LBP. We included 205 participants (mean age 68.19 years; 72.20% women). A total of 45 participants (22.0%) showed varus thrust in their painful knee, in whom 31 (68.89%) and 18 (40.00%) were identified as having any LBPand moderate‐to‐severe LBP(numerical rating scale ≥4 points), respectively. Patients with varus thrust demonstrated a 3.6‐fold higher risk of the presence of moderate‐to‐severe LBP(95% confidence interval [95% CI] 1.62–8.10). In patients with LBP, the presence of varus thrust was associated with more severe LBPintensity (proportional odds ratio 2.25 [95% CI1.02–4.96]). This study highlights the novel relationship between varus thrust and LBP, which supports the idea of a biomechanical link, the so‐called knee–spine syndrome. These findings provide new insight for clarifying the pathogenesis of LBPrelated to knee OA.

To evaluate the clinical impact in knee osteoarthritis (OA) of coexisting patellofemoral (PF) joint OA (PFOA) in Japanese patients with medial tibiofemoral (TF) joint OA (TFOA). Patients with medial knee OA (n = 143) were enrolled. The radiographic severity of the TF and PF joints, anatomic axis angle of the TF joint, patellar alignment, trochlear morphology, patellar height, and passive range of motion (ROM) of the painful knee were evaluated. Additionally, the Japanese Knee Osteoarthritis Measure (JKOM) was used to investigate the association between the presence of PFOA and clinical symptoms. PFOA was present in 98 of 143 patients (68.5%) with medial knee OA. Quantile regression analysis revealed that coexisting PFOA was associated with the pain‐related subcategory of the JKOM. Furthermore, multiple logistic regression analysis showed that coexisting PFOA was associated with higher odds of reporting knee pain on using stairs while ascending (odds ratio [OR] 4.81 [95% confidence interval (95% CI) 1.73, 14.3]) and descending (OR 3.86 [95% CI 1.44, 10.8]). A more varus knee alignment and lower knee flexion ROM, which are features of patients with coexisting PFOA, were associated with knee pain while ascending/descending stairs. However, patellar alignment, trochlear morphology, and patellar height were not significantly associated with knee pain. PFOA coexisting with medial knee OA was associated with worse clinical symptoms, particularly while ascending/descending stairs, although patellar alignment did not contribute to reporting knee pain. Further studies that include evaluation of the PF joint are warranted to develop a basis for an optimal intervention based on compartmental involvement.

Some reports showed that low intensity pulsed ultrasound (LIPUS) could stimulate mesenchymal stromal cell (MSC) differentiation into osteochondrocyte in vitro. The purpose of this study was to investigate whether LIPUS treatment combined with cell therapy could affect cartilage regeneration in rats which have poor intrinsic repair capacity.