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Cam-type deformities of the proximal femur have long been associated with femoroacetabular impingement (FAI); an orthopedic condition recognized in the etiology of early osteoarthritis (OA) in the non-dysplastic adult hip. However, the optimal clinical management (including the long-term prognosis) of patients with cam-type deformities with or without FAI symptoms remains uncertain. In this imaging case review (ICR), we present the 10-year follow-up of a retired chiropractor with bilateral cam-type femoral deformities who initially underwent total right hip joint arthroplasty for advanced hip joint OA, and subsequently developed advanced hip joint OA on the contralateral side. [ABSTRACT FROM AUTHOR]

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L'impact de l'arthrose sur la participation au travail est important et augmentera probablement avec l'augmentation de la prévalence de l'arthrose et le vieillissement de la population active. Bien que les études présentent des résultats contradictoires quant à la question de savoir si les personnes atteintes d'arthrose quittent prématurément le marché du travail, il est clair que l'arthrose entraîne des limitations au travail qui ont un impact sur les performances et la productivité des personnes au travail. Une scoping review (« revue de portée ») a été réalisée afin d'identifier les facteurs associés aux conséquences négatives de l'arthrose (hanche, genou et digitale) sur l'emploi. Ces facteurs sont nombreux. Ils peuvent être structurés en caractéristiques de l'arthrose (symptômes, et prise en charge), caractéristiques personnelles (sociodémographiques et individuelles telles que l'obésité, les comorbidités, la pratique d'activités physique, la représentation de la maladie, le sentiment de responsabilité dans sa prise en charge), caractéristique de l'emploi (demandes physiques, travail de nuit, temps de travail, possibilités d'adaptation du travail, soutien de la part des collègues), environnement (difficultés liées au transport, exigences liées à la multiplicité des rôles dans la vie, manque de diffusion d'information sur les possibilités d'adaptations), et stratégies d'adaptation (modifier de la façon d'exécuter les tâches, utiliser d'aides techniques, être plus prudent, réfléchir à la manière d'effectuer chaque mouvement, planifier les activités, ralentir, éviter des tâches, se faire aider, augmenter le temps de récupération, être proactif dans l'autogestion de la maladie, utiliser des techniques cognitives). En conclusion, ces études épidémiologiques complétées par des études qualitatives permettent de retenir de nombreux facteurs associés aux conséquences négatives de l'arthrose sur l'emploi. Nombre d'entre eux sont modifiables et des stratégies déjà utilisées par certains ou à développer existent et permettront de développer des interventions visant à aider les personnes atteintes d'arthrose à conserver leur emploi. The impact of osteoarthritis on work participation is significant and is likely to increase as the prevalence of osteoarthritis increases and the working population ages. Although studies present conflicting results as to whether people with osteoarthritis leave the labour market prematurely, it is clear that osteoarthritis leads to limitations at work that have an impact on people's performance and productivity at work. A scoping review was carried out to identify the factors associated with the negative consequences of osteoarthritis (hip, knee and digital) on employment. These factors are numerous. They can be structured into characteristics of the osteoarthritis (symptoms and management), personal characteristics (socio-demographic and individual characteristics such as obesity, co-morbidities, physical activity, representation of the disease, feeling of responsibility in its management), job characteristics (physical demands, night work, working hours, possibilities of adapting the work, support from colleagues), environment (difficulties linked to transport, demands of multiple roles in life, lack of information about adaptation possibilities), and adaptation strategies (changing the way tasks are performed, using technical aids, being more careful, thinking about how to perform each movement, planning activities, slowing down, avoiding tasks, getting help, increasing recovery time, being proactive in self-managing the disease, using cognitive techniques). In conclusion, these epidemiological studies, supplemented by qualitative studies, make it possible to identify numerous factors associated with the negative consequences of osteoarthritis on employment. Many of these factors can be modified, and strategies already used by some people or yet to be developed exist and will make it possible to develop interventions aimed at helping people with osteoarthritis to keep their jobs. [ABSTRACT FROM AUTHOR]

L'arthrose est la maladie articulaire la plus fréquente. Le mode de définition (clinique, radiologique) doit être précisé ainsi que l'articulation ciblée pour l'appréciation des donnés épidémiologique et des multiples facteurs de risque clairement identifiés ou encore discutés (non envisagés ici). En France, la prévalence de l'arthrose symptomatique de la hanche et du genou en population générale âgée de 45 à 75 ans s'établit à 1,9 % pour les hommes et 4,7 % chez les femmes. Son taux d'incidence augmente rapidement avec l'âge, de façon plus marquée chez les femmes que chez les hommes. Des facteurs de risque systémiques peuvent être en cause : âge, sexe féminin, ethnie, génétique (30 à 65 % du risque), nutrition (vitamines D, C, K), obésité et syndrome métabolique, densité et masse osseuse élevées. Des facteurs de risque locaux interviennent aussi tels que la morphologie articulaire (particulièrement l'effet came), les troubles statiques (genu varum), l'activité physique excessive, les traumatismes articulaires ou encore les déficits musculaires. Le facteur individuel majeur modifiable, dont la prévalence ne va faire qu'augmenter dans les années à venir est l'obésité. Il est donc impératif de mieux comprendre le lien reliant l'excès de poids à l'arthrose afin de mettre en place des politiques de santé adaptées. Osteoarthritis is the most common joint disease. In France, the prevalence of symptomatic hip and knee osteoarthritis in the general population aged 45 to 75 is 1.9% in men and 4.7% in women. The incidence rate increases rapidly with age, more markedly in women than in men. Systemic risk factors may be involved: age and gender, ethnicity, genetics (30 to 65% of the risk), nutrition (vitamins D, C, K), obesity and metabolic syndrome, high bone density and mass. Local risk factors are also involved: joint morphology (particularly the cam effect), static disorders (genu varum), excessive physical activity, joint trauma, muscle deficiencies. The major modifiable individual factor, whose prevalence is set to increase in the years ahead, is obesity. It is therefore imperative to better understand the link between excess weight and osteoarthritis, in order to implement appropriate health policies. [ABSTRACT FROM AUTHOR]

La matrice extracellulaire a longtemps été considérée comme un « simple » tissu de soutien des cellules, produisant des forces de tension permettant leur adhésion et les protégeant contre le stress mécanique, en particulier dans le cartilage. Pourtant, un grand nombre des constituants matriciels subissent des modifications structurales très dynamiques, impactant de façon notable les propriétés qu'ils confèrent à l'environnement mais aussi aux cellules. C'est le cas des glycosaminoglycannes, polysaccharides linéaires sulfatés et complexes, présents dans toutes les matrices, mais particulièrement enrichis dans le cartilage, sous la forme de chondroïtines sulfates et d'acide hyaluronique. L'arthrose est encore actuellement principalement identifiée comme une pathologie dégénérative de la matrice cartilagineuse liée à l'usure de l'âge. Mais d'autres phénotypes sont à présent caractérisés et permettent de mieux comprendre les processus physiopathologiques complexes de cette pathologie qui affectent l'ensemble des tissus de l'articulation. Alors que les traitements en cours, visant à combler les déficits en composés matriciels ou à bloquer les activités cataboliques des chondrocytes, ne paraissent plus suffisants pour réparer le cartilage, nous reviendrons dans cet article à la source « glycanique » des composés de la matrice cartilagineuse et à leur rôle dans les processus physiopathologiques de l'arthrose, pour identifier de nouvelles voies de recherches et produits thérapeutiques en devenir. The extracellular matrix has long been considered as a "simple" tissue supporting cells, producing tension forces allowing their adhesion and protecting them against mechanical stress, particularly in cartilage. However, a large number of matrix components undergo very dynamic structural modifications, significantly impacting the properties they confer to the environment but also to cells. This is the case for glycosaminoglycans, linear sulfated and complex polysaccharides, present in all matrices, but particularly enriched in cartilage, in the form of chondroitin sulfates and hyaluronic acid. Osteoarthritis is still mainly identified as a degenerative pathology of the cartilaginous matrix linked to the wear and tear of age. But other phenotypes are now characterized and provide a better understanding of the complex pathophysiological processes of this pathology which affect all joint tissues. Current treatments aimed at making up for deficiencies in matrix compounds or blocking the catabolic activities of chondrocytes, but no longer appear sufficient to repair cartilage. In this context, we will return to the "glycanic" source of the cartilaginous matrix and the role of these complex sugars in the pathophysiological processes of osteoarthritis, to identify new avenues of research and future therapeutic products. [ABSTRACT FROM AUTHOR]

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The present article presents the basic concepts of OA pain management. Due to the multiple different causes for OA and the fact that OA patients suffer from multiple co-morbidities and take multiple co-medications, the treatment of OA never be unidimensional. There need to be, however, an individual multimodal and interdisciplinary concept for every patient. [ABSTRACT FROM AUTHOR]

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L'arthrose est une maladie articulaire incurable, douloureuse et handicapante qui touche plus de 500 millions de personnes dans le monde. Au cours de l'arthrose, la membrane synoviale est infiltrée par diverses cellules, notamment des macrophages, capables d'induire ou de perpétuer son inflammation, appelée synovite. La synovite et sa composante macrophagique sont corrélées à la sévérité de l'arthrose, à la douleur et à la perte de fonction physique, représentant ainsi une cible d'intérêt pour développer de nouveaux traitements. Cette revue propose un tour d'horizon des dernières études ayant permis de mieux caractériser les macrophages, notamment synoviaux, leurs changements phénotypiques observés au sein de l'articulation arthrosique, et l'impact des stratégies thérapeutiques palliatives actuelles sur ces cellules. Osteoarthritis (OA) is an incurable, painful and debilitating joint disease that affects more than 500 million people worldwide. During OA, the synovial tissue is infiltrated by several cell types, including macrophages, able to induce and perpetuate its inflammation, called synovitis. Synovitis and its macrophage component are both correlated with the severity of OA, pain, and loss of joint physical function, thus representing a target of interest for the development of new treatments. This review provides an overview of the recent literature focusing on the characterization of macrophages, with a focus on synovial macrophages, their phenotype changes observed within the OA joint and the impact of current palliative therapeutic strategies on these cells. [ABSTRACT FROM AUTHOR]

Les traitements de fond antirhumatismaux (DMARD) utilisés dans la polyarthrite rhumatoïde pourraient être également efficaces dans l'arthrose, qui se caractérise par une inflammation systémique et locale. Or les données publiées sur les effets des DMARD dans l'arthrose sont contradictoires et les études qui ont été menées n'étaient pas suffisamment étendues pour pouvoir tirer des conclusions. Dans cette méta-analyse, nous avons souhaité estimer les effets sur l'arthrose de DMARD tels que le méthotrexate, l'hydroxychloroquine, les inhibiteurs du facteur de nécrose tumorale (anti-TNF) ou les inhibiteurs de l'interleukine-1 (anti-IL-1). Nous avons recherché des articles pertinents d'essais comparatifs randomisés publiés jusqu'en mars 2022 dans les bases de données PubMed, Embase et Cochrane Library. La revue a été réalisée dans le respect des recommandations PRISMA 2020. Les effets des DMARD sur les critères de l'arthrose (symptômes, qualité de vie, vitesse de sédimentation) ont été exprimés sous la forme d'une différence moyenne standardisée. Nous avons sélectionné 29 publications, dont 23 essais comparatifs randomisés comparant les effets des DMARD à ceux d'un placebo ou d'autres traitements sur l'activité de la maladie, incluant 1143 patients arthrosiques recevant des DMARD et 1155 patients arthrosiques dans le groupe contrôle. Nous avons observé une amélioration statistiquement significative de la douleur et de la raideur avec le méthotrexate, en particulier dans la gonarthrose. Les anti-TNF ont amélioré le nombre d'articulations gonflées dans l'arthrose digitale, ainsi que les paramètres de l'inflammation, mais aucun changement n'a été constaté concernant la douleur, la raideur ou la capacité fonctionnelle. L'hydroxychloroquine et les anti-IL-1 n'ont pas démontré d'efficacité. Globalement, les données disponibles concernant les effets des DMARD sur l'intensité des symptômes de l'arthrose sont décevantes. Seul le méthotrexate pourrait avoir un effet analgésique, notamment dans la gonarthrose, justifiant des études complémentaires. Osteoarthritis (OA) displays features of systemic and local inflammation, suggesting that DMARDs used in rheumatoid arthritis could potentially also be effective in OA. However, studies of the effects of DMARDs in OA have yielded conflicting data, and have been insufficiently large to draw conclusions. In this meta-analysis, we aimed to estimate the effect of DMARDs — such as methotrexate, hydroxychloroquine, TNF, and IL-1 inhibitors — on OA. We searched for relevant articles of randomized controlled trials published up to March 2022, using Pubmed, EMBASE, and the Cochrane Library. Studies were reviewed in accordance with PRISMA 2020 guidelines. The effects of DMARDs on OA outcomes (symptoms, quality of life, ESR) were expressed as the standardized mean difference. We retrieved 29 references. Among these, 23 randomized controlled trials compared the effects of DMARDs versus placebo or other treatments on disease activity, including 1143 DMARD-treated OA patients and 1155 OA patients in the control group. We found statistically significant improvement of pain and stiffness with methotrexate, especially in knee OA. TNF inhibitors improved the swollen joint count in hand OA, and inflammation parameters, without change in pain, stiffness, or function. Hydroxychloroquine and IL-1 inhibitors were not effective. Overall, the presently available data regarding the effects of DMARDs on OA symptoms intensity are disappointing. Only methotrexate might have an analgesic effect, especially in knee OA, which warrants further investigation. [ABSTRACT FROM AUTHOR]

L'arthrose digitale a fait l'objet de très nombreuses publications ces dernières années. Dans le domaine de l'imagerie, il faut noter les très nombreux travaux conduits en IRM et en échographie. Ces derniers ont mis en évidence la bonne corrélation entre la présence de synovites et/ou d'un œdème sous chondral et la douleur articulaire arthrosique. L'arthrose digitale a surtout été un véritable laboratoire d'évaluation des biothérapies et des traitements de fond conventionnel des rhumatismes inflammatoires chroniques. Ainsi, pas moins de 6 essais randomisés contrôlés ont évalué l'efficacité symptomatique et pour certains, structurale, des traitements anti-IL-1β, anti-TNF-α ou Ac anti-IL-6R. Globalement, les résultats de ces essais sont décevants, aucun n'ayant démontré une supériorité par rapport au placebo. Il faut aussi citer deux essais négatifs avec l'hydroxychloroquine. Le seul essai finalement positif est celui ayant évalué une petite cortisonothérapie orale (10 mg/j) versus placebo durant 6 semaines chez des patients souffrant d'une arthrose digitale en poussée avec synovite échographique. Ce dernier essai vient confirmer le rôle de l'inflammation au cours de cette affection, mais ne doit évidemment pas inciter à utiliser la cortisone au long cours comme traitement symptomatique. Hand osteoarthritis (OA) has been the subject of numerous publications in recent years, notably in the field of imaging and therapeutics. Several RCTs have assessed the efficacy of biotherapies and conventional DMARDs in patients with symptomatic hand OA. No less than 6 randomized controlled trials have evaluated the symptomatic and, in some cases, structural efficacy of anti-IL-1, anti TNF or anti-IL-6 drugs. Overall, the results of these trials were disappointing, none of them having demonstrated superiority over placebo. There were also two negative trials with hydroxychloroquine. The only trial that was finally positive was the one that evaluated a small oral steroid therapy (10 mg/) versus placebo for 6 weeks in patients with relapsing digital osteoarthritis with ultrasound synovitis. This latest trial confirms the role of inflammation in this condition, but should obviously not encourage the use of long-term cortisone as a symptomatic treatment. [ABSTRACT FROM AUTHOR]

La rhizarthrose est l'arthrose trapézométacarpienne (TM) accompagnée ou non d'une arthrose scaphotrapézotrapézoidienne (STT). Cette pathologie fréquente est bien connue des passionnés de la main et son traitement bien codifié : le traitement conservateur doit toujours être testé au moins 6 mois (orthèse sur mesure, repos, antalgiques, infiltration de corticoides ...) avant d'envisager un traitement chirurgical. Il est courant d'entendre que l'arthrose de la main est une condition sans solution et qu'il faut l'accepter comme la vieillesse. Concernant la rhizarthrose, les traitements chirurgicaux sont anciens (plus de 40 ans) et de plus en plus efficaces à long terme. Cet article a pour but de rapporter les évolutions validées des dernières années dans la prise en charge chirurgicale de la rhizarthrose et n'est en aucun cas une mise au point ou un ensemble de recommandations de prise en charge. Basal thumb arthritis is the trapeziometacarpal arthritis (TM) with or without scaphotrapeziotrapezoidal (STT) arthritis. This frequent condition is well known by the hand medical doctor. The conservative treatment has to be conducted during at least 6 months (rest, customized splint, painkillers, steroid injection...) before discussing the surgical treatment. Unfortunately, patients are often told arthritis of the hand is a no issue pathology and they have to accept it. However, surgical treatment is now very efficient with a long term follow up. This article reports what is new in surgery for basal thumb arthritis. [ABSTRACT FROM AUTHOR]

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The prevalence of joint complaints in the general population is very high. These diseases are therefore considered a so-called lifestyle disease. With increasing age, the arthrosis rate increases and in a large proportion of aging patients joint complaints are caused by arthrosis. Before planning therapy, an individual analysis of the symptoms (pain, functional impairment and reduction in quality of life) in combination with an exact clinical examination and a meaningful application of further, usually radiological procedures is always required in each individual case. The synopsis of these various diagnostic components then prescribes an arthrosis stage in most cases, which then prescribes the individual therapy planning. However, it must be clear to the practitioner that there is no diagnostic gold standard for the diagnosis of this very complex clinical picture. Again and again, it must be warned to overestimate paraclinical findings and thus provoke overtreatment. In recent years, the paraclinical methods have been refined and in the future further improvements in the diagnostic possibility of the clinical picture of osteoarthritis are to be expected. [ABSTRACT FROM AUTHOR]

Arthritis and its symptoms are triggered by multifactorial pathogenetic mechanisms. Pain expressed by patients does not always relate to orthopaedic diagnostic findings and therapeutic management might be unsuccessful. Multidisciplinary diagnostic evaluation promotes a better understanding of neuroinflammation and chronic pain developing via central sensitization in patients suffering from arthritis. This paper illustrates our neuro-orthopaedic approach to cases apparently not responding to conventional treatment. Thereby, we hope to avoid potentially unsuccessful surgery and development of chronic pain. [ABSTRACT FROM AUTHOR]

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Copyright of Arthroskopie is the property of Springer Nature and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Compte tenu de la fréquence et de l'impact socio-économique de l'arthrose, sa prise en charge préventive s'impose comme un enjeu majeur. La prévention a le double objectif de prévenir l'apparition (prévention primaire) et de ralentir la progression de la maladie (prévention secondaire et tertiaire). Elle peut faire intervenir des mesures thérapeutiques pharmacologiques ou non pharmacologiques et des moyens de dépistage clinique, biologique et/ou radiologique. Dans cette mise au point, nous avons fait le choix de passer en revue les différents moyens de prévention dont nous disposons dans la gonarthrose et la coxarthrose. La prévention primaire visera principalement à lutter contre les principaux facteurs de risque modifiables, incluant notamment le type et l'intensité des activités physiques, les traumatismes, la surcharge pondérale et les troubles métaboliques mais également les défauts des axes des membres inférieurs et les dysplasies articulaires. Concernant la prévention secondaire et/ou tertiaire, nous discuterons principalement des techniques de dépistage des atteintes précoces grâce aux progrès de l'imagerie et des biomarqueurs, des traitements non pharmacologiques tels que la perte de poids, l'activité physique, certains régimes alimentaires, le port d'orthèses et les traitements pharmacologiques oraux tels que « les anti-arthrosiques d'action lente » et les molécules injectables par voie intra articulaire et enfin, nous évoquerons la place de la chirurgie. Mais gardons dès à présent à l'esprit qu'il n'existe aucun traitement à ce jour ayant montré un véritable effet structural une fois l'arthrose installée et que la prévention primaire a plus que jamais une place centrale dans cette pathologie. Considering the high prevalence and imposing social-economic burden of osteoarthritis, its prevention prevails as the backbone of the management. The prevention hinders the onset (primary prevention) and slows down the progression (secondary and tertiary prevention) of the disease. It includes pharmacological and non-pharmacological treatments and clinical, biological and/or radiological screening techniques. We have chosen to review available primary and secondary/tertiary preventives measures for knee and hip osteoarthritis. The primary prevention will address mainly modifiable risk factors including the choice and the intensity of the physical activity, traumas, overweight, metabolic abnormalities, misalignment, and dysplasia. Concerning the secondary and/or tertiary prevention, we will discuss early screening techniques including diagnostic imaging and biomarkers, non-pharmacological therapeutics as weight loss, physical activity, diet or braces and pharmacological therapeutics as "slow acting parenteral anti-osteoarthritis treatments", intraarticular injections, and surgeries. One must bear in mind that to date, no single treatment measure has proven a structural efficacy against established osteoarthritis hence the tremendous role of primary prevention in osteoarthritis management. [ABSTRACT FROM AUTHOR]

Objective: To evaluate, in long-term, the functional abilities and the occurrence of osteoarthritis in patients treated for a posterior perilunate carpal dislocation without bone lesion associated., Patients and Method: This was a monocentric retrospective observational study on patients operated on at the University Hospital of Guadeloupe for a posterior perilunate dislocation without bone lesion associated with a minimum of 18years of follow-up. Ten patients were included with a mean follow-up of 22.8years. The evaluation criteria were clinical (PRWE, QuickDASH, pain, grip strength, wrist joint mobility, Watson and Reagan tests, Cooney functional score) and radiographic (Gilula curves, carpal height, carpal ulnar translation, scapholunate and radiolunar angles, scapholunate and triquetro-lunar interlines in statics and dynamics, Herzberg's classification of complications)., Results: The average Cooney score was 67.5/100. Mean PRWE and QuickDASH scores were 33.9 and 24.8 respectively. The mean flexion-extension arc on the injured side was 71.5° (66.7% compared to the healthy side). Mean grip strength was 27kg (72.8% compared to the healthy side). The prevalence of osteoarthritis was 60%, with three A types, two A1 types, one B type and four B1 types according to Herzberg., Conclusion: The factors influencing the long-term prognosis are the initial displacement of the lunate, the quality of the reduction and the presence of chronic carpal instability, particularly scapholunate. The high prevalence of osteoarthritis in our series (60%) is apparently not correlated with the functional capacities of patients over the long term., (Copyright © 2024 The Authors. Published by Elsevier Masson SAS.. All rights reserved.)