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- Dell'Isola, Andrea, et al.
(författare)
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The coexistence of diabetes, hypertension and obesity is associated with worse pain outcomes following exercise for osteoarthritis: A cohort study on 80,893 patients
- 2024
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Ingår i: Osteoarthritis and Cartilage. - 1063-4584 .- 1522-9653.
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Tidskriftsartikel (refereegranskat)abstract
- Objectives To investigate how the co-occurrence of diabetes, hypertension and overweight/obesity is associated with pain following an exercise intervention for knee and hip osteoarthritis (OA).Methods Register-based cohort study. We included people from the Swedish Osteoarthritis Register who underwent education and exercise for knee or hip OA. Diabetes and hypertension were defined using medical records and dispensation of medication. Body Mass Index (BMI) was used to identify people with overweight (≥25 to <30), and obesity (≥30). We used linear mixed-effect models with patients nested into clinics to estimate the associations between the exposures and pain (Numeric Rating Scale 0–10), adjusting for age, sex, education, and physical activity.Results We analysed 80,893 patients with knee or hip OA. The accumulation of metabolic conditions was associated with worse pain at baseline and follow-ups. When obesity, hypertension and diabetes coexisted, patients treated for knee OA reported more pain at baseline (adjusted mean pain difference 0.9 [95 %CI: 0.8; 1.0]), 3 months (1.0 [0.9; 1.1]) and 12 months (1.3 [1.1; 1.4]) compared to those without any of the conditions. Similar results were observed for patients treated for hip OA when obesity, hypertension and diabetes coexisted (baseline (0.7 [0.5; 0.8], 3 (0.8[0.6; 1.0]) and 12 months (1.1[0.8; 1.3]).Conclusions When diabetes, hypertension and obesity coexist with OA, patients not only experience heightened baseline pain compared to metabolically healthy individuals, but the disparity increases after an education and exercise intervention suggesting that a one-size-fits-all approach may be inadequate in addressing the complex interplay between metabolic health and OA.
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- Aspenberg, P., et al.
(författare)
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Drug test chamber : a titanium implant for administration of biochemical agents to a standardized bone callus in situ
- 1988
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Ingår i: Journal of Biomedical Engineering. - : Elsevier BV. - 0141-5425. ; 10:1, s. 70-73
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Tidskriftsartikel (refereegranskat)abstract
- A titanium implant in which a conduit is gradually filled with ingrowing bone (the Bone Harvest Chamber) has been modified to allow continuous local treatment of the conduit tissue with biochemical agents. Implants were inserted bilaterally in rabbit tibiae. The tissue content of the bone ingrowth conduits was studied with histology, 99mTc-MDP scintimetry and measurements of total calcium content. Bone was formed in the conduit by endochondral formation starting at both ends and continuing until fusion in the middle. After 2 weeks the bone had not yet met in the middle where fibrous tissue was seen. In eight animals 3H-proline was applied via one of the chambers, with the contralateral chamber as a saline-treated control. The collagen of the harvested tissue from the 3H-proline treated side had a 3H-hydroxyproline content 1000 times greater than had the control side. The 'drug test chamber' makes possible the study of local effects of drugs on healing of mature bone in vivo.
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- Dell'Isola, Andrea, et al.
(författare)
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Within-person change in patient-reported outcomes and their association with the wish to undergo joint surgery during a digital first-line intervention for osteoarthritis
- 2023
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Ingår i: Osteoarthritis and Cartilage. - : Elsevier. - 1063-4584 .- 1522-9653. ; 31:9, s. 1257-1264
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Tidskriftsartikel (refereegranskat)abstract
- Aim: To study the association between within-person changes in patient-reported outcomes (PROMs) and wish for joint surgery during participation in a digital first-line intervention comprising exercise and education for knee/hip osteoarthritis (OA).Methods: Retrospective observational registry study. Participants enrolled between 01/06/2018 and 30/10/2021 with follow-up data at 3 months (n=13,961). We used asymmetric fixed effect (conditional) logistic regressions to study the association between change in wish to undergo surgery at last available time point (3,6,9 or 12 months) and improvement or worsening of PROMs pain (0-10), quality of life (EQ5D-5L, 0.243-0.976), overall health (0-10), activity impairment (0-10), walking difficulties (yes/no), fear of movement (yes/no) and Knee/Hip injury and Osteoarthritis Outcome Score 12 Items (KOOS-12/HOOS-12, 0-100) function and quality of life (QoL) subscales.Results: The proportion of participants wishing to undergo surgery declined by 2% (95% CI 1.9, 3.0), from 15.7% at the baseline to 13.3% at 3 months. Generally, improvements in PROMs were associated with reduced likelihood of wishing for surgery while worsening was associated with increased likelihood. For pain, activity impairment EQ-5D and KOOS/HOOS QoL, a worsening led to a change in the probability of wish for surgery of larger absolute magnitude than an improvement in the same PROM.Conclusions: Within-person improvements in PROMs are associated with reduced wish for surgery, while worsenings with an increased wish for surgery. Larger improvements in PROMs may be needed to match the magnitude of the change in wish for surgery associated with a worsening in the same PROM.
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- Johansson, Helena, 1981, et al.
(författare)
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Low risk for hip fracture and high risk for hip arthroplasty due to osteoarthritis among Swedish farmers
- 2018
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Ingår i: Osteoporosis International. - : Springer Science and Business Media LLC. - 0937-941X .- 1433-2965. ; 29:3, s. 741-749
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Tidskriftsartikel (refereegranskat)abstract
- We aimed to study the risk of hip fracture and risk of hip arthroplasty among farmers in Sweden. Our results indicate that farming, representing an occupation with high physical activity, in men is associated with a lower risk of hip fracture but an increased risk of hip arthroplasty. Introduction The risks of hip fracture and hip arthroplasty are influenced by factors including socioeconomic status, education, urbanization, latitude of residence, and physical activity. Farming is an occupation encompassing rural living and high level of physical activity. Therefore, we aimed to study the risk of hip fracture and risk of hip arthroplasty among farmers in Sweden. Methods We studied the risk of hip fracture, and hip arthroplasty due to primary osteoarthritis, in all men and women aged 35 years or more in Sweden between 1987 and 2002. Documented occupations were available in 3.5 million individuals, of whom 97,136 were farmers. The effects of age, sex, income, education, location of residence, and occupation on risk of hip fracture or hip arthroplasty were examined using a modification of Poisson regression. Results A total of 4027 farmers and 93,109 individuals with other occupations sustained a hip fracture, while 5349 farmers and 63,473 others underwent a hip arthroplasty. Risk of hip fracture was higher with greater age, lower income, lower education, higher latitude, and urban area for all men and women. Compared to all other occupations, male farmers had a 20% lower age-adjusted risk of hip fracture (hazard ratio (HR) 0.80, 95% CI 0.77-0.84), an effect that was not seen in female farmers (HR 0.96, 95% CI 0.91-1.01). Both male and female farmers had a higher age-adjusted risk for hip arthroplasty. Conclusions Our results indicate that farming, representing an occupation with high physical activity, in men is associated with a lower risk of hip fracture but an increased risk of hip arthroplasty.
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