| 1. |
- Burkard, Theresa, et al.
(author)
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The associations between bariatric surgery and hip or knee arthroplasty, and hip or knee osteoarthritis : Propensity score-matched cohort studies
- 2022
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In: Osteoarthritis and cartilage open. - : Elsevier. - 2665-9131 .- 2665-9131. ; 4:2
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Journal article (peer-reviewed)abstract
- OBJECTIVE: To investigate the associations between bariatric surgery and hip or knee arthroplasty, and secondary care hip or knee osteoarthritis (OA).METHODS: We performed cohort studies using data from Swedish nationwide healthcare registries. Patients aged 18-79 years who underwent bariatric surgery between 2006 and 2019 were matched on their propensity score (PS) to up to 2 obese patients ("unexposed episodes") in risk-set sampling. After a 1-year run-in period, episodes were followed in an "as-treated" approach. Using Cox proportional hazard regression, we calculated hazard ratios (HR) with 95% confidence intervals (CIs) of hip or knee arthroplasty overall and in subgroups of age, sex, joint location, arthroplasty type, bariatric surgery type, and by duration of follow-up if proportional hazard assumptions were violated. In a secondary cohort, we assessed the outcome incident secondary care hip or knee osteoarthritis (OA).RESULTS: Among 39'392 bariatric surgery episodes when compared to 61'085 PS-matched unexposed episodes (47'594 unique patients), the risk of hip or knee arthroplasty was strongest increased within the first three years of follow-up (HR 1.79, 95% CI 1.56-2.07), decreased thereafter, but remained elevated throughout follow-up. In a secondary cohort of 37'929 exposed when compared to 58'600 PS-matched unexposed episodes, the risk of hip or knee osteoarthritis was decreased (HR 0.84, 95% CI 0.79-0.90).CONCLUSION: Bariatric surgery is associated with increased risks of hip or knee arthroplasty, but also with decreased risks of secondary care OA. This contradiction supports the hypothesis that bariatric surgery may act as an enabler for hip or knee arthroplasty.
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| 3. |
- Dell’isola, Andrea, et al.
(author)
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The association between preexisting conditions and osteoarthritis development in peripheral joints: A population based nested case-control study
- 2022
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In: Osteoarthritis and Cartilage Open. - : Elsevier BV. - 2665-9131. ; 4:2
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Journal article (peer-reviewed)abstract
- AimTo study the risk of receiving a new (incident) osteoarthritis (OA) diagnosis in different joint sites based on conditions diagnosed in the 20 years prior the OA diagnosis.MethodsWe used register data for the entire population of the Skåne region (Sweden) to perform a nested case-control study. The outcome was newly diagnosed (incident) OA in peripheral joints, i.e. knee (ICD-10 code M17), hip (M16) and other joints (M15, M18, M19), diagnosed in 2018 or 2019 in persons aged 45+ years with 20 years of register coverage. For each OA case, we sampled 1 control matched on age (1-year strata), sex and residential area in the year of index date using incidence density sampling. The exposures of interest comprised 50 comorbidities. We used adjusted conditional logistic regression for analysis.ResultsBetween January 1st, 2018 and December 31st, 2019, we identified 7 201, 2 895, and 7863 persons, respectively, with newly diagnosed knee, hip and other OA. Hypertension, back pain, gout, allergy, depression, anxiety and migraine were all associated with increased risk of knee OA diagnosis, while only gastroesophageal reflux disease and back pain were associated with newly diagnosed hip OA. Interestingly, many of the analysed conditions were associated with increased risk of OA diagnosis in other peripheral joints, including diagnosed generalised OA.ConclusionsThe risk of being diagnosed with OA increases with the presence of multimorbidity earlier in life, but the associations seem to differ between weight-bearing and non-weight-bearing joints.
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| 4. |
- Kiadaliri, Ali, et al.
(author)
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Impact of the first wave of the COVID-19 pandemic on healthcare use in osteoarthritis : A population register-based study in Sweden
- 2022
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In: Osteoarthritis and Cartilage Open. - : Elsevier BV. - 2665-9131. ; 4:2
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Journal article (peer-reviewed)abstract
- Objective: To investigate whether the first wave of the COVID-19 pandemic impacted healthcare consultations (HCC) and hospitalization among people with and without osteoarthritis (OA).Methods: Using register data, we included individuals aged ≥35 years residing in Skåne region, Sweden, during 2009-2019 with (n = 123,523) and without (n = 552,412) a diagnosis of OA during January 1, 2009-December 31, 2019. We collected bi-weekly individual data on HCC/hospitalization between January and May for years 2017-2020. Treating the year 2020 as intervention and 2017-2019 as control as well as dividing data to pre- (January-February) and post-pandemic (March-May), we applied event study design to measure the dynamic effects of the COVID-19 pandemic on HCC/hospitalization. We used fixed-effect Poisson regressions for estimation and subgroup analyses by sex, age, and comorbidity were conducted among OA patients.Results: The impact of the pandemic on healthcare use was evident from mid-March 2020 (34-45%/12-25% reductions in in-person HCC/hospitalization) among people with OA relative to 2017-2019. Smaller reductions were seen in those without OA with 25-34%/8-16% reductions in in-person HCC/hospitalization. On contrary, there were increases in remote HCC following the pandemic (5-25% and 11-31% in people with and without OA, respectively). Among persons with OA, there were variations in the pandemic's effects by sex, age and comorbidity.Conclusion: Despite no lockdown in Sweden there were substantial reductions in in-person healthcare use during the first wave of COVID-19 pandemic with greater reductions among people with than without OA.
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| 5. |
- Larsson, Staffan, et al.
(author)
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Biological variation of human aggrecan ARGS neoepitope in synovial fluid and serum in early-stage knee osteoarthritis and after knee injury
- 2022
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In: Osteoarthritis and Cartilage Open. - : Elsevier BV. - 2665-9131. ; 4:4, s. 1-7
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Journal article (peer-reviewed)abstract
- OBJECTIVE: To determine biological variation of the aggrecanase-generated aggrecan ARGS neoepitope in serum (sARGS) and synovial fluid (sfARGS) within and between patients with osteoarthritis (OA) or anterior cruciate ligament (ACL) injury.DESIGN: Matched samples of serum and synovial fluid were available, as parts of clinical trials, from i) 16 subjects with early-stage OA on 8 occasions over 1 year, and ii) 120 subjects with acute ACL injury with samples available from at least 2 of 6 visits over 5 years. We used an in-house immunoassay to quantify ARGS and one-way ANOVA for statistical analyses.RESULTS: Variability in ARGS was higher in synovial fluid than in serum in both patient groups. Subjects with OA had the lowest variability both within and between patients and showed no variation over time in the degree of variability or in the cross-sectional mean, neither in serum nor in synovial fluid. After ACL injury, the concentration and the variability of ARGS was highest immediately after injury, with a subsequent decline both in concentration and in variability with time. In both patient groups there was a positive correlation between sfARGS and sARGS both within and between individuals (correlation coefficients between 0.16 and 0.20).CONCLUSIONS: The biological variation of ARGS is lower in serum than in synovial fluid, and lower in OA than after ACL injury. Serum ARGS is a measure of the total release of ARGS aggrecan from the whole body and a poor reflection of the release of ARGS aggrecan within the affected joint.
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| 6. |
- Mulrooney, Elisabeth, et al.
(author)
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The associations of psychological symptoms and cognitive patterns with pain and pain sensitization in people with hand osteoarthritis
- 2022
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In: Osteoarthritis and Cartilage Open. - : Elsevier BV. - 2665-9131. ; 4:2
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Journal article (peer-reviewed)abstract
- Objective: To examine whether psychological symptoms and cognitive patterns are associated with self-reported pain and pain sensitization in people with hand osteoarthritis (OA). Design: In the Nor-Hand study (n = 300), people with hand OA self-reported psychological symptoms (Hospital Anxiety and Depression Scale), cognitive patterns (Pain catastrophizing Scale and Arthritis Self-Efficacy Scale) as well as their pain severity in hands, overall pain and multi-joint pain. Central pain sensitization was measured clinically by temporal summation and pressure pain threshold tests. We examined whether psychological symptoms and cognitive patterns were cross-sectionally associated with pain using linear regression. Beta coefficients (β) per one standard deviation of the independent variable were presented. Stratified analyses were performed in cases of significant interactions (p < 0.10). Results: Higher levels of anxiety, depressive symptoms and pain catastrophizing and low levels of self-efficacy were statistically significantly associated with higher levels of hand pain by Numeric Rating Scale (β = 0.43, 0.48 and −0.57, respectively). Similar associations were found for overall pain, but not for measures of central pain sensitization. In stratified analyses, anxiety and depressive symptoms were more strongly related with pain in subgroups with younger age and higher comorbidity burden. Pain catastrophizing was more strongly related with pain in subgroups with younger age, overweight/obesity, higher comorbidity burden and poor sleep. Conclusion: Psychological symptoms and cognitive patterns were associated with self-reported OA pain, especially in people with younger age, overweight/obesity, higher comorbidity burden and poor sleep. No associations were found for psychological symptoms and cognitive patterns with pain sensitization.
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| 7. |
- Struglics, André, et al.
(author)
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Technical performance of a proximity extension assay inflammation biomarker panel with synovial fluid
- 2022
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In: Osteoarthritis and Cartilage Open. - : Elsevier BV. - 2665-9131. ; 4:3
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Journal article (peer-reviewed)abstract
- The plasma proteome can provide a deeper understanding of the pathophysiology of different diseases and is a key source for detection of new biomarkers. Proximity extension assay (PEA), developed by Olink Proteomics (Uppsala, Sweden), detects proteins by using pairs of antibodies that are linked to oligonucleotides; upon target binding, the probes anneal when in proximity and the oligonucleotides are extended by DNA polymerase and the newly formed antigen is quantified by real-time PCR [1]. PEA provides high specificity and sensitivity, and the possibility to measure the relative abundance of a large number of proteins (92 up to 384 biomarkers), only using a few μL of biofluid per sample. This technique makes it possible to assess low-abundant proteins which are not accessible using mass spectrometry techniques [2]. The multi-assay/plex capacity of PEA is comparable with other multiplex assays like Meso Scale Discovery (MSD); MSD uses electrochemiluminescence measuring the concentration of up to 10 biomarkers per well in 25 μl per sample. The PEA has an advantage over enzyme-linked immunosorbent assay (ELISA) and MSD assays in that PEA has a high number of biomarkers which are quantifiable in very low sample volume.In plasma and serum, the correlation between the PEA technique and other techniques, including ELISA and electrochemiluminescence has been shown to be strong [[3], [4], [5], [6], [7], [8]]. The technical performance of the PEA technique in synovial fluid is unknown. The characteristics of synovial fluid differs from plasma in that some proteins are more abundant, whereas other proteins are less abundant. Compared to plasma, synovial fluid is very viscous due to high levels of hyaluronic acid [9]. These differences could interfere with the PEA analysis technique. To interpret protein data generated by the PEA technique in synovial fluid, information on the technical performance of this assay on synovial fluid samples is needed [10].The purpose of the present study was to evaluate the technical performance of Olink's inflammation PEA with synovial fluid samples and compare it with the performance of the same PEA in the more commonly used biofluids, serum and plasma. The second aim was to compare some of the PEA data with data obtained by immunoassays using MSD.
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| 8. |
- Tiulpin, Aleksei, et al.
(author)
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Predicting total knee arthroplasty from ultrasonography using machine learning
- 2022
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In: Osteoarthritis and Cartilage Open. - : Elsevier BV. - 2665-9131. ; 4:4, s. 1-8
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Journal article (peer-reviewed)abstract
- OBJECTIVE: To investigate the value of ultrasonographic data in predicting total knee replacement (TKR).DESIGN: Data from the Musculoskeletal Pain in Ullensaker study (MUST) was linked to the Norwegian Arthroplasty Register to form a 5-7 year prospective cohort study of 630 persons (69% women, mean (SD) age 64 (8.7) years). We examined the predictive power of ultrasound (US) features, i.e. osteophytes, meniscal extrusion, synovitis in the suprapatellar recess, femoral cartilage thickness, and quality for future knee osteoarthritis (OA) surgery. We investigated 4 main settings for multivariate predictive modeling: 1) clinical predictors (age, sex, body mass index, knee injury, familial OA and workload), 2) radiographic data (assessed by the Kellgren Lawrence grade, KL) with clinical predictors, 3) US features and clinical predictors. Finally, we also considered an ensemble of models 2) and 3) and used it as our fifth model. All models were compared using the Average Precision (AP) and the Area Under Receiver Operating Characteristic Curve (AUC) metrics.RESULTS: Clinical predictors yielded AP of 0.11 (95% confidence interval [CI] 0.05-0.23) and AUC of 0.69 (0.58-0.79). Clinical predictors with KL grade yielded AP of 0.20 (0.12-0.33) and AUC of 0.81 (0.67-0.90). The clinical variables with ultrasound yielded AP of 0.17 (0.08-0.30) and AUC of 0.79 (0.69-0.86).CONCLUSION: Ultrasonographic examination of the knee may provide added value to basic clinical and demographic descriptors when predicting TKR. While it does not achieve the same predictive performance as radiography, it can provide additional value to the radiographic examination.
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