Adipokines as potential prognostic biomarkers in patients with acute knee injury

This review considers adipokines as predictive biomarkers for early onset post-traumatic knee osteoarthritis (KOA). Serum concentrations of leptin and resistin can predict radiographic changes and are elevated in early KOA, with higher leptin concentrations independently associated with more severe knee changes. Plasma concentrations of resistin are chronically elevated after injury. Leptin, resistin, chemerin and vistfatin induce catabolic enzymes associated with cartilage degeneration. Available literature on adipokines in post-traumatic KOA pathogenesis suggests that they could contribute to risk prediction of early onset post-traumatic KOA. Further research is needed to further understand the association between adipokines, synovitis and long-term outcomes in this population

Total or Partial Knee Arthroplasty Trial - TOPKAT : study protocol for a randomised controlled trial

Peer reviewedPublisher PD

A pilot investigation of the prevalence of US-detectable forefoot joint pathology and reported foot-related disability in participants with systemic lupus erythematosus

The main aim of this study was to determine the prevalence of US-detectable forefoot bursae, metatarsophalangeal (MTP) joint and metacarpophalangeal (MCP) joint synovial hypertrophy (SH), Power Doppler (PD) signal or erosion in participants with systemic lupus erythematosus (SLE). A secondary aim was to determine the strength of potential association between patient reported foot-related disability and US-detected forefoot bursae, MTP joint SH, PD signal or erosion in participants with SLE.A cross-sectional observational study of 20 participants with SLE was completed to determine the prevalence of US-detected forefoot bursal, MTP and MCP joint pathology. Patient-reported foot-related impairment and activity limitation (accumulatively referred to as disability) were also recorded. Spearmans' Rank Correlation analyses were completed to determine the potential strength of association between US-detected pathology and patient report disability.The prevalence of MTP joint SH and PD was 80 % (16/20) and 10 % (2/20), respectively. The prevalence of MCP joint SH and PD was 60 % (12/20) and 30 % (6/20) respectively. A significant association was noted between PD scores for the MTP joints and MCP joints (r = 0.556; p = 0.011) although this was not demonstrated for SH scores (r = 0.176; p = 0.459). Significant associations between forefoot bursal prevalence and MTP joint PD were noted (r = 0.467; p = 0.038). The prevalence of bursae and bursal PD (grade 2 or above) was 100 % (20/20) and 10 % (2/20), respectively. Moderate foot-related impairment and activity limitation was reported by 95 and 85 % of participants respectively.This pilot study suggests that US-detected MTP, MCP joint and forefoot bursal abnormalities may be prevalent in participants with SLE and they may experience a moderate level of foot-related disability. Further research is required to substantiate these preliminary findings

Natural history of radiographic first metatarsophalangeal joint osteoarthritis: A nineteen‐year population‐based cohort study

Objective: To assess the long-term prevalence, natural history, progression and incidence of 73 radiographic first metatarsophalangeal joint (1st MTPJ) osteoarthritis (OA). Methods: A longitudinal, cohort design was used in which radiographic OA at the 1st MTPJ was 75 investigated in participants at year 6 (1995) and year 23 (2013-2015) from the Chingford 1000 76 Women study. Radiographic features of osteophytes (OPs) and/or joint space narrowing (JSN) at the 77 1st MTPJ were scored according to a validated foot atlas. Natural history was determined by the 78 change in prevalence, incidence, progression and worsening of OA in the 1st MTPJ. Results: Complete case matched foot radiographic data were available for 193 of the women 80 currently enrolled in the study, mean age: 75.7 years (SD: 5.2; range 69-90). At the level of the 1st 81 MTPJ, prevalence of OA at year 6 was 21.76% in the left and 24.35% in the right and at year 23 was 82 23.83% in the left and 32.64% in the right. Over the 19-year period, 13.5% of women developed 83 incident OA in the right 1st MTPJ and 8.3% in the left. Both progression and worsening of OA were 84 more evident for OPs and in the right 1st MTPJs. Conclusion: In this longest study of the natural history of radiographic 1st MTPJ OA to date, the 86 prevalence and incidence of 1st MTPJ OA increased over a 19-year period. Progression and/or 87 worsening of 1st MTPJ OA over time appears to be driven by OP development rather than JSN 88 suggestive of a biomechanical cause

Behavioural physical activity interventions in participants with lower-limb osteoarthritis: a systematic review with meta-analysis

Objective: To assess effectiveness of osteoarthritis interventions to promote long-term physical activity behaviour change.Design: A systematic review and meta-analysis. Protocol registration PROSPERO CRD4201300444 5 (http://www.crd.york.ac.uk/prospero/).Study selection: Randomised controlled trials (RCTs) comparing physical activity interventions with placebo, no/or minimal intervention in community-dwelling adults with symptomatic knee or hip osteoarthritis. Primary outcomes were change in physical activity or cardiopulmonary fitness after a minimum follow-up of 6 months.Data extraction: Outcomes were measures of physical activity (self-reported and objectively measured) and cardiovascular fitness. Standard mean differences between postintervention values were used to describe the effect sizes.Results: 27 984 titles were screened and 180 papers reviewed in full. Eleven RCTs satisfied inclusion criteria, total study population of 2741 participants, mean age 62.2. The commonest reasons for study exclusion were follow-up less than 6 months and no physical activity measures. The majority of included interventions implement an arthritis self-management programme targeting coping skills and self-efficacy. Seven studies used self-report measures, the pooled effect of these studies was small with significant heterogeneity between studies (SMD 0.22 with 95% CI −0.11 to 0.56, z=1.30 (p=0.19) I2 statistic of 85%). Subgroup analysis of 6–12 month outcome reduced heterogeneity and increased intervention effect compared to control (SMD 0.53, 95% CI 0.41 to 0.65, z=8.84 (