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@article{henriksen_exercise_2024, title = {{EXERCISE} {FOR} {KNEE} {OSTEOARTHRITIS} {PAIN}: {ASSOCIATION} {OR} {CAUSATION}?}, issn = {1522-9653}, shorttitle = {{EXERCISE} {FOR} {KNEE} {OSTEOARTHRITIS} {PAIN}}, doi = {10.1016/j.joca.2024.03.001}, abstract = {Exercise is universally recommended as a primary strategy for the management of knee osteoarthritis (OA) pain. The recommendations are based on results from more than 100 randomized controlled trials (RCTs) that compare exercise to no-attention control groups. However, due to the inherent difficulties with adequate placebo control, participant blinding and the use of patient reported outcomes, the existing RCT evidence is imperfect. To better understand the evidence used to support a causal relationship between exercise and knee OA pain relief, we examined the existing evidence through the Bradford Hill considerations for causation. The Bradford Hill considerations, first proposed in 1965 by Sir Austin Bradford Hill, provide a framework for assessment of possible causal relationships. There are 9 considerations by which the evidence is reviewed: Strength of association, Consistency, Specificity, Temporality, Biological Gradient (Dose-Response), Plausibility, Coherence, Experiment, and Analogy. Viewing the evidence from these 9 viewpoints did neither bring forward indisputable evidence for nor against the causal relationship between exercise and improved knee OA pain. Rather, we conclude that the current evidence is not sufficient to support claims about (lack of) causality. With our review, we hope to advance the continued global conversation about how to improve the evidence-based management of patients with knee OA.}, language = {eng}, journal = {Osteoarthritis and Cartilage}, author = {Henriksen, Marius and Runhaar, Jos and Turkiewicz, Aleksandra and Englund, Martin}, month = mar, year = {2024}, pmid = {38490293}, keywords = {Bradford Hill, Osteoarthritis, association, causality, exercise, knee}, pages = {S1063--4584(24)01005--7}, }
@article{mahmoudian_timing_2024, title = {Timing is everything: towards classification criteria for early-stage symptomatic knee osteoarthritis}, issn = {1522-9653}, shorttitle = {Timing is everything}, doi = {10.1016/j.joca.2024.02.888}, language = {eng}, journal = {Osteoarthritis and Cartilage}, author = {Mahmoudian, Armaghan and King, Lauren K. and Liew, Jean W. and Wang, Qiuke and Appleton, C. Thomas and Englund, Martin and Haugen, Ida K. and Lohmander, L. Stefan and Runhaar, Jos and Turkiewicz, Aleksandra and Neogi, Tuhina and Hawker, Gillian A. and {OARSI Early-stage Symptomatic Knee Osteoarthritis Initiative}}, month = mar, year = {2024}, pmid = {38437945}, keywords = {Knee OA, early identification, secondary prevention, symptomatic knee}, pages = {S1063--4584(24)00928--2}, }
@article{whittaker_toward_2024, title = {Toward designing human intervention studies to prevent osteoarthritis after knee injury: {A} report from an interdisciplinary {OARSI} 2023 workshop}, volume = {6}, issn = {2665-9131}, shorttitle = {Toward designing human intervention studies to prevent osteoarthritis after knee injury}, doi = {10.1016/j.ocarto.2024.100449}, abstract = {OBJECTIVE: The global impact of osteoarthritis is growing. Currently no disease modifying osteoarthritis drugs/therapies exist, increasing the need for preventative strategies. Knee injuries have a high prevalence, distinct onset, and strong independent association with post-traumatic osteoarthritis (PTOA). Numerous groups are embarking upon research that will culminate in clinical trials to assess the effect of interventions to prevent knee PTOA despite challenges and lack of consensus about trial design in this population. Our objectives were to improve awareness of knee PTOA prevention trial design and discuss state-of-the art methods to address the unique opportunities and challenges of these studies. DESIGN: An international interdisciplinary group developed a workshop, hosted at the 2023 Osteoarthritis Research Society International Congress. Here we summarize the workshop content and outputs, with the goal of moving the field of PTOA prevention trial design forward. RESULTS: Workshop highlights included discussions about target population (considering risk, homogeneity, and possibility of modifying osteoarthritis outcome); target treatment (considering delivery, timing, feasibility and effectiveness); comparators (usual care, placebo), and primary symptomatic outcomes considering surrogates and the importance of knee function and symptoms other than pain to this population. CONCLUSIONS: Opportunities to test multimodal PTOA prevention interventions across preclinical models and clinical trials exist. As improving symptomatic outcomes aligns with patient and regulator priorities, co-primary symptomatic (single or aggregate/multidimensional outcome considering function and symptoms beyond pain) and structural/physiological outcomes may be appropriate for these trials. To ensure PTOA prevention trials are relevant and acceptable to all stakeholders, future research should address critical knowledge gaps and challenges.}, language = {eng}, number = {2}, journal = {Osteoarthritis and Cartilage Open}, author = {Whittaker, Jackie L. and Kalsoum, Raneem and Bilzon, James and Conaghan, Philip G. and Crossley, Kay and Dodge, George R. and Getgood, Alan and Li, Xiaojuan and Losina, Elena and Mason, Deborah J. and Pietrosimone, Brian and Risberg, May Arna and Roemer, Frank and Felson, David and Culvenor, Adam G. and Meuffels, Duncan and Gerwin, Nicole and Simon, Lee S. and Lohmander, L. Stefan and Englund, Martin and Watt, Fiona E.}, month = jun, year = {2024}, pmid = {38440780}, pmcid = {PMC10910316}, keywords = {Knee, Osteoarthritis, Post-traumatic osteoarthritis, Prevention, Randomised controlled trials, Trial design}, pages = {100449}, }
@article{wijn_arthroscopic_2023, title = {Arthroscopic partial meniscectomy for the degenerative meniscus tear: a comparison of patients included in {RCTs} and prospective cohort studies}, volume = {94}, issn = {1745-3682}, shorttitle = {Arthroscopic partial meniscectomy for the degenerative meniscus tear}, doi = {10.2340/17453674.2023.24576}, abstract = {BACKGROUND AND PURPOSE: Concerns exist regarding the generalizability of results from randomized controlled trials (RCTs) evaluating arthroscopic partial meniscectomy (APM) to treat degenerative meniscus tears. It has been suggested that study populations are not representative of subjects selected for surgery in daily clinical practice. Therefore, we aimed to compare patients included in trials and prospective cohort studies that received APM for a degenerative meniscus tear. PATIENTS AND METHODS: Individual participant data from 4 RCTs and 2 cohort studies undergoing APM were collected. 1,970 patients were analyzed: 605 patients included in RCTs and 1,365 included in the cohorts. We compared patient and disease characteristics, knee pain, overall knee function, and health-related quality of life at baseline between the RCT and cohort groups using standardized differences, ratios comparing the variance of continuous covariates, and graphical methods such as quantile-quantile plots, side-by-side boxplots, and non-parametric density plots. RESULTS: Differences between RCT and the cohort were observed primarily in age (younger patients in the cohort; standardized difference: 0.32) and disease severity, with the RCT group having more severe symptoms (standardized difference: 0.38). While knee pain, overall knee function, and quality of life generally showed minimal differences between the 2 groups, it is noteworthy that the largest observed difference was in knee pain, where the cohort group scored 7 points worse (95\% confidence interval 5-9, standardized difference: 0.29). CONCLUSION: Patients in RCTs were largely representative of those in cohort studies regarding baseline scores, though variations in age and disease severity were observed. Younger patients with less severe osteoarthritis were more common in the cohort; however, trial participants still appear to be broadly representative of the target population.}, language = {eng}, journal = {Acta Orthopaedica}, author = {Wijn, Stan R. W. and Hannink, Gerjon and Thorlund, Jonas B. and Sihvonen, Raine and Englund, Martin and Rovers, Maroeska M. and {meniscus IPDMA collaboration group}}, month = nov, year = {2023}, pmid = {38037388}, pmcid = {PMC10690978}, keywords = {Arthroscopy, Cohort Studies, Humans, Knee Joint, Meniscectomy, Menisci, Tibial, Meniscus, Osteoarthritis, Knee, Pain, Randomized Controlled Trials as Topic}, pages = {570--576}, }
@article{pineda-moncusi_classification_2023, title = {Classification of patients with osteoarthritis through clusters of comorbidities using 633 330 individuals from {Spain}}, volume = {62}, issn = {1462-0332}, doi = {10.1093/rheumatology/kead038}, abstract = {OBJECTIVES: To explore clustering of comorbidities among patients with a new diagnosis of OA and estimate the 10-year mortality risk for each identified cluster. METHODS: This is a population-based cohort study of individuals with first incident diagnosis of OA of the hip, knee, ankle/foot, wrist/hand or 'unspecified' site between 2006 and 2020, using SIDIAP (a primary care database representative of Catalonia, Spain). At the time of OA diagnosis, conditions associated with OA in the literature that were found in ≥1\% of the individuals (n = 35) were fitted into two cluster algorithms, k-means and latent class analysis. Models were assessed using a range of internal and external evaluation procedures. Mortality risk of the obtained clusters was assessed by survival analysis using Cox proportional hazards. RESULTS: We identified 633 330 patients with a diagnosis of OA. Our proposed best solution used latent class analysis to identify four clusters: 'low-morbidity' (relatively low number of comorbidities), 'back/neck pain plus mental health', 'metabolic syndrome' and 'multimorbidity' (higher prevalence of all studied comorbidities). Compared with the 'low-morbidity' cluster, the 'multimorbidity' cluster had the highest risk of 10-year mortality (adjusted hazard ratio [HR]: 2.19 [95\% CI: 2.15, 2.23]), followed by the 'metabolic syndrome' cluster (adjusted HR: 1.24 [95\% CI: 1.22, 1.27]) and the 'back/neck pain plus mental health' cluster (adjusted HR: 1.12 [95\% CI: 1.09, 1.15]). CONCLUSION: Patients with a new diagnosis of OA can be clustered into groups based on their comorbidity profile, with significant differences in 10-year mortality risk. Further research is required to understand the interplay between OA and particular comorbidity groups, and the clinical significance of such results.}, language = {eng}, number = {11}, journal = {Rheumatology (Oxford, England)}, author = {Pineda-Moncusí, Marta and Dernie, Francesco and Dell'Isola, Andrea and Kamps, Anne and Runhaar, Jos and Swain, Subhashisa and Zhang, Weiya and Englund, Martin and Pitsillidou, Irene and Strauss, Victoria Y. and Robinson, Danielle E. and Prieto-Alhambra, Daniel and Khalid, Sara}, month = nov, year = {2023}, pmid = {36688706}, pmcid = {PMC10629784}, keywords = {Cohort Studies, Comorbidity, Humans, Neck Pain, OA, Osteoarthritis, Hip, Osteoarthritis, Knee, Spain, clustering, comorbidities, epidemiology}, pages = {3592--3600}, }
@article{battista_income-related_2023, title = {Income-{Related} {Inequality} {Changes} in an {Osteoarthritis} {First}-{Line} {Intervention}: a {Cohort} {Study}}, issn = {1532-821X}, shorttitle = {Income-{Related} {Inequality} {Changes} in an {Osteoarthritis} {First}-{Line} {Intervention}}, doi = {10.1016/j.apmr.2023.10.012}, abstract = {OBJECTIVE: To examine income-related inequality changes in the outcomes of an osteoarthritis (OA) first-line intervention. DESIGN: Retrospective cohort study. SETTING: Swedish healthcare system. PARTICIPANTS: We included 115,403 people (age: 66.2 ±9.7 years; female 67.8\%) with knee (67.8\%) or hip OA (32.4\%) recorded in the 'Swedish Osteoarthritis Registry' (SOAR). INTERVENTIONS: Exercise and education. MAIN OUTCOME MEASURES: Erreygers' concentration index (E) measured income-related inequalities in 'Pain intensity,' 'Self-efficacy,' 'Use of NSAIDs,' and 'Desire for surgery' at baseline, 3-month, and 12-month follow-ups and their differences over time. E-values range from -1 to +1 if the health variables are more concentrated among people with lower or higher income. Zero represents perfect equality. We used entropy balancing to address demographic and outcome imbalances and bootstrap replications to estimate confidence intervals for E differences over time. RESULTS: Comparing baseline to 3 months, 'pain' concentrated more among individuals with lower income initially (E=-0.027), intensifying at 3 months (E=-0.011 [95\% CI: -0.014; -0.008]). Similarly, the 'Desire for surgery' concentrated more among individuals with lower income initially (E = -0.009), intensifying at 3 months (E=-0.012 [-0.018; -0.005]). Conversely, 'Self-efficacy' concentrated more among individuals with higher income initially (E=0.058), intensifying at 3 months (E=0.008 [0.004; 0.012]). Lastly, the 'Use of NSAIDs' concentrated more among individuals with higher income initially (E=0.068) but narrowed at 3 months (E=-0.029 [-0.038; -0.021]). Comparing baseline to 12 months, 'pain' concentrated more among individuals with lower income initially (E=-0.024), intensifying at 12 months (E=-0.017 [-0.022; -0.012]). Similarly, the 'Desire for surgery' concentrated more among individuals with lower income initially (E=-0.016), intensifying at 12 months (E=-0.012 [-0.022; -0.002]). Conversely, 'Self-efficacy' concentrated more among individuals with higher income initially (E=0.059), intensifying at 12 months (E=0.016 [0.011; 0.021]). CONCLUSION: Our results highlight the increase of income-related inequalities in the SOAR over time.}, language = {eng}, journal = {Archives of Physical Medicine and Rehabilitation}, author = {Battista, Simone and Kiadaliri, Ali and Jönsson, Thérése and Gustafsson, Kristin and Englund, Martin and Testa, Marco and Dell'Isola, Andrea}, month = nov, year = {2023}, pmid = {37935314}, keywords = {Epidemiology, Health Policy, National Health Programs, Personal Health Services, Physical Therapy Specialty}, pages = {S0003--9993(23)00607--X}, }
@article{clausen_two-year_2023, title = {Two-year {MRI}-defined structural damage and patient-reported outcomes following surgery or exercise for meniscal tears in young adults}, issn = {1473-0480}, doi = {10.1136/bjsports-2023-107352}, abstract = {OBJECTIVE: To investigate potential differences in structural knee joint damage assessed by MRI and patient-reported outcomes (PROMs) at 2-year follow-up between young adults randomised to early surgery or exercise and education with optional delayed surgery for a meniscal tear. METHODS: A secondary analysis of a multicentre randomised controlled trial including 121 patients (18-40 years) with an MRI-verified meniscal tear. For this study, only patients with 2-year follow-up were included. The main outcomes were the difference in worsening of structural knee damage, assessed by MRI using the Anterior Cruciate Ligament OsteoArthrits Score, and the difference in change in the mean score of four Knee Injury and Osteoarthritis Outcome Score (KOOS4) subscales covering pain, symptoms, function in sport and recreation, and quality of life, from baseline to 2 years. RESULTS: In total, 82/121 (68\%) patients completed the 2-year follow-up (39 from the surgical group and 43 from the exercise group). MRI-defined cartilage damage had developed or progressed in seven (9.1\%) patients and osteophytes developed in two (2.6\%) patients. The worsening of structural damage from baseline to 2-year follow-up was similar between groups. The mean (95\% CI) adjusted differences in change in KOOS4 between intervention groups from baseline to 2 years was -1.4 (-9.1, 6.2) points. The mean improvement in KOOS4 was 16.4 (10.4, 22.4) in the surgical group and 21.5 (15.0, 28.0) in the exercise group. No between group differences in improvement were found in the KOOS subscales. CONCLUSIONS: The 2-year worsening of MRI-defined structural damage was limited and similar in young adult patients with a meniscal tear treated with surgery or exercise with optional delayed surgery. Both groups had similar clinically relevant improvements in KOOS4, suggesting the choice of treatment strategy does not impact 2-year structural knee damage or PROMs. TRIAL REGISTRATION NUMBER: NCT02995551.}, language = {eng}, journal = {British Journal of Sports Medicine}, author = {Clausen, Stine Haugaard and Skou, Søren T. and Boesen, Mikael Ploug and Radev, Dimitar Ivanon and Kurt, Engin Yeter and Damsted, Camma and Hölmich, Per and Lind, Martin and Tørring, Sofus and Isaksen, Christin and Varnum, Claus and Englund, Martin and Thorlund, Jonas Bloch}, month = oct, year = {2023}, pmid = {37879858}, keywords = {Arthroscopy, Exercise Therapy, Meniscus, Osteoarthritis}, pages = {bjsports--2023--107352}, }
@article{jahangir_sensitivity_2023, title = {Sensitivity of simulated knee joint mechanics to selected human and bovine fibril-reinforced poroelastic material properties}, volume = {160}, issn = {1873-2380}, doi = {10.1016/j.jbiomech.2023.111800}, abstract = {Fibril-reinforced poroviscoelastic material models are considered state-of-the-art in modeling articular cartilage biomechanics. Yet, cartilage material parameters are often based on bovine tissue properties in computational knee joint models, although bovine properties are distinctly different from those of humans. Thus, we aimed to investigate how cartilage mechanical responses are affected in the knee joint model during walking when fibril-reinforced poroviscoelastic properties of cartilage are based on human data instead of bovine. We constructed a finite element knee joint model in which tibial and femoral cartilages were modeled as fibril-reinforced poroviscoelastic material using either human or bovine data. Joint loading was based on subject-specific gait data. The resulting mechanical responses of knee cartilage were compared between the knee joint models with human or bovine fibril-reinforced poroviscoelastic cartilage properties. Furthermore, we conducted a sensitivity analysis to determine which fibril-reinforced poroviscoelastic material parameters have the greatest impact on cartilage mechanical responses in the knee joint during walking. In general, bovine cartilage properties yielded greater maximum principal stresses and fluid pressures (both up to 30\%) when compared to the human cartilage properties during the loading response in both femoral and tibial cartilage sites. Cartilage mechanical responses were very sensitive to the collagen fibril-related material parameter variations during walking while they were unresponsive to proteoglycan matrix or fluid flow-related material parameter variations. Taken together, human cartilage material properties should be accounted for when the goal is to compare absolute mechanical responses of knee joint cartilage as bovine material parameters lead to substantially different cartilage mechanical responses.}, language = {eng}, journal = {Journal of Biomechanics}, author = {Jahangir, Sana and Esrafilian, Amir and Ebrahimi, Mohammadhossein and Stenroth, Lauri and Alkjær, Tine and Henriksen, Marius and Englund, Martin and Mononen, Mika E. and Korhonen, Rami K. and Tanska, Petri}, month = sep, year = {2023}, pmid = {37797566}, keywords = {Articular cartilage, Fibril-reinforced poroelastic, Finite element modeling, Knee joint, Material properties}, pages = {111800}, }
@article{liew_diagnostic_2023, title = {Diagnostic accuracy of candidate {MRI} knee osteoarthritis definitions versus radiograph in an acute anterior cruciate ligament injury cohort}, issn = {2151-4658}, doi = {10.1002/acr.25248}, abstract = {BACKGROUND: We tested diagnostic accuracy of previously proposed magnetic resonance imaging (MRI) OA definitions in a cohort following acute anterior cruciate ligament (ACL) injury. METHODS: We studied participants with posteroanterior and lateral knee radiographs and MRIs 5 years after ACL injury, scored using the Anterior Cruciate Ligament Osteoarthritis Score. Radiographic OA (ROA) was defined using Osteoarthritis Research Society International scoring of osteophytes and joint space narrowing considering medial/lateral tibiofemoral and patellofemoral compartments. We tested three candidate MRI OA definitions that performed well in an older adult cohort. "MOST simple" required cartilage score ≥2 (range 0-6) and osteophyte score ≥2 (0-7); "MOST optional" included cartilage score ≥2 and osteophyte score ≥2, and either bone marrow lesions (BML) ≥1 (0-3) or synovitis ≥2 (0-3). The third, a Delphi panel definition, included nonzero scores for cartilage, osteophyte, BML, meniscus and other structures. We calculated sensitivity and specificity with 95\% confidence intervals for each MRI definition versus ROA. RESULTS: We included 113 participants (mean age 26 years, 26\% female). At 5 years, 29 (26\%) had ROA. "MOST simple" had a sensitivity of 52\% (95\% CI 33-71\%), and specificity of 76\% (95\% CI 66-85\%). Sensitivity and specificities for "MOST optional" were 28\% (95\% CI 29-67\%) and 83\% (95\% CI 74-91\%), respectively. The Delphi panel definition had a sensitivity of 48\% (95\% CI 29-67\%) and specificity of 77\% (95\% CI 67-86\%). CONCLUSION: Simple MRI-based OA definitions requiring at least cartilage damage and an osteophyte have low sensitivity and high specificity in young persons after knee injury. This article is protected by copyright. All rights reserved.}, language = {eng}, journal = {Arthritis Care \& Research}, author = {Liew, Jean W. and Turkiewicz, Aleksandra and Roemer, Frank W. and Frobell, Richard B. and Felson, David and Englund, Martin}, month = oct, year = {2023}, pmid = {37781746}, }
@article{johansson_use_2023, title = {Use of prescribed analgesics before and after exercise therapy and patient education in patients with knee or hip osteoarthritis}, issn = {1437-160X}, doi = {10.1007/s00296-023-05432-0}, abstract = {The aim of this study was to investigate utilisation patterns of prescribed analgesics before, during, and after an exercise therapy and patient education program among patients with knee or hip osteoarthritis. This cohort study is based on data from the nationwide Good Life with osteoarthritis in Denmark (GLA:D®) patient-register linked with national health registries including data on prescribed analgesics. GLA:D® consists of 8-12 weeks of exercise and patient education. We included 35,549 knee/hip osteoarthritis patients starting the intervention between January 2013 and November 2018. Utilisation patterns the year before, 3 months during, and the year after the intervention were investigated using total dispensed defined daily doses (DDDs) per month per 1000 population as outcome. During the year before the intervention, use of prescribed paracetamol, non-steroidal anti-inflammatory drugs (NSAIDs), and opioids increased with 85\%, 79\% and 22\%, respectively. During the intervention, use of paracetamol decreased with 16\% with a stable use the following year. Use of NSAIDs and opioids decreased with 38\% and 8\%, respectively, throughout the intervention and the year after. Sensitivity analyses indicated that the prescription of most analgesics changed over time. For paracetamol, NSAIDs, and opioids, 10\% of analgesic users accounted for 45\%, 50\%, and 70\%, respectively, of the total DDDs dispensed during the study period. In general, analgesic use increased the year before the intervention followed by a decrease during the intervention and the year after. A small proportion of analgesic users accounted for half or more of all paracetamol, NSAIDs, and opioids dispensed during the study period.}, language = {eng}, journal = {Rheumatology International}, author = {Johansson, Melker S. and Pottegård, Anton and Søndergaard, Jens and Englund, Martin and Grønne, Dorte T. and Skou, Søren T. and Roos, Ewa M. and Thorlund, Jonas B.}, month = sep, year = {2023}, pmid = {37775621}, keywords = {Exercise therapy, Non-steroidal anti-inflammatory drugs, Opioids, Osteoarthritis, Paracetamol, Patient education}, }
@article{battista_factors_2023, title = {Factors {Associated} {With} {Adherence} to a {Supervised} {Exercise} {Intervention} for {Osteoarthritis}: {Data} {From} the {Swedish} {Osteoarthritis} {Registry}}, volume = {75}, issn = {2151-4658}, shorttitle = {Factors {Associated} {With} {Adherence} to a {Supervised} {Exercise} {Intervention} for {Osteoarthritis}}, doi = {10.1002/acr.25135}, abstract = {OBJECTIVE: To explore how lifestyle and demographic, socioeconomic, and disease-related factors are associated with supervised exercise adherence in an osteoarthritis (OA) management program and the ability of these factors to explain exercise adherence. METHODS: A cohort register-based study on participants from the Swedish Osteoarthritis Registry who attended the exercise part of a nationwide Swedish OA management program. We ran a multinomial logistic regression to determine the association of exercise adherence with the abovementioned factors. We calculated their ability to explain exercise adherence with the McFadden R2 . RESULTS: Our sample comprises 19,750 participants (73\% female, mean ± SD age 67 ± 8.9 years). Among them, 5,862 (30\%) reached a low level of adherence, 3,947 (20\%) a medium level, and 9,941 (50\%) a high level. After a listwise deletion, the analysis was run on 16,685 participants (85\%), with low levels of adherence as the reference category. Some factors were positively associated with high levels of adherence, such as older age (relative risk ratio [RRR] 1.01 [95\% confidence interval (95\% CI) 1.01-1.02] per year), and the arthritis-specific self-efficacy (RRR 1.04 [95\% CI 1.02-1.07] per 10-point increase). Others were negatively associated with high levels of adherence, such as female sex (RRR 0.82 [95\% CI 0.75-0.89]), having a medium (RRR 0.89 [95\% CI 0.81-0.98] or a high level of education (RRR 0.84 [95\% CI 0.76-0.94]). Nevertheless, the investigating factors could explain 1\% of the variability in exercise adherence (R2 = 0.012). CONCLUSION: Despite the associations reported above, the poorly explained variability suggests that strategies based on lifestyle and demographic, socioeconomic, and disease-related factors are unlikely to improve exercise adherence significantly.}, language = {eng}, number = {10}, journal = {Arthritis Care \& Research}, author = {Battista, Simone and Kiadaliri, Ali and Jönsson, Thérése and Gustafsson, Kristin and Englund, Martin and Testa, Marco and Dell'Isola, Andrea}, month = oct, year = {2023}, pmid = {37070612}, keywords = {Aged, Exercise, Exercise Therapy, Female, Humans, Male, Middle Aged, Osteoarthritis, Osteoarthritis, Knee, Registries, Sweden}, pages = {2117--2126}, }
@article{dellisola_use_2023, title = {Use of non-surgical treatments on the journey to knee replacement in patients with knee osteoarthritis: a 10-year population-based case-control study}, volume = {9}, issn = {2056-5933}, shorttitle = {Use of non-surgical treatments on the journey to knee replacement in patients with knee osteoarthritis}, doi = {10.1136/rmdopen-2023-003422}, abstract = {AIM: To investigate temporal trends in primary care visits, physiotherapy visits, dispensed non-steroidal anti-inflammatory drugs (NSAIDs) and opioids in knee osteoarthritis (OA) patients who have and have not undergone knee replacement. METHODS: We analysed 5665 OA patients from the Skåne Healthcare Register, Sweden, who underwent knee replacement between 2015 and 2019. Controls were OA patients without knee replacement, matched 1:1 by sex, age, time and healthcare level of initial OA diagnosis, and assigned a pseudo-index date corresponding to their case's knee replacement date. Annual prevalence and prevalence ratio of primary care and physiotherapy visits, dispensed NSAIDs and opioids (all for any cause) in the 10 years before knee replacement were estimated using Poisson regression. RESULTS: The annual prevalence of all-cause primary care visits, physiotherapy visits and opioid use was similar between cases and controls until 3 years before the index date when it started to increase among the cases. The year before the index date, the prevalence ratio (cases vs controls) for physiotherapy use was 1.8 (95\% CI 1.7, 1.8), while for opioid use 1.6 (1.5, 1.7). NSAID use was consistently higher among cases, even 10 years before the index date when the prevalence ratio versus controls was 1.3 (1.2, 1.3), increasing to 1.8 (1.7, 1.9) in the year preceding the index date. CONCLUSIONS: Management of OA patients who have and have not undergone knee replacement appears largely similar except for higher use of NSAIDs in knee replacement cases. Symptomatic treatments start to increase a few years before the surgery in knee replacement cases.}, language = {eng}, number = {3}, journal = {RMD open}, author = {Dell'Isola, Andrea and Hellberg, Clara and Turkiewicz, Aleksandra and Appleyard, Tom and Yu, Dahai and Thomas, Geraint and Peat, George and Englund, Martin}, month = sep, year = {2023}, pmid = {37739449}, keywords = {Analgesics, Opioid, Anti-Inflammatory Agents, Non-Steroidal, Case-Control Studies, Epidemiology, Humans, Opioid-Related Disorders, Osteoarthritis, Knee, Rehabilitation}, pages = {e003422}, }
@article{magnusson_genetic_2023, title = {Genetic influence to osteoarthritis versus other rheumatic diseases}, issn = {2326-5205}, doi = {10.1002/art.42696}, abstract = {AIM: To compare the genetic contribution to osteoarthritis (OA) vs other rheumatic/musculoskeletal diseases (RMDs) in the same population, and 2) to explore the role for any shared genetics between OA and other RMDs. METHODS: In 59 970 Swedish twins aged 35 years or older, we estimated the heritability (the variance explained by genetic factors) to OA in peripheral joints, back and neck pain, shoulder pain (adhesive capsulitis, impingement syndrome, etc), rheumatoid arthritis (RA), spondyloarthritis and psoriatic arthritis (SpA/PSA), myalgia and osteoporosis diagnosed in specialist and inpatient care. We also studied how much of covariance between OA and each of the RMDs could be explained by genetics, by studying phenotypic correlations in bivariate classical twin models. RESULTS: Any-site OA and hip OA (50\% and 64\%) were among the most heritable RMDs (as compared to 23\% for fibromyalgia (lowest) and 63\% for spondylarthritis (highest)). The highest phenotypic correlations were between OA (any joint site) and shoulder pain in the same individual (r=0.33, 95\% CI=0.31-0.35), of which 70\% (52-88) could be explained by shared genetics. The phenotypic correlation between OA and back/neck pain was r=0.25, with 25\%-75\% explained by genetics. Phenotypic correlations between OA and each of the other RMDs were lower (r{\textasciitilde}0.1 to r{\textasciitilde}0.2) with inconclusive sources of variation. CONCLUSION: OA has relatively large heritability as compared to other RMDs. The co-existence of OA and shoulder pain, as well as back pain, was common and could often be explained by genetic factors. Findings imply similar etiologies of OA and several pain conditions.}, language = {eng}, journal = {Arthritis \& Rheumatology (Hoboken, N.J.)}, author = {Magnusson, Karin and Turkiewicz, Aleksandra and Rydén, Martin and Englund, Martin}, month = sep, year = {2023}, pmid = {37691153}, }
@article{englund_osteoarthritis_2023, title = {Osteoarthritis, part of life or a curable disease? {A} bird's-eye view}, issn = {1365-2796}, shorttitle = {Osteoarthritis, part of life or a curable disease?}, url = {https://onlinelibrary.wiley.com/doi/full/10.1111/joim.13634}, doi = {10.1111/joim.13634}, abstract = {Osteoarthritis (OA) is a chronic joint disease caused by disruption of joint homeostasis by a variety of systemic and biomechanical factors. The disease is characterized by degradation of cartilage and other joint tissues, and low-grade inflammation which may result in pain, reduced function, and disability. The disease appears to have ancient origins, with findings of OA recognized in fossilized bones from birdlike dinosaurs living some 130 million years ago. Today, the burden of OA in the world's population is steadily increasing due to aging and often rising rates of obesity. Structural findings, indicative of the disease, are also frequent in asymptomatic persons, which make the distinction between disease and normal aging sometimes challenging. OA is frequently associated with comorbidity in the form of obesity, cardiovascular disease, and depressive symptoms. The current management and treatments largely rely on contextual factors, and the actual effects of the intended therapeutic element of today's interventions are minor. The different mechanistic pathways (endotypes) and clinical characteristics (phenotypes) of OA make the development of disease-modifying treatments challenging. Current development of drug candidates, aimed to restore joint homeostasis, is mainly targeting either inhibition of catabolic factors or stimulation of anabolic factors. However, there is yet no breakthrough in stage III clinical trials. Earlier diagnosis, better knowledge of endotypes-for example, by new insights into soluble biomarkers, and compositional imaging-and more careful selection of patients into clinical trials are possible tools to aid development of future therapies.}, language = {eng}, journal = {Journal of Internal Medicine}, author = {Englund, Martin}, month = apr, year = {2023}, pmid = {37004213}, keywords = {epidemiology, etiology, osteoarthritis, pain, therapeutics}, }
@article{liew_scoping_2023, title = {A scoping review of how early-stage knee osteoarthritis has been defined}, volume = {293}, issn = {1063-4584}, url = {https://www.sciencedirect.com/science/article/pii/S1063458423007975}, doi = {10.1016/j.joca.2023.04.015}, abstract = {Background Early-stage knee osteoarthritis (KOA) classification criteria will enable consistent identification and trial recruitment of individuals with knee osteoarthritis (OA) at an earlier stage of the disease when interventions may be more effective. Toward this goal, we identified how early-stage KOA has been defined in the literature. Methods We performed a scoping literature review in PubMed, EMBASE, Cochrane, and Web of Science, including human studies where early-stage KOA was included as a study population or outcome. Extracted data included demographics, symptoms/history, examination, laboratory, imaging, performance-based measures, gross inspection/histopathologic domains, and the components of composite early-stage KOA definitions. Results Of 6142 articles identified, 211 were included in data synthesis. An early-stage KOA definition was used for study inclusion in 194 studies, to define study outcomes in 11 studies, and in the context of new criteria development or validation in six studies. The element most often used to define early-stage KOA was Kellgren–Lawrence (KL) grade (151 studies, 72\%), followed by symptoms (118 studies, 56\%), and demographic characteristics (73 studies, 35\%); 14 studies (6\%) used previously developed early-stage KOA composite criteria. Among studies defining early-stage KOA radiographically, 52 studies defined early-stage KOA by KL grade alone; of these 52, 44 (85\%) studies included individuals with KL grade 2 or higher in their definitions. Conclusion Early-stage KOA is variably defined in the published literature. Most studies included KL grades of 2 or higher within their definitions, which reflects established or later-stage OA. These findings underscore the need to develop and validate classification criteria for early-stage KOA.}, language = {en}, number = {6}, urldate = {2023-06-07}, journal = {Osteoarthritis and Cartilage}, author = {Liew, Jean W. and King, Lauren K. and Mahmoudian, Armaghan and Wang, Qiuke and Atkinson, Hayden F. and Flynn, David B. and Appleton, C. Thomas and Englund, Martin and Haugen, Ida K. and Lohmander, L. Stefan and Runhaar, Jos and Neogi, Tuhina and Hawker, Gillian}, month = may, year = {2023}, note = {Number: 6}, keywords = {Classification criteria, Early-stage osteoarthritis, Knee osteoarthritis, Osteoarthritis, Scoping review, Symptomatic knee osteoarthritis}, pages = {681--693}, }
@article{pineda-moncusi_classification_2023-1, title = {Classification of patients with osteoarthritis through clusters of comorbidities using 633,330 individuals from {Spain}}, issn = {1462-0332}, url = {https://doi.org/10.1093/rheumatology/kead038}, doi = {10.1093/rheumatology/kead038}, abstract = {OBJECTIVES: To explore clustering of comorbidities among patients with a new diagnosis of osteoarthritis (OA) and estimate the 10-year mortality risk for each identified cluster. METHODS: This is a population-based cohort study of individuals with first incident diagnosis of OA of the hip, knee, ankle/foot, wrist/hand, or 'unspecified' site between 2006 and 2020, using SIDIAP (a primary care database representative from Catalonia, Spain). At the time of OA diagnosis, conditions associated with OA in the literature that were found in ≥ 1\% of the individuals (n = 35) were fitted into two cluster algorithms, K-means and latent class analysis (LCA). Models were assessed using a range of internal and external criteria evaluation procedures. Mortality risk of the obtained clusters was assessed by survival analysis using Cox proportional hazards. RESULTS: We identified 633 330 patients with a diagnosis of OA. Our proposed best solution used LCA to identify four clusters: 'Low-morbidity (relatively low number of comorbidities), 'Back/neck pain plus mental health', 'Metabolic syndrome' and 'Multimorbidity' (higher prevalence of all study comorbidities). Compared with the 'Low-morbidity, the 'Multimorbidity' cluster had the highest risk of 10-year mortality (adjusted HR: 2.19 [95\%CI: 2.15-2.23]), followed by 'Metabolic syndrome' (adjusted HR: 1.24 [95\%CI: 1.22-1.27]]) and 'Back/neck pain plus mental health' (adjusted HR: 1.12 [95\%CI: 1.09-1.15]). CONCLUSION: Patients with a new diagnosis of OA can be clustered into groups based on their comorbidity profile, with significant differences in 10-year mortality risk. Further research is required to understand the interplay between OA and particular comorbidity groups, and the clinical significance of such results.}, language = {eng}, journal = {Rheumatology (Oxford, England)}, author = {Pineda-Moncusí, Marta and Dernie, Francesco and Dell'Isola, Andrea and Kamps, Anne and Runhaar, Jos and Swain, Subhashisa and Zhang, Weiya and Englund, Martin and Pitsillidou, Irene and Strauss, Victoria Y. and Robinson, Danielle E. and Prieto-Alhambra, Daniel and Khalid, Sara}, month = jan, year = {2023}, pmid = {36688706}, keywords = {Epidemiology, clustering, comorbidities, osteoarthritis}, pages = {kead038}, }
@article{lindeus_does_2023, title = {Does lower educational attainment increase the risk of osteoarthritis surgery? a {Swedish} twin study}, volume = {24}, issn = {1471-2474}, shorttitle = {Does lower educational attainment increase the risk of osteoarthritis surgery?}, url = {https://doi.org/10.1186/s12891-023-06163-w}, doi = {10.1186/s12891-023-06163-w}, abstract = {Previous studies have reported an inverse association between educational attainment and different osteoarthritis (OA) outcomes. However, none of the previous studies have accounted for potential confounding by early-life environment and genetics. Thus, we aimed to examine the association between educational attainment and knee and hip OA surgery using twin data.}, number = {1}, urldate = {2023-02-02}, journal = {BMC Musculoskeletal Disorders}, author = {Lindéus, Maria and Turkiewicz, Aleksandra and Magnusson, Karin and Englund, Martin and Kiadaliri, Ali}, month = jan, year = {2023}, note = {Number: 1}, keywords = {Education, Inequalities, Osteoarthritis surgery, Twin study}, pages = {72}, }
@article{isacsson_incidence_2023, title = {Incidence and concomitant chondral injuries in a consecutive cohort of primary traumatic patellar dislocations examined with sub-acute {MRI}}, volume = {47}, issn = {1432-5195}, url = {https://doi.org/10.1007/s00264-023-05707-y}, doi = {10.1007/s00264-023-05707-y}, abstract = {To present age- and sex-specific cumulative annual incidences of primary traumatic lateral patellar dislocation (LPD) and to detail patient characteristics and concomitant chondral injuries including osteochondral fractures, as visualized on magnetic resonance imaging (MRI), in a large consecutive cohort of knee-injured individuals.}, language = {en}, number = {4}, urldate = {2023-03-06}, journal = {International Orthopaedics}, author = {Isacsson, Anders and Olsson, Ola and Englund, Martin and Frobell, Richard B.}, month = feb, year = {2023}, note = {Number: 4}, keywords = {Epidemiology, Osteochondral injury, Patellar dislocation, Sports}, pages = {973--981}, }
@article{emin_imaging-based_2023, title = {Imaging-based assessment of fatty acid composition in human bone marrow adipose tissue at 7 {T}: {Method} comparison and in vivo feasibility}, volume = {90}, copyright = {© 2023 The Authors. Magnetic Resonance in Medicine published by Wiley Periodicals LLC on behalf of International Society for Magnetic Resonance in Medicine.}, issn = {1522-2594}, shorttitle = {Imaging-based assessment of fatty acid composition in human bone marrow adipose tissue at 7 {T}}, url = {https://onlinelibrary.wiley.com/doi/abs/10.1002/mrm.29623}, doi = {10.1002/mrm.29623}, abstract = {Purpose To demonstrate the feasibility and accuracy of chemical shift–encoded imaging of the fatty acid composition (FAC) of human bone marrow adipose tissue at 7 T, and to determine suitable image-acquisition parameters using simulations. Methods The noise performance of FAC estimation was investigated using simulations with a range of inter-echo time, and accuracy was assessed using a phantom experiment. Furthermore, one knee of 8 knee-healthy subjects (ages 35–54 years) was imaged, and the fractions of saturated fatty acids (SFA) and polyunsaturated fatty acids (PUFA) were mapped. Values were compared between reconstruction methods, and between anatomical regions. Results Based on simulations, ΔTE = 0.6 ms was chosen. The phantom experiment demonstrated high accuracy of especially SFA using a constrained reconstruction model (slope = 1.1, average bias = −0.2\%). The lowest accuracy was seen for PUFA using a free model (slope = 2.0, average bias = 9.0\%). For in vivo images, the constrained model resulted in lower intersubject variation compared with the free model (e.g., in the femoral shaft, the SFA percent-point range was within 1.0\% [vs. 3.0\%]). Furthermore, significant regional FAC differences were detected. For example, using the constrained approach, the femoral SFA in the medial condyle was lower compared with the shaft (median [range]: 27.9\% [27.1\%, 28.4\%] vs. 32.5\% [31.8\%, 32.8\%]). Conclusion Bone marrow adipose tissue FAC quantification using chemical-shift encoding is feasible at 7 T. Both the noise performance and accuracy of the technique are superior using a constrained signal model.}, language = {en}, number = {1}, urldate = {2023-03-28}, journal = {Magnetic Resonance in Medicine}, author = {Emin, Sevgi and Oei, Edwin H. G. and Englund, Martin and Peterson, Pernilla}, month = feb, year = {2023}, note = {Number: 1 \_eprint: https://onlinelibrary.wiley.com/doi/pdf/10.1002/mrm.29623}, keywords = {7 T, MRI, bone marrow adipose tissue, chemical shift–encoded imaging, fatty acid composition}, pages = {240--249}, }
@article{boric-persson_sick_2023, title = {Sick leave after arthroscopic meniscus repair vs. arthroscopic partial meniscectomy}, volume = {5}, issn = {2665-9131}, url = {https://www.sciencedirect.com/science/article/pii/S2665913123000079}, doi = {10.1016/j.ocarto.2023.100340}, abstract = {Objective To evaluate sick leave after meniscal repair vs arthroscopic partial meniscectomy (APM) and, for comparison, vs the general population. Method Using Swedish register data we included all employed persons aged 19–49 years in the general population of Skåne region and identified those having had meniscus repair or APM in the period of 2005–2012. We retrieved data on sick leave during 1 year before until 2 years after surgery. We used logistic regression to estimate the risk differences of being on sick leave and negative binomial model to analyze differences in the number of days on sick leave. Results We included 192 persons with meniscus repair, 2481 with APM, and 376 345 references without meniscus surgery. Of these, 55\% of meniscus repair group, 43\% of APM group had any sick leave in the 2-year period following the surgery, while 17\% of the references were on sick leave in the corresponding period. The mean (SD) number of days of sick leave after meniscus repair was 55 (77) days and for APM 37 (86) days. Meniscus repair was associated with higher probability of sick leave compared to APM with an adjusted risk difference of 0.13 (95\% CI 0.07–0.19). Conclusion Persons undergoing meniscus repair have more frequent and 37\% longer periods of sick leave in the short term than persons undergoing APM. However, sick leave in the long-term warrant further attention as successful repair may be associated with less knee osteoarthritis development than APM.}, language = {en}, number = {1}, urldate = {2023-03-06}, journal = {Osteoarthritis and Cartilage Open}, author = {Boric-Persson, Fredrik and Turkiewicz, Aleksandra and Neuman, Paul and Englund, Martin}, month = mar, year = {2023}, note = {Number: 1}, keywords = {Arthroscopy, Meniscus, Meniscus repair, Partial meniscectomy, Sick leave}, pages = {100340}, }
@article{diarbakerli_learning_2022, title = {Learning from the past to plan for the future: {A} scoping review of musculoskeletal clinical research in {Sweden} 2010–2020}, volume = {127}, copyright = {Copyright (c) 2022 Elias Diarbakerli, Olof Thoreson, Martin Björklund, Leif E. Dahlberg, Martin Englund, Paul Gerdhem, Joanna Kvist, Maziar Mohaddes, Anneli Peolsson, Ola Rolfson, Birgitta Öberg, Allan Abbott}, issn = {2000-1967}, shorttitle = {Learning from the past to plan for the future}, url = {https://ujms.net/index.php/ujms/article/view/8709}, doi = {10.48101/ujms.v127.8709}, abstract = {Background: The aims of this study are to 1) determine the scope of musculoskeletal (MSK)-related clinical research in Sweden; 2) collate the amount of first-tier funding received; 3) discuss strategies and infrastructure supporting future MSK clinical trials in Sweden. Methods: A systematic scoping review protocol was applied in PubMed, Scopus, and SweCRIS databases. The articles were examined, and data were extracted in multiple stages by three blinded authors. Results: The search strategy resulted in 3,025 publications from 479 Swedish-affiliated authors. Primary health care was the basis for 14\% of the publications, 84\% from secondary health care, and 2\% from occupational health care with a similar proportional distribution of first-tier research grant financing. Approximately one in six publications were randomized controlled trials (RCTs), while the majority were of observational cohort design. The majority of publications in primary and occupational health care were related to pain disorders (51 and 67\%, respectively), especially diagnosis, prognosis, and healthcare organizational-related interventions (34\%) and rehabilitation (15\%) with similar proportional distribution of first-tier research grant financing. In secondary health care, rheumatic inflammatory disorder-related publications were most prevalent (30\%), most frequently concerning diagnosis, prognosis, and healthcare organizational-related interventions (20\%), attracting approximately half of all first-tier funding. Publications related to degenerative joint disorders (25\%), fractures (16\%), and joint, tendon, and muscle injuries (13\%) frequently concerned surgical and other orthopedic-related interventions (16, 6, and 8\%, respectively). Pain disorder-related publications (10\%) as well as bone health and osteoporosis-related publications (4\%) most frequently concerned diagnosis, prognosis, and healthcare organizational-related interventions (5 and 3\%, respectively). Conclusions: Swedish-affiliated MSK disorder research 2010–2020 was predominantly observational cohort rather than RCT based. There was skewed first-tier funding allocation considering prevalence/incidence and burden of disease. Use of infrastructure supporting register-based RCTs, placebo-controlled RCTs, and hybrid effectiveness-implementation studies on prevention and clinical intervention is important strategies for the future in all healthcare sectors.}, language = {en}, urldate = {2022-11-22}, journal = {Upsala Journal of Medical Sciences}, author = {Diarbakerli, Elias and Thoreson, Olof and Björklund, Martin and Dahlberg, Leif E. and Englund, Martin and Gerdhem, Paul and Kvist, Joanna and Mohaddes, Maziar and Peolsson, Anneli and Rolfson, Ola and Öberg, Birgitta and Abbott, Allan}, month = sep, year = {2022}, keywords = {Musculoskeletal disorders, Sweden, clinical research, occupational health care, primary health care, research design, research funding, secondary health care}, }
@article{swain_clustering_2022, title = {Clustering of comorbidities and associated outcomes in people with osteoarthritis - {A} {UK} {Clinical} {Practice} {Research} {Datalink} study}, issn = {1063-4584}, url = {https://www.sciencedirect.com/science/article/pii/S1063458422000139}, doi = {10.1016/j.joca.2021.12.013}, abstract = {Objective To examine the clusters of chronic conditions present in people with osteoarthritis and the associated risk factors and health outcomes. Methods Clinical Practice Research Datalink (CPRD) GOLD was used to identify people diagnosed with incident osteoarthritis (n = 221,807) between 1997 and 2017 and age (±2 years), gender, and practice matched controls (no osteoarthritis, n = 221,807) from UK primary care. Clustering of people was examined for 49 conditions using latent class analysis. The associations between cluster membership and covariates were quantified by odds ratios (OR) using multinomial logistic regression. General practice (GP) consultations, hospitalisations, and all-cause mortality rates were compared across the clusters identified at the time of first diagnosis of osteoarthritis (index date). Results In both groups, conditions largely grouped around five clusters: relatively healthy; cardiovascular (CV), musculoskeletal-mental health (MSK-MH), CV-musculoskeletal (CV-MSK) and metabolic (MB). In the osteoarthritis group, compared to the relatively healthy cluster, strong associations were seen for 1) age with all clusters; 2) women with the MB cluster (OR 5.55: 5.14–5.99); 3) obesity with the CV-MSK (OR 2.11: 2.03–2.20) and CV clusters (OR 2.03: 1.97–2.09). The CV-MSK cluster in the osteoarthritis group had the highest number of GP consultations and hospitalisations, and the mortality risk was 2.45 (2.33–2.58) times higher compared to the relatively healthy cluster. Conclusions Of the five identified clusters, CV-MSK, CV, and MSK-MH are more common in OA and CV-MSK cluster had higher health utilisation. Further research is warranted to better understand the mechanistic pathways and clinical implications.}, language = {en}, urldate = {2022-04-21}, journal = {Osteoarthritis and Cartilage}, author = {Swain, S. and Coupland, C. and Strauss, V. and Mallen, C. and Kuo, C. F. and Sarmanova, A. and Bierma-Zeinstra, S. M. A. and Englund, M. and Prieto-Alhambra, D. and Doherty, M. and Zhang, W.}, month = feb, year = {2022}, keywords = {Clusters, Comorbidity, Health utilisation, Osteoarthritis, Primary care, UK}, }
@article{stamatis_epidemiology_2022, title = {Epidemiology of biopsy-confirmed giant cell arteritis in southern {Sweden}—an update on incidence and first prevalence estimate}, volume = {61}, issn = {1462-0324}, url = {https://doi.org/10.1093/rheumatology/keab269}, doi = {10.1093/rheumatology/keab269}, abstract = {To characterize the epidemiology of temporal artery biopsy-positive (TAB+) GCA, including trends in incidence, seasonal variation and prevalence in Skåne, the southernmost region of Sweden.All histopathology reports of TABs from 1997 through 2019 were reviewed to identify patients diagnosed with TAB+ GCA. Incidence rates based on the 23-year period and the point-prevalence at 31 December 2014 were determined. An alternative prevalence calculation included only TAB+ GCA patients living in the study area and receiving immunosuppressant therapy on the point-prevalence date.One thousand three hundred and sixty patients were diagnosed with TAB+ GCA (71\% female). The average annual incidence 1997–2019 was 13.3 (95\% CI: 12.6, 14.0) per 100 000 inhabitants aged ≥50 years and was higher in females (17.8; 95\% CI: 16.7, 18.9) than in males (8.2; 95\% CI: 7.4, 9.0). The age- and sex-standardized incidence declined from 17.3 in 1997 to 8.7 in 2019, with incidence ratio (IR) of 0.98 per year (95\% CI: 0.98, 0.99). A seasonal variation was observed with higher incidence during spring than winter [IR = 1.19 (95\% CI: 1.03, 1.39)]. The overall point-prevalence of TAB+ GCA was 127.1/100 000 (95\% CI: 117, 137.3) and was 75.5 (95\% CI: 67.7, 83.3) when including only patients receiving immunosuppressants.Over the past 2 decades, the incidence of biopsy-confirmed GCA has decreased by ∼2\% per year. Still, a high prevalence of GCA on current treatment was observed. More cases are diagnosed during spring and summer than in the winter.}, number = {1}, urldate = {2022-04-21}, journal = {Rheumatology}, author = {Stamatis, Pavlos and Turkiewicz, Aleksandra and Englund, Martin and Turesson, Carl and Mohammad, Aladdin J}, month = jan, year = {2022}, note = {Number: 1}, pages = {146--153}, }
@article{haugen_development_2022, title = {Development of radiographic classification criteria for hand osteoarthritis: a methodological report ({Phase} 2)}, volume = {8}, issn = {2056-5933}, shorttitle = {Development of radiographic classification criteria for hand osteoarthritis}, url = {https://doi.org/10.1136/rmdopen-2021-002024}, doi = {10.1136/rmdopen-2021-002024}, abstract = {OBJECTIVES: In Phase 1 of developing new hand osteoarthritis (OA) classification criteria, features associated with hand OA were identified in a population with hand complaints. Radiographic findings could better discriminate patients with hand OA and controls than clinical examination findings. The objective of Phase 2 was to achieve consensus on the features and their weights to be included in three radiographic criteria sets of overall hand OA, interphalangeal OA and thumb base OA. METHODS: Multidisciplinary, international expert panels were convened. Patient vignettes were used to identify important features consistent with hand OA. A consensus-based decision analysis approach implemented using 1000minds software was applied to identify the most important features and their relative importance influencing the likelihood of symptoms being due to hand OA. Analyses were repeated for interphalangeal and thumb base OA. The reliability and validity of the proposed criteria sets were tested. RESULTS: The experts agreed that the criteria sets should be applied in a population with pain, aching or stiffness in hand joint(s) not explained by another disease or acute injury. In this setting, five additional criteria were considered important: age, morning stiffness, radiographic osteophytes, radiographic joint space narrowing and concordance between symptoms and radiographic findings. The reliability and validity were very good. CONCLUSION: Radiographic features were considered critical when determining whether a patient had symptoms due to hand OA. The consensus-based decision analysis approach in Phase 2 complemented the data-driven results from Phase 1, which will form the basis of the final classification criteria sets.}, language = {eng}, number = {1}, journal = {RMD open}, author = {Haugen, Ida K. and Felson, David and Abhishek, Abhishek and Berenbaum, Francis and Edwards, John James and Herrero Beaumont, Gabriel and Hermann-Eriksen, Merete and Hill, Catherine L. and Ishimori, Mariko and Jonsson, Helgi and Karjalainen, Teemu and Leung, Ying Ying and Maheu, Emmanuel and Mallen, Christian D. and Moe, Rikke Helene and Ramonda, Roberta and Ritschl, Valentin and Stamm, Tanja A. and Szekanecz, Zoltan and van der Giesen, Florus J. and Ritt, Marco J. P. F. and Wittoek, Ruth and Kjeken, Ingvild and Osteras, Nina and van de Stadt, Lotte A. and Englund, Martin and Dziedzic, Krysia S. and Marshall, M. and Bierma-Zeinstra, Sita and Hansen, Paul and Greibrokk, Elsie and Smeets, Wilma and Kloppenburg, Margreet}, month = feb, year = {2022}, pmid = {35121640}, pmcid = {PMC8819785}, note = {Number: 1}, keywords = {Hand, Humans, Osteoarthritis, Radiography, Reproducibility of Results, epidemiology, health care, osteoarthritis, outcome assessment}, pages = {e002024}, }
@article{ali_proteomics_2022, title = {Proteomics profiling of human synovial fluid suggests increased protein interplay in early-osteoarthritis ({OA}) that is lost in late-stage {OA}}, volume = {21}, issn = {1535-9484}, url = {https://doi.org/10.1016/j.mcpro.2022.100200}, doi = {10.1016/j.mcpro.2022.100200}, abstract = {The underlying molecular mechanisms in osteoarthritis (OA) development are largely unknown. This study explores the proteome and the pairwise interplay of proteins in synovial fluid from patients with late-stage knee OA (arthroplasty), early knee OA (arthroscopy due to degenerative meniscal tear), and from deceased controls without knee OA. Synovial fluid samples were analyzed using state-of-the-art mass spectrometry with data-independent acquisition. The differential expression of the proteins detected was clustered and evaluated with data mining strategies and a multilevel model. Group-specific slopes of associations were estimated between expressions of each pair of identified proteins to assess the co-expression (i.e., interplay) between the proteins in each group. More proteins were increased in early-OA versus controls than late-stage OA versus controls. For most of these proteins, the fold changes between late-stage OA versus controls and early-stage OA versus controls were remarkably similar suggesting potential involvement in the OA process. Further, for the first time, this study illustrated distinct patterns in protein co-expression suggesting that the interplay between the protein machinery is increased in early-OA and lost in late-stage OA. Further efforts should focus on earlier stages of the disease than previously considered.}, language = {eng}, number = {3}, journal = {Molecular \& cellular proteomics: MCP}, author = {Ali, Neserin and Turkiewicz, Aleksandra and Hughes, Velocity and Folkesson, Elin and Tjörnstand, Jon and Neuman, Paul and Önnerfjord, Patrik and Englund, Martin}, month = mar, year = {2022}, pmid = {35074580}, pmcid = {PMC8941261}, note = {Number: 3}, keywords = {DIA, Humans, Mass Spectrometry, Osteoarthritis, Knee, Proteome, Proteomics, Synovial Fluid, early- and late-stage OA, osteoarthritis, proteomics, synovial fluid}, pages = {100200}, }
@article{rathmann_infection_2022, title = {Infection is associated with increased risk of {MPO}- but not {PR3}-{ANCA} associated vasculitis}, issn = {1462-0332}, url = {https://doi.org/10.1093/rheumatology/keac163}, doi = {10.1093/rheumatology/keac163}, abstract = {OBJECTIVES: To determine whether development of ANCA-associated vasculitis (AAV) shows a relationship to a prior infection and if prior infection affects disease characteristics and outcome. METHODS: All incident cases of AAV diagnosed in a defined region of Sweden from 2000 through 2016 were identified. For each case, 10 individuals from the general population, matched for age, sex, and area of residence, were selected. Infections occurring in AAV patients and controls prior to the date of AAV diagnosis (index date for respective controls) were identified using an administrative database. Conditional logistic regression models were used to calculate odds ratios (OR) of developing AAV. Occurrence, clinical characteristics, and outcome of AAV were analysed with respect to prior infection. RESULTS: Two-hundred-seventy patients with AAV (48\% female) and 2687 controls were included. Prior to diagnosis/index date, 146 (54\%) AAV patients had been diagnosed with infection vs 1282 (48\%) controls, with OR for AAV 1.57 (95\% CI 1.18-2.19) in those with infections of the upper respiratory tract and 1.68 (1.02-2.77) in those with pneumonia. Difference from controls was significant in patients with myeloperoxidase (MPO-) 1.99 (95\% CI 1.25-3.1) but not in those with proteinase-3 (PR3)-ANCA 1.0 (0.61-1.52). Patients with prior infection showed higher disease activity at AAV diagnosis. No differences in disease characteristics, comorbidities, or outcome in those with and without prior infections were observed. CONCLUSIONS: Respiratory tract infections are positively associated with development of MPO- but not PR3-ANCA-vasculitis. Prior infection is associated with higher disease activity at AAV diagnosis.}, language = {eng}, journal = {Rheumatology (Oxford, England)}, author = {Rathmann, Jens and Stamatis, Pavlos and Jönsson, Göran and Englund, Martin and Segelmark, Mårten and Jayne, David and Mohammad, Aladdin J.}, month = mar, year = {2022}, pmid = {35289842}, keywords = {Epidemiology, autoantibodies, autoimmune disease, granulomatosis with polyangiitis, systemic vasculitis}, pages = {keac163}, }
@article{meng_causal_2022, title = {Causal {Associations} of {Circulating} {Lipids} with {Osteoarthritis}: {A} {Bidirectional} {Mendelian} {Randomization} {Study}}, volume = {14}, issn = {2072-6643}, shorttitle = {Causal {Associations} of {Circulating} {Lipids} with {Osteoarthritis}}, url = {https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9000847/}, doi = {10.3390/nu14071327}, abstract = {Osteoarthritis (OA) imposes an increasing social burden due to global activity limitations, especially among the aged. Links between circulating lipids and OA have been reported; however, confounding data from observational studies have hindered causal conclusions. We used Mendelian randomization (MR) approach to evaluate the genetic causal effects of circulating apolipoproteins and lipoprotein lipids on OA risk. Genetic instruments at the genome-wide significance level (p {\textless} 5 × 10−8) were selected from genome-wide association studies (n = 393,193–441,016 individuals). Summary-level OA data were obtained from the UK Biobank (39,427 cases, 378,169 controls). Bidirectional two-sample Mendelian randomization (MR) analyses used MR-Egger, weighted median, and MR-PRESSO for sensitivity analysis. Genetic predisposition to 1-SD increments of Apolipoprotein B (APOB), and low-density lipoprotein (LDL) was associated with a decreased risk of knee or hip OA (KHOA) (odds ratio (OR) = 0.925, 95\% confidence interval (95\% CI): 0.881–0.972, p = 0.002; OR = 0.898, 95\% CI: 0.843–0.957, p = 0.001) and hip OA (HOA) (OR = 0.894; 95\% CI: 0.832–0.961, p = 0.002; OR = 0.870 95\% CI: 0.797–0.949, p = 0.002). Genetically predicted APOB showed an association with knee OA (KOA) (OR per SD increase, 0.930, 95\% CI: 0.876–0.987, p = 0.016). The OR of KOA was 0.899 (95\% CI: 0.835–0.968, p = 0.005) for a 1-SD increase in LDL. Apolipoprotein A1, high-density lipoprotein, and triglycerides showed no association. Inverse MR showed no causal effect of KOA, HOA, or KHOA on these serum lipids. Distinct protective genetic-influence patterns were observed for APOB and LDL on OA, offering new insights into relationships between lipids and OA risk and a better understanding of OA etiology.}, number = {7}, urldate = {2023-06-19}, journal = {Nutrients}, author = {Meng, Hongen and Jiang, Li and Song, Zijun and Wang, Fudi}, month = mar, year = {2022}, pmid = {35405941}, pmcid = {PMC9000847}, note = {Number: 7}, pages = {1327}, }
@article{casula_quantitative_2022, title = {Quantitative evaluation of the tibiofemoral joint cartilage by {T2} mapping in patients with acute anterior cruciate ligament injury vs contralateral knees: {Results} from the subacute phase using data from the {NACOX} study cohort}, volume = {In Press}, issn = {1522-9653}, shorttitle = {Quantitative evaluation of the tibiofemoral joint cartilage by {T2} mapping in patients with acute anterior cruciate ligament injury vs contralateral knees}, url = {https://doi.org/10.1016/j.joca.2022.02.623}, doi = {10.1016/j.joca.2022.02.623}, abstract = {OBJECTIVE: Immediate cartilage structural alterations in the acute phase after an anterior cruciate ligament (ACL) rupture may be a precursor to posttraumatic osteoarthritis (PTOA) development. Our aim was to describe changes in cartilage matrix in the subacute phase of the acutely ACL-injured knee compared to the contralateral uninjured knee. DESIGN: Participants (n=118) aged 15-40 years with an acute ACL injury were consecutively included in subacute phase after acute ACL-injury and underwent MRI (mean 29 days post trauma) of both knees. Mean T2 relaxation times, T2 spatial coefficient of variation and cartilage thickness were determined for different regions of the tibiofemoral cartilage. Differences between the acutely ACL-injured and uninjured knee were evaluated using Wilcoxon signed-rank test. RESULTS: T2 relaxation time in injured knees was increased in multiple cartilage regions from both medial and lateral compartment compared to contralateral knees, mostly in medial trochlea and posterior tibia (P-value{\textless}0.001). In the same sites of injured knees, we observed significantly thinner cartilage. Moreover, injured knees presented shorter T2 relaxation time in superficial cartilage on lateral central femur and trochlea (P-value{\textless}0.001), and decreased T2 spatial coefficient of variation in lateral trochlea and load bearing regions of medial-central femoral condyle and central tibia in both compartments. CONCLUSION: Small but statistically significant differences were observed in the subacute phase between ACL-injured and uninjured knee in cartilage T2 relaxation time and cartilage thickness. Future longitudinal observations of the same cohort will allow for better understanding of early development of PTOA. TRIAL REGISTRATION NUMBER: NCT02931084.}, language = {eng}, journal = {Osteoarthritis and Cartilage}, author = {Casula, Victor and Tajik, Bashir Edwardsson and Kvist, Joanna and Frobell, Richard and Haapea, Marianne and Nieminen, Miika T. and Gauffin, Håkan and Englund, Martin}, month = apr, year = {2022}, pmid = {35421548}, keywords = {ACL, PTOA, T2-mapping}, pages = {S1063--4584(22)00716--6}, }
@article{battista_giving_2022, title = {Giving an account of patients' experience: {A} qualitative study on the care process of hip and knee osteoarthritis}, volume = {25}, issn = {1369-7625}, shorttitle = {Giving an account of patients' experience}, url = {https://doi.org/10.1111/hex.13468}, doi = {10.1111/hex.13468}, abstract = {INTRODUCTION: Despite the publication of clinical practice guidelines, the quality of the care process as experienced by patients with osteoarthritis (OA) appears suboptimal. Hence, this study investigates how patients with OA experience their disease and care process, highlighting potential elements that can enhance or spoil it, to optimise their quality of care. METHODS: A qualitative study based on semi-structured interviews. Patients with hip and knee OA in Italy were interviewed. The interview guide was created by a pool of health professionals and patients. The interviews were analysed through a theme-based analysis following a philosophy of descriptive phenomenological research. RESULTS: Our analysis revealed seven main themes: (1) Experiencing a sense of uncertainty, as interviewees perceived treatment choices not to be based on medical evidence; (2) Establishing challenging relationships with the self and the other, as they did not feel understood and felt ashamed or hopeless about their condition; (3) Being stuck in one's own or the health professionals' beliefs about the disease management, as a common thought was the perception of movement as something dangerous together with a frequent prescription of passive therapies; (4) Dealing with one's own attitudes towards the disease; Understanding (5) the barriers to and (6) the facilitators of the adherence to therapeutic exercise, which revolve around the therapy cost, the time needed and the patients' willingness to change their life habits and (7) Developing an uneasy relationship with food since the diet was considered as something that "you force yourself to follow" and overeating as a way "to eat your feelings". CONCLUSION: The lack of clear explanations and a negative attitude towards first-line nonsurgical treatments (mainly physical exercise), which are considered as a way to fill the time while waiting for surgery, underlines the importance of providing patients with adequate information about OA treatments and to better explain the role of first-line intervention in the care of OA. This will enhance patient-centred and shared decision-making treatments. PATIENT CONTRIBUTION: Patients with hip and knee OA participated in creating the interview and contributed with their experience of their care process.}, language = {eng}, number = {3}, journal = {Health Expectations: An International Journal of Public Participation in Health Care and Health Policy}, author = {Battista, Simone and Manoni, Mattia and Dell'Isola, Andrea and Englund, Martin and Palese, Alvisa and Testa, Marco}, month = mar, year = {2022}, pmid = {35266257}, note = {Number: 3}, keywords = {clinical governance, osteoarthritis, phenomenology, physical therapists, physical therapy specialty, policy making, practice guidelines as topic}, pages = {1140--1156}, }
@article{yu_opioid_2022, title = {Opioid use prior to total knee replacement: comparative analysis of trends in {England} and {Sweden}}, issn = {1063-4584}, shorttitle = {Opioid use prior to total knee replacement}, url = {https://www.sciencedirect.com/science/article/pii/S1063458422006872}, doi = {10.1016/j.joca.2022.02.621}, abstract = {Objectives To describe and compare trends in the frequency of opioid prescribing/dispensing in English and Swedish patients with osteoarthritis prior to total knee replacement (TKR). Methods 49,043 patients from an English national database (Clinical Practice Research Datalink) and 5,955 patients from the Swedish Skåne Healthcare register undergoing TKR between 2015 and 2019 were included, alongside 1:1 age-, sex-, and practice (residential area) matched controls. Annual prevalence and prevalence rates ratio (PRR) of opioid prescribing/dispensing (any, by strength) in the 10 years prior to TKR (or matched index date for controls) were estimated using Poisson regression. Results In England and Sweden, the prevalence of patients with osteoarthritis receiving any opioid prior to TKR increased towards the date of surgery from 24\% to 44\% in England and from 16\% to 33\% in Sweden. Prescribing in controls was stable, resulting in an increasing PRR (1.6–2.7) between 10 and 1 years prior to index date in both countries. No relevant cohort or period effect was observed in either country. Prevalence of opioid prescribing was higher in English cases and controls; weaker opioids were more commonly prescribed in England, stronger opioids in Sweden. Conclusions Temporal prevalence patterns of opioid prescribing between cases and controls are similar in England and Sweden. Opioids are still commonly used in TKR cases in both countries highlighting the lack of valid alternatives for OA pain management.}, language = {en}, urldate = {2022-04-21}, journal = {Osteoarthritis and Cartilage}, author = {Yu, D. and Hellberg, C. and Appleyard, T. and Dell'Isola, A. and Thomas, G. E. R. and Turkiewicz, A. and Englund, M. and Peat, G.}, month = mar, year = {2022}, keywords = {Electronic health care record, Opioid, Total knee replacement}, }
@article{swain_comorbidities_2022, title = {Comorbidities in osteoarthritis ({ComOA}): a combined cross-sectional, case–control and cohort study using large electronic health records in four {European} countries}, volume = {12}, copyright = {© Author(s) (or their employer(s)) 2022. Re-use permitted under CC BY. Published by BMJ.. https://creativecommons.org/licenses/by/4.0/This is an open access article distributed in accordance with the Creative Commons Attribution 4.0 Unported (CC BY 4.0) license, which permits others to copy, redistribute, remix, transform and build upon this work for any purpose, provided the original work is properly cited, a link to the licence is given, and indication of whether changes were made. See: https://creativecommons.org/licenses/by/4.0/.}, issn = {2044-6055, 2044-6055}, shorttitle = {Comorbidities in osteoarthritis ({ComOA})}, url = {https://bmjopen.bmj.com/content/12/4/e052816}, doi = {10.1136/bmjopen-2021-052816}, abstract = {Introduction Osteoarthritis (OA) is one of the leading chronic conditions in the older population. People with OA are more likely to have one or more other chronic conditions than those without. However, the temporal associations, clusters of the comorbidities, role of analgesics and the causality and variation between populations are yet to be investigated. This paper describes the protocol of a multinational study in four European countries (UK, Netherlands, Sweden and Spain) exploring comorbidities in people with OA. Methods and analysis This multinational study will investigate (1) the temporal associations of 61 identified comorbidities with OA, (2) the clusters and trajectories of comorbidities in people with OA, (3) the role of analgesics on incidence of comorbidities in people with OA, (4) the potential biomarkers and causality between OA and the comorbidities, and (5) variations between countries.A combined case–control and cohort study will be conducted to find the temporal association of OA with the comorbidities using the national or regional health databases. Latent class analysis will be performed to identify the clusters at baseline and joint latent class analysis will be used to examine trajectories during the follow-up. A cohort study will be undertaken to evaluate the role of non-steroidal anti-inflammatory drugs (NSAIDs), opioids and paracetamol on the incidence of comorbidities. Mendelian randomisation will be performed to investigate the potential biomarkers for causality between OA and the comorbidities using the UK Biobank and the Rotterdam Study databases. Finally, a meta-analyses will be used to examine the variations and pool the results from different countries. Ethics and dissemination Research ethics was obtained according to each database requirement. Results will be disseminated through the FOREUM website, scientific meetings, publications and in partnership with patient organisations.}, language = {en}, number = {4}, urldate = {2022-04-21}, journal = {BMJ Open}, author = {Swain, Subhashisa and Kamps, Anne and Runhaar, Jos and Dell'Isola, Andrea and Turkiewicz, Aleksandra and Robinson, Danielle and Strauss, V. and Mallen, Christian and Kuo, Chang-Fu and Coupland, Carol and Doherty, Michael and Sarmanova, Aliya and Prieto-Alhambra, Daniel and Englund, Martin and Bierma-Zeinstra, Sita M. A. and Zhang, Weiya}, month = apr, year = {2022}, pmid = {35387809}, note = {Number: 4 Publisher: British Medical Journal Publishing Group Section: Rheumatology}, keywords = {EPIDEMIOLOGY, Musculoskeletal disorders, RHEUMATOLOGY}, pages = {e052816}, }
@article{kiadaliri_gout_2022, title = {Gout and hospital admission for ambulatory care sensitive conditions:risks and trajectories}, copyright = {© 2022 The Journal of Rheumatology}, issn = {0315-162X, 1499-2752}, shorttitle = {Gout and hospital admission for ambulatory care sensitive conditions}, url = {https://www.jrheum.org/content/early/2022/04/11/jrheum.220038}, doi = {10.3899/jrheum.220038}, abstract = {Objective To investigate the risks and trajectories of hospital admission for ambulatory care sensitive conditions (HACSCs) in gout. Methods Among individuals aged 35-85 years residing in Skåne, Sweden, in 2005, those with no doctor-diagnosed gout during 1998–2005 (n=576,700) were followed from January 1st 2006 until an HACSC, death, relocation outside Skåne, or December 31st 2016. Treating a new gout diagnosis (ICD 10 code: M10) as a time-varying exposure, we used Cox proportional and additive hazard models to estimate the effects of gout on HACSCs. We investigated the trajectory of HACSCs from 3 years before to 3 years after gout diagnosis using generalized estimating equations and group-based trajectory modelling in an age- and sex-matched cohort study. Results Gout was associated with 41\% increased rate of HACSCs (hazard ratio 1.41; 95\% CI: 1.35, 1.47), corresponding to 121 (104, 138) more HACSCs per 10,000 person-years compared with those without gout. Our trajectory analysis showed that higher rates of HACSCs among persons with gout were observed from 3 years before to 3 years after diagnosis with the highest prevalence rate ratio (2.22, 95\% CI: 1.92, 2.53) at the 3-month period after diagnosis. We identified three classes with distinct trajectories of HACSCs among gout persons: almost none (88.5\%), low-rising (9.7\%), and moderate-sharply rising (1.8\%). Charlson comorbidity index was the most important predictor of trajectory class membership. Conclusion Increased risk of HACSCs in gout highlights the need for better management of the disease at outpatient care, especially among foreign-born older patients with comorbidities.}, language = {en}, urldate = {2023-08-28}, journal = {The Journal of Rheumatology}, author = {Kiadaliri, Ali and Neogi, Tuhina and Englund, Martin}, month = apr, year = {2022}, pmid = {35428711}, note = {Publisher: The Journal of Rheumatology Section: Accepted Article}, }
@article{brown_clinical_2022, title = {Clinical versus {MRI} grading of the medial collateral ligament in acute knee injury}, volume = {In Press}, issn = {1543-8635}, url = {https://doi.org/10.1080/15438627.2022.2079981}, doi = {10.1080/15438627.2022.2079981}, abstract = {Sensitivity, specificity, and agreement between clinical and magnetic resonance imaging (MRI) gradings of the medial collateral ligament (MCL) after acute knee injury were evaluated in 362 patients. Ninety-seven per cent were injured during sports/recreation. Sensitivity and specificity of MRI for grade II or III MCL injury was 68\% (95\% CI 58-77\%) and 90\% (95\% CI 86-93\%), respectively. Weighted Kappa analysis showed moderate agreement between clinical and MRI grading (0.56 [95\% CI 0.48-0.65]). Findings were similar for patients with and without concomitant cruciate ligament rupture (0.57 [95\% CI 0.48-0.66] and 0.55 [95\% CI 0.35-0.75], respectively) and for specialists in orthopaedics and knee sub-specialists (0.55 [95\% CI 0.39-0.70] and 0.57 [95\% CI 0.47-0.67], respectively). Agreement between clinical and MRI grading of MCL injuries by orthopaedic specialists in a general hospital is at least moderate regardless of the presence of cruciate ligament injury.}, language = {eng}, journal = {Research in Sports Medicine (Print)}, author = {Brown, Jamie S. and Olsson, Ola and Isacsson, Anders and Englund, Martin}, month = may, year = {2022}, pmid = {35621350}, keywords = {Medial collateral ligament injury, clinical examination, magnetic resonance imaging}, pages = {1--5}, }
@article{dellisola_does_2022, title = {Does osteoarthritis modify the association between {NSAID} use and risk of comorbidities and adverse events?}, volume = {4}, issn = {2665-9131}, url = {https://www.sciencedirect.com/science/article/pii/S2665913122000218}, doi = {10.1016/j.ocarto.2022.100253}, abstract = {Objectives To investigate the role of osteoarthritis (OA) in the incidence of musculoskeletal, metabolic, cardiovascular, digestive, neuro-psychological, kidney and other comorbidities/adverse events after (i) incident non-steroidal anti-inflammatory drug (NSAID) initiation and (ii) NSAID discontinuation. Methods We used register data for the population of Skåne, Sweden. For (i), we analysed the association between starting NSAIDs and the risk of incident outcome events in the 6 years following NSAID dispensation among people with prevalent OA vs no OA. For (ii) we studied the effect of discontinuing NSAIDs among people with and without OA up to 120 days. We used flexible parametric models to estimate adjusted differences in cumulative incidence with NSAIDs as time-varying exposure in the presence of non-proportional hazards. Results For (i) we included between 243,832 and 409,749 persons. In the whole cohort, over the 6 years of follow-up, NSAID initiation was associated with a 3\% (metabolic) to 16\% (musculoskeletal) higher cumulative incidence of outcomes compared to non-users. The difference between those initiating NSAIDs vs non-users was similar in those with and without OA for most outcomes, but in those with OA the increase was lower for neuro-psychological (95\%CI: 3.7\%–4.6\% vs 7.1\%–7.9\%) and musculoskeletal comorbidities (12\%–14.5\% vs 16.2\%–17.2\%). In (ii), we found no interaction between OA and NSAID discontinuation. NSAID discontinuation was associated with decreased risks for most of the outcomes, from −1.3\% for musculoskeletal to −0.4\% for cardiovascular comorbidities. Conclusions OA appears to have little influence on the increased risk of comorbidities observed after NSAID initiation or decrease after discontinuation.}, language = {en}, number = {2}, urldate = {2023-02-02}, journal = {Osteoarthritis and Cartilage Open}, author = {Dell’Isola, Andrea and Turkiewicz, Aleksandra and Zhang, Weiya and Kiadaliri, Ali and Bierma-Zeinstra, Sita and Runhaar, Jos and Prieto-Alhambra, Daniel and Englund, Martin}, month = jun, year = {2022}, note = {Number: 2}, keywords = {Comorbidity, Hip, Knee, NSAID, Osteoarthritis}, pages = {100253}, }
@article{dellisola_association_2022, title = {The association between preexisting conditions and osteoarthritis development in peripheral joints: {A} population based nested case-control study}, volume = {4}, issn = {2665-9131}, shorttitle = {The association between preexisting conditions and osteoarthritis development in peripheral joints}, url = {https://www.sciencedirect.com/science/article/pii/S2665913122000334}, doi = {10.1016/j.ocarto.2022.100265}, abstract = {Aim To 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. Methods We 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. Results Between 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. Conclusions The 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.}, language = {en}, number = {2}, urldate = {2023-02-02}, journal = {Osteoarthritis and Cartilage Open}, author = {Dell’Isola, Andrea and Turkiewicz, Aleksandra and Zhang, Weiya and Bierma-Zeinstra, Sita and Runhaar, Jos and Prieto-Alhambra, Daniel and Swain, Subhashisa and Kiadaliri, Ali and Englund, Martin}, month = jun, year = {2022}, note = {Number: 2}, keywords = {Hip, Incidence, Knee, Multimorbidity, Osteoarthritis}, pages = {100265}, }
@article{kiadaliri_impact_2022, title = {Impact of the first wave of the {COVID}-19 pandemic on healthcare use in osteoarthritis: {A} population register-based study in {Sweden}}, volume = {4}, issn = {2665-9131}, shorttitle = {Impact of the first wave of the {COVID}-19 pandemic on healthcare use in osteoarthritis}, url = {https://www.sciencedirect.com/science/article/pii/S2665913122000206}, doi = {10.1016/j.ocarto.2022.100252}, 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.}, language = {en}, number = {2}, urldate = {2022-04-21}, journal = {Osteoarthritis and Cartilage Open}, author = {Kiadaliri, Ali and Magnusson, Karin and Turkiewicz, Aleksandra and Dell’Isola, Andrea and Runhaar, Jos and Bierma-Zeinstra, Sita and Englund, Martin}, month = jun, year = {2022}, note = {Number: 2}, keywords = {Covid-19, Event-study design, Healthcare use, Osteoarthritis, Sweden}, pages = {100252}, }
@article{xie_trends_2022, title = {Trends of dispensed opioids in {Catalonia}, {Spain}, 2007–19: a population-based cohort study of over 5 million individuals}, volume = {13}, issn = {1663-9812}, shorttitle = {Trends of dispensed opioids in catalonia, spain, 2007–19}, url = {https://www.frontiersin.org/articles/10.3389/fphar.2022.912361}, abstract = {Objective: To characterize the trend of opioid use (number of users, dispensations and oral morphine milligram equivalents) in Catalonia (Spain).Design, setting, and participants: This population-based cohort study included all individuals aged 18 years or older, registered in the Information System for Research in Primary Care (SIDIAP), which covers {\textgreater}75\% of the population in Catalonia, Spain, from 1 January 2007, to 31 December 2019.Main exposure and outcomes: The exposures were all commercialized opioids and their combinations (ATC-codes): codeine, tramadol, oxycodone, tapentadol, fentanyl, morphine, and other opioids (dihydrocodeine, hydromorphone, dextropropoxyphene, buprenorphine, pethidine, pentazocine). The main outcomes were the annual figures per 1,000 individuals of 1) opioid users, 2) dispensations, and 3) oral morphine milligram equivalents (MME). Results were stratified separately by opioid types, age (5-year age groups), sex (male or female), living area (rural or urban), and socioeconomic status (from least, U1, to most deprived, U5). The overall trends were quantified using the percentage change (PC) between 2007 and 2019.Results: Among 4,656,197 and 4,798,114 residents from 2007 to 2019, the number of opioid users, dispensations and morphine milligram equivalents per 1,000 individuals increased 12\% (percentage change: 95\% confidence interval (CI) 11.9–12.3\%), 105\% (95\% confidence interval 83\%–126\%) and 339\% (95\% CI 289\%–390\%) respectively. Tramadol represented the majority of opioid use in 2019 (61, 59, and 54\% of opioid users, dispensations, and total MME, respectively). Individuals aged 80 years or over reported the sharpest increase regarding opioid users (PC: 162\%), dispensations (PC: 424\%), and MME (PC: 830\%). Strong opioids were increasingly prescribed for non-cancer pains over the years.Conclusion: Despite the modest increase of opioid users, opioid dispensations and MME increased substantially, particularly in the older population. In addition, strong opioids were incrementally indicated for non-cancer pains over the years. These findings suggest a transition of opioid prescriptions from intermittent to chronic and weak to strong and call for more rigorous opioid stewardship.}, urldate = {2022-08-26}, journal = {Frontiers in Pharmacology}, author = {Xie, Junqing and Strauss, Victoria Y. and Collins, Gary S. and Khalid, Sara and Delmestri, Antonella and Turkiewicz, Aleksandra and Englund, Martin and Tadrous, Mina and Reyes, Carlen and Prieto-Alhambra, Daniel}, month = jun, year = {2022}, }
@article{magnusson_genetic_2022, title = {The genetic contribution to hand osteoarthritis}, issn = {1063-4584}, url = {https://www.sciencedirect.com/science/article/pii/S1063458422007750}, doi = {10.1016/j.joca.2022.06.011}, abstract = {Objective To estimate the genetic contribution to doctor-diagnosed hand osteoarthritis (OA). Methods Using data from the Swedish Twin Registry and National Patient Register, we conducted a 20-year population-based longitudinal cohort study including 59,970 twins aged 35 years or older. We studied inpatient and outpatient doctor-diagnosed hand OA using ICD-10 codes from 1997 until 2016, including both the distal/proximal interphalangeal (DIP/PIP) joints and/or the first carpometacarpal (CMC-1) joints. We calculated intra-pair correlation, estimated the heritability (i.e., the percentage variation in hand OA that can be explained by genetic factors) as well as a genetic risk. Results Among 59,970 included persons, 936 had a hand OA diagnosis registered during the study period. The heritabilities of hand OA (any joint), CMC-1 OA and DIP/PIP OA were ∼87\%, 86\% and 48\%, respectively, yet the two latter should be interpreted with care due to low numbers. Hand OA in any joint in both twins in a pair occurred more frequently in identical twins (54/554 = 9.7\%, intra-pair correlation = 0.54, 95\% CI = 0.44–0.63) than in fraternal twins (18/1,246 = 1.4\%, intra-pair correlation = 0.10, 95\% CI = −0.01–0.22). Identical twins who were diagnosed with hand OA in any joint had a far higher risk than fraternal twins with hand OA to also have their co-twin diagnosed with hand OA in any joint (Hazard Ratio = 6.98, 95\% CI = 3.08–15.45). Conclusion The genetic contribution to hand OA is high and likely varying between 48\% and 87\%. Potential differential heritability by hand OA phenotypes should be further explored.}, language = {en}, urldate = {2022-08-26}, journal = {Osteoarthritis and Cartilage}, author = {Magnusson, K. and Turkiewicz, A. and Haugen, I. K. and Englund, M.}, month = jul, year = {2022}, keywords = {Epidemiology, Genetics, Hand OA}, }
@article{finnila_mineral_2022, title = {Mineral crystal thickness in calcified cartilage and subchondral bone in healthy and osteoarthritic human knees}, volume = {37}, issn = {1523-4681}, url = {https://onlinelibrary.wiley.com/doi/abs/10.1002/jbmr.4642}, doi = {10.1002/jbmr.4642}, abstract = {Osteoarthritis (OA) is the most common joint disease, where articular cartilage degradation is often accompanied with sclerosis of the subchondral bone. However, the association between OA and tissue mineralization at the nanostructural level is currently not understood. In particular, it is technically challenging to study calcified cartilage, where relevant but poorly understood pathological processes such as tidemark multiplication and advancement occur. Here, we used state-of-the-art microfocus small-angle X-ray scattering with a 5-μm spatial resolution to determine the size and organization of the mineral crystals at the nanostructural level in human subchondral bone and calcified cartilage. Specimens with a wide spectrum of OA severities were acquired from both medial and lateral compartments of medial compartment knee OA patients (n = 15) and cadaver knees (n = 10). Opposing the common notion, we found that calcified cartilage has thicker and more mutually aligned mineral crystals than adjoining bone. In addition, we, for the first time, identified a well-defined layer of calcified cartilage associated with pathological tidemark multiplication, containing 0.32 nm thicker crystals compared to the rest of calcified cartilage. Finally, we found 0.2 nm thicker mineral crystals in both tissues of the lateral compartment in OA compared with healthy knees, indicating a loading-related disease process because the lateral compartment is typically less loaded in medial compartment knee OA. In summary, we report novel changes in mineral crystal thickness during OA. Our data suggest that unloading in the knee might be involved with the growth of mineral crystals, which is especially evident in the calcified cartilage. © 2022 The Authors. Journal of Bone and Mineral Research published by Wiley Periodicals LLC on behalf of American Society for Bone and Mineral Research (ASBMR).}, language = {en}, number = {9}, urldate = {2022-09-19}, journal = {Journal of Bone and Mineral Research}, author = {Finnilä, Mikko A.J. and Das Gupta, Shuvashis and Turunen, Mikael J. and Hellberg, Iida and Turkiewicz, Aleksandra and Lutz-Bueno, Viviane and Jonsson, Elin and Holler, Mirko and Ali, Neserin and Hughes, Velocity and Isaksson, Hanna and Tjörnstrand, Jon and Önnerfjord, Patrik and Guizar-Sicairos, Manuel and Saarakkala, Simo and Englund, Martin}, month = sep, year = {2022}, note = {Number: 9 \_eprint: https://onlinelibrary.wiley.com/doi/pdf/10.1002/jbmr.4642}, keywords = {ANALYSIS/QUANTITATION OF BONE, BONE MODELING AND REMODELING, COLLAGEN, MATRIX MINERALIZATION, OSTEOARTHRITIS}, pages = {1700--1710}, }
@article{einarsson_phase-contrast_2022, title = {Phase-contrast enhanced synchrotron micro-tomography of human meniscus tissue}, volume = {30}, issn = {1063-4584}, url = {https://www.sciencedirect.com/science/article/pii/S1063458422007671}, doi = {10.1016/j.joca.2022.06.003}, abstract = {Objective To investigate the feasibility of synchrotron radiation-based phase contrast enhanced micro-computed tomography (SR-PhC-μCT) for imaging of human meniscus. Quantitative parameters related to fiber orientation and crimping were evaluated as potential markers of tissue degeneration. Design Human meniscus specimens from 10 deceased donors were prepared using different preparation schemes: fresh frozen and thawed before imaging or fixed and paraffin-embedded. The samples were imaged using SR-PhC-μCT with an isotropic voxel size of 1.625 μm. Image quality was evaluated by visual inspection and spatial resolution. Fiber voxels were defined using a grey level threshold and a structure tensor analysis was applied to estimate collagen fiber orientation. The area at half maximum (FAHM) was calculated from angle histograms to quantify orientation distribution. Crimping period was calculated from the power spectrum of image profiles of crimped fibers. Parameters were compared to degenerative stage as evaluated by Pauli histopathological scoring. Results Image quality was similar between frozen and embedded samples and spatial resolutions ranged from 5.1 to 5.8 μm. Fiber structure, including crimping, was clearly visible in the images. Fibers appeared to be less organized closer to the tip of the meniscus. Fiber density might decrease slightly with degeneration. FAHM and crimping period did not show any clear association with histopathological scoring. Conclusion SR-PhC-μCT is a feasible technique for high-resolution 3D imaging of fresh frozen meniscus tissue. Further work is needed to establish quantitative parameters that relate to tissue degeneration, but this imaging technique is promising for future studies of meniscus structure and biomechanical response.}, language = {en}, number = {9}, urldate = {2022-08-26}, journal = {Osteoarthritis and Cartilage}, author = {Einarsson, E. and Pierantoni, M. and Novak, V. and Svensson, J. and Isaksson, H. and Englund, M.}, month = sep, year = {2022}, note = {Number: 9}, keywords = {Collagen fiber, Crimp, Synchrotron radiation}, pages = {1222--1233}, }
@article{johansson_chronic_2022, title = {Chronic opioid use before and after exercise therapy and patient education among patients with knee or hip osteoarthritis}, issn = {1063-4584}, url = {https://www.sciencedirect.com/science/article/pii/S1063458422008032}, doi = {10.1016/j.joca.2022.08.001}, abstract = {Objective To investigate changes in opioid use after supervised exercise therapy and patient education among knee or hip osteoarthritis patients with chronic opioid use. Method In this cohort study, we linked data from the Good Life with osteoArthritis in Denmark register (GLA:D®; standardised treatment program for osteoarthritis; January 2013 to November 2018) with national health registries. Among 35,549 patients, 1,262 were classified as chronic opioid users based on amount and temporal distribution of dispensed opioids the year before the intervention. We investigated changes in opioid use, measured as mg oral morphine equivalents (OMEQs), from the year before the intervention to the year after using generalized estimating equations. Results We found a 10\% decrease in mg OMEQs from the year before to the year after the intervention (incidence rate ratio [IRR]: 0.90, 95\% confidence interval [CI]: 0.86, 0.94). Additional analyses suggested this decrease to be mainly attributable to regulatory actions targeting opioid prescribing during the study period (IRR among patients participating in the intervention before: 0.98 [95\% CI: 0.89, 1.07] vs after: 0.83 [0.74, 0.93] regulatory actions). In a random general population sample of matched chronic opioid users, a similar opioid use pattern was observed over time, further supporting the impact of regulatory actions on the opioid use in the study population. Conclusion Among patients with knee or hip osteoarthritis and chronic opioid use, a standardised treatment program did not change opioid use when regulatory changes in opioid prescribing were taken into account.}, language = {en}, urldate = {2022-08-26}, journal = {Osteoarthritis and Cartilage}, author = {Johansson, M. S. and Pottegård, A. and Søndergaard, J. and Englund, M. and Grønne, D. T. and Skou, S. T. and Roos, E. M. and Thorlund, J. B.}, month = aug, year = {2022}, keywords = {Chronic opioid use, Deprescribing, Exercise therapy, Osteoarthritis, Patient education}, }
@article{tayfur_variation_2022, title = {Variation in patient-reported outcomes in young and old patients up to 4 to 6 years after arthroscopic partial meniscectomy}, volume = {32}, issn = {1050-642X}, url = {https://journals.lww.com/cjsportsmed/Abstract/2022/09000/Variation_in_Patient_Reported_Outcomes_in_Young.13.aspx}, doi = {10.1097/JSM.0000000000001011}, abstract = {Objective: To assess the variation in changes in patient-reported outcomes 4 to 6 years after arthroscopic partial meniscectomy (APM). Design: Prospective cohort study. Setting: Orthopedic departments at public hospitals. Patients: Patients (n = 447) from the Knee Arthroscopy Cohort Southern Denmark undergoing APM. Interventions: All patients underwent APM. Main Outcome Measures: Change in KOOS4 scores from baseline before surgery to ∼5 years (range 4-6 years) after surgery. KOOS4 is the average aggregated score of 4 of 5 of the Knee injury and Osteoarthritis Outcome Score (KOOS) excluding the activities of daily living subscale (minimal clinical important improvement ∼10 points). A mixed linear model adjusted for sex and body mass index was used to assess change from baseline to ∼5-year follow-up. Change in KOOS4 was divided into 5 categories based on change from baseline to ∼5-year follow-up: {\textless}0 points, 0 to 9 points, 10 to 19 points, 20 to 29 points, and ≥30 points. Results: On average, patient-reported outcomes continued to improve from baseline to ∼5-year follow-up (mean KOOS4 change: 26, 95\% CI, 24-28). Proportions in the different response groups were {\textless}0 points (12\%), 0 to 9 points (13\%), 10 to 19 points (16\%), 20 to 29 points (19\%), and ≥30 points (40\%), with no difference between younger (≤40 years, n = 75) and older ({\textgreater}40 years, n = 337) patients (P = 0.898). Conclusions: Patient-reported outcomes on average improved up to ∼5 years after APM; however, large variability was observed. The similar variability in younger and older patients questions the assumption that younger patients with traumatic injuries experience larger benefits from APM.}, language = {en-US}, number = {5}, urldate = {2022-10-10}, journal = {Clinical Journal of Sport Medicine}, author = {Tayfur, Beyza and Pihl, Kenneth and Varnum, Claus and Lohmander, Stefan and Englund, Martin and Thorlund, Jonas Bloch}, month = sep, year = {2022}, note = {Number: 5}, pages = {523--530}, }
@article{dellisola_risk_2022, title = {Risk of comorbidities following physician-diagnosed knee or hip osteoarthritis: a register-based cohort study}, volume = {74}, issn = {2151-4658}, shorttitle = {Risk of comorbidities following physician-diagnosed knee or hip osteoarthritis}, url = {https://onlinelibrary.wiley.com/doi/abs/10.1002/acr.24717}, doi = {10.1002/acr.24717}, abstract = {Objective To estimate the risk of developing comorbidities in patients after physician-diagnosed knee or hip osteoarthritis (OA). Design Cohort study using Swedish longitudinal healthcare register data; we studied residents in the Skåne region aged ≥35 years at January 1, 2010 free from diagnosed hip or knee OA (n= 548,681). We then identified subjects with at least one new diagnosis of knee or hip OA (incident OA) between 2010 and 2017 (n=50,942 considered exposed). Subjects without diagnosed OA were considered unexposed. From January 2010 both unexposed and exposed subjects were observed for the occurrence of 18 different pre-defined comorbidities until either relocation outside of the region, death, occurrence of the comorbidity, or December 2017, whichever came first. We calculated unadjusted and adjusted hazard ratios (HR, aHR) of comorbidities using Cox models with knee and hip OA as time-varying exposures. Results Subjects with incident knee or hip OA had 7\% to 60\% higher adjusted hazards (aHR between 1.07 to 1.60), of depression, cardiovascular diseases, back pain, and osteoporosis than individuals without an OA diagnosis. An increased risk of diabetes was found only for knee OA (aHR 1.19, 95\% CI 1.13-1.26). For the rest of the diagnoses, we found either no increased risk or estimates with wide confidence intervals, excluding clear interpretations of the direction or size of effects. Conclusions Incident physician-diagnosed knee and hip OA is associated with increased risk of depression, cardiovascular diseases, back pain, osteoporosis, and diabetes. However, the latter only for knee OA.}, language = {en}, number = {10}, urldate = {2021-09-06}, journal = {Arthritis Care \& Research}, author = {Dell’Isola, Andrea and Pihl, Kenneth and Turkiewicz, Aleksandra and Hughes, Velocity and Zhang, Weiya and Bierma-Zeinstra, Sita and Prieto-Alhambra, Daniel and Englund, Martin}, month = oct, year = {2022}, note = {Number: 10 \_eprint: https://onlinelibrary.wiley.com/doi/pdf/10.1002/acr.24717}, keywords = {Comorbidity, Epidemiology, Osteoarthritis, hip, knee}, pages = {1689--1695}, }
@article{lindeus_socioeconomic_2022, title = {Socioeconomic inequalities in all-cause and cause-specific mortality among patients with osteoarthritis in the {Skåne} region, {Sweden}}, volume = {74}, copyright = {This article is protected by copyright. All rights reserved.}, issn = {2151-4658}, url = {https://onlinelibrary.wiley.com/doi/abs/10.1002/acr.24613}, doi = {https://doi.org/10.1002/acr.24613}, abstract = {Objective To assess the association between education and all-cause and cause-specific mortality among patients with osteoarthritis (OA) in comparison to an OA-free reference cohort. Methods Using data from the Skåne healthcare register, we identified all residents aged ≥45 years in the region of Skåne, with doctor-diagnosed OA of peripheral joints between 1998 and 2013 (n=123,993). We created an age and sex-matched reference cohort without OA diagnosis (n=121,318). Subjects were followed until death, relocation outside Skåne, or the end of 2014. The relative index of inequality (RII) and the slope index of inequality (SII) were estimated by the Cox model and Aalen´s additive hazard model, respectively. Results We found an inverse association between education and mortality. The magnitude of relative inequalities in all-cause mortality were comparable in the OA (RII 1.53, 95\% CI:1.46, 1.61) and reference cohorts (RII:1.54, 95\% CI:1.47, 1.62). The absolute inequalities were smaller in the OA (SII 937 all-cause deaths per 100,000 person-years, 95\% CI:811, 1063) compared with the reference cohort (SII 1265, 95\% CI:1109, 1421). Cardiovascular mortality contributed more to the absolute inequalities in the OA than in the reference cohort (60.1\% vs. 48.1\%) while the opposite was observed for cancer mortality (8.5\% vs. 22.3\%). Conclusion We found higher all-cause and cause-specific mortality in OA patients with lower education. The observed inequalities in the OA cohort reflect the inequalities in the population at large. The greater burden of cardiovascular diseases in OA patients suggests that proper management of cardiovascular risk factors in OA patients is important.}, language = {en}, number = {10}, urldate = {2021-04-08}, journal = {Arthritis Care \& Research}, author = {Lindéus, Maria and Turkiewicz, Aleksandra and Englund, Martin and Kiadaliri, Ali}, month = oct, year = {2022}, note = {Number: 10 \_eprint: https://onlinelibrary.wiley.com/doi/pdf/10.1002/acr.24613}, keywords = {Education, Inequalities, Mortality, Osteoarthritis}, pages = {1704--1712}, }
@article{hellberg_3d_2022, title = {{3D} analysis and grading of calcifications from ex {VIVO} human meniscus}, issn = {1063-4584}, url = {https://www.sciencedirect.com/science/article/pii/S1063458422008962}, doi = {10.1016/j.joca.2022.10.016}, abstract = {Objective Meniscal calcifications are associated with the pathogenesis of knee osteoarthritis (OA). We propose a micro-computed tomography (μCT) based 3D analysis of meniscal calcifications ex vivo, including a new grading system. Method Human medial and lateral menisci were obtained from 10 patients having total knee replacement for medial compartment OA and 10 deceased donors without knee OA (healthy references). The samples were fixed; one subsection was imaged with μCT, and the adjacent tissue was processed for histological evaluation. Calcifications were examined from the reconstructed 3D μCT images, and a new grading system was developed. To validate the grading system, meniscal calcification volumes (CVM) were quantitatively analyzed and compared between the calcification grades. Furthermore, we estimated the relationship between histopathological degeneration and the calcification severity. Results 3D μCT images depict calcifications in every sample, including diminutive calcifications that are not visible in histology. In the new grading system, starting from grade 2, each grade results in a CVM that is 20.3 times higher (95\% CI 13.3–30.5) than in the previous grade. However, there was no apparent difference in CVM between grades 1 and 2. The calcification grades appear to increase with the increasing histopathological degeneration, although histopathological degeneration is also observed with small calcification grades. Conclusions 3D μCT grading of meniscal calcifications is feasible. Interestingly, it seems that there are two patterns of degeneration in the menisci of our sample set: 1) with diminutive calcifications (calcification grades 1–2), and 2) with large to widespread calcifications (calcification grades 3–5).}, language = {en}, urldate = {2022-11-22}, journal = {Osteoarthritis and Cartilage}, author = {Hellberg, I. and Karjalainen, V. -P. and Finnilä, M. A. J. and Jonsson, E. and Turkiewicz, A. and Önnerfjord, P. and Hughes, V. and Tjörnstrand, J. and Englund, M. and Saarakkala, S.}, month = nov, year = {2022}, keywords = {Calcification grading, Meniscal calcification, Micro-computed tomography, Volumetric analysis}, }
@article{tiulpin_predicting_2022, title = {Predicting total knee arthroplasty from ultrasonography using machine learning}, volume = {4}, issn = {2665-9131}, url = {https://www.sciencedirect.com/science/article/pii/S2665913122000875}, doi = {10.1016/j.ocarto.2022.100319}, 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.}, language = {en}, number = {4}, urldate = {2023-02-02}, journal = {Osteoarthritis and Cartilage Open}, author = {Tiulpin, Aleksei and Saarakkala, Simo and Mathiessen, Alexander and Hammer, Hilde Berner and Furnes, Ove and Nordsletten, Lars and Englund, Martin and Magnusson, Karin}, month = dec, year = {2022}, note = {Number: 4}, keywords = {Machine learning, Multivariate predictive modeling, Total knee replacement, Ultrasonography}, pages = {100319}, }
@article{gong_association_2022, title = {The association between quadriceps strength and synovitis in knee osteoarthritis: an exploratory study from the {Osteoarthritis} {Initiative}}, volume = {50}, copyright = {© 2023 The Journal of Rheumatology}, issn = {0315-162X, 1499-2752}, shorttitle = {The association between quadriceps strength and synovitis in knee osteoarthritis}, url = {https://www.jrheum.org/content/early/2023/01/25/jrheum.220538}, doi = {10.3899/jrheum.220538}, abstract = {Objective The aim of this study was to explore the association between quadriceps strength and synovitis in knee osteoarthritis (KOA). Methods This study was derived from the Osteoarthritis Initiative (OAI), which recruited adults from the OAI cohort with or at risk of KOA. Knees with complete records of isometric quadriceps strength and effusion-synovitis and Hoffa-synovitis assessments were included. Quadriceps strength was measured isometrically at baseline. Effusion-synovitis and Hoffa-synovitis were measured using the Magnetic Resonance Imaging Osteoarthritis Knee Score at baseline and at 1-year and 2-year follow-ups. Generalized estimating equations were used to analyze the associations of baseline quadriceps strength with changes in effusion-synovitis and Hoffa-synovitis in multivariable analyses. Additionally, analyses were stratified by synovitis-driven inflammatory phenotypes. Results A total of 1513 knees were included in this study. In total, 61\% of the subjects were female; subjects had an average age of 61.9 (SD 8.8) years and a mean BMI of 29.4 (SD 4.7). Regarding the whole population, baseline quadriceps strength was negatively associated with baseline effusion-synovitis and follow-up changes in effusion-synovitis (odds ratio [OR] 0.77-0.86), but no significant association was observed in terms of Hoffa-synovitis. Stratified by synovitis-driven inflammatory phenotype, baseline quadriceps strength was significantly associated with follow-up changes in effusion-synovitis—but not in Hoffa-synovitis—in the population with existing effusion-synovitis (OR 0.75-0.79). Conclusion Higher baseline quadriceps strength was negatively associated with changes in effusion-synovitis—but not in Hoffa-synovitis—especially in the population with existing effusion-synovitis. Our findings suggested a potential protective role of the quadriceps in effusion-synovitis.}, language = {en}, number = {4}, urldate = {2023-02-02}, journal = {The Journal of Rheumatology}, author = {Gong, Ze and Li, Shengfa and Cao, Peihua and Ruan, Guangfeng and Zhang, Yan and Zeng, Qing and He, Zijun and Li, Shilin and Chen, Rong and Zheng, Peng and Fan, Tao and Lu, Pengcheng and Zhao, Yijin and Englund, Martin and Madry, Henning and Huang, Guozhi and Li, Le and Li, Jia and Ding, Changhai}, month = dec, year = {2022}, pmid = {36521912}, note = {Number: 4 Publisher: The Journal of Rheumatology Section: Article}, pages = {548--555}, }
@article{kamps_occurrence_2022, title = {Occurrence of comorbidity following osteoarthritis diagnosis: a cohort study in the {Netherlands}}, issn = {1063-4584}, shorttitle = {Occurrence of comorbidity following osteoarthritis diagnosis}, url = {https://www.sciencedirect.com/science/article/pii/S1063458422009578}, doi = {10.1016/j.joca.2022.12.003}, abstract = {Objective To determine the risk of comorbidity following diagnosis of knee or hip osteoarthritis (OA). Design A cohort study was conducted using the Integrated Primary Care Information database, containing electronic health records of 2.5 million patients from the Netherlands. Adults at risk for OA were included. Diagnosis of knee or hip OA (=exposure) and 58 long-term comorbidities (=outcome) were defined by diagnostic codes following the International Classification of Primary Care coding system. Time between the start of follow-up and incident diagnosis of OA was defined as unexposed, and between diagnosis of OA and the end of follow-up as exposed. Age and sex adjusted hazard ratios (HRs) comparing comorbidity rates in exposed and unexposed patient time were estimated with 99.9\% confidence intervals (CI). Results The study population consisted of 1,890,712 patients. For 30 of the 58 studied comorbidities, exposure to knee OA showed a HR larger than 1. Largest positive associations (HR with (99.9\% CIs)) were found for obesity 2.55 (2.29–2.84) and fibromyalgia 2.06 (1.53–2.77). For two conditions a HR {\textless} 1 was found, other comorbidities showed no association with exposure to knee OA. For 26 comorbidities, exposure to hip OA showed a HR larger than 1. The largest were found for polymyalgia rheumatica 1.81 (1.41–2.32) and fibromyalgia 1.70 (1.10–2.63). All other comorbidities showed no associations with hip OA. Conclusion This study showed that many comorbidities were diagnosed more often in patients with knee or hip OA. This suggests that the management of OA should consider the risk of other long-term-conditions.}, language = {en}, urldate = {2023-02-02}, journal = {Osteoarthritis and Cartilage}, author = {Kamps, A. and Runhaar, J. and de Ridder, M. A. J. and de Wilde, M. and van der Lei, J. and Zhang, W. and Prieto-Alhambra, D. and Englund, M. and de Schepper, E. I. T. and Bierma-Zeinstra, S. M. A.}, month = dec, year = {2022}, keywords = {Comorbidity, Electronic health record (EHR), Osteoarthritis, Primary care}, }
@article{filbay_evidence_2022, title = {Evidence of {ACL} healing on {MRI} following {ACL} rupture treated with rehabilitation alone may be associated with better patient-reported outcomes: a secondary analysis from the {KANON} trial}, volume = {57}, copyright = {© Author(s) (or their employer(s)) 2022. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.. http://creativecommons.org/licenses/by-nc/4.0/This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/.}, issn = {0306-3674, 1473-0480}, shorttitle = {Evidence of {ACL} healing on {MRI} following {ACL} rupture treated with rehabilitation alone may be associated with better patient-reported outcomes}, url = {https://bjsm.bmj.com/content/early/2022/11/03/bjsports-2022-105473}, doi = {10.1136/bjsports-2022-105473}, abstract = {Objectives Evaluate the natural course of anterior cruciate ligament (ACL) healing on MRI within 5 years of acute ACL rupture and compare 2-year and 5-year outcomes based on healing status and treatment group. Methods Secondary analysis of 120 Knee Anterior Cruciate Ligament Nonsurgical vs Surgical Treatment (KANON) trial participants randomised to rehabilitation and optional delayed ACL reconstruction (ACLR) or early ACLR and rehabilitation. ACL continuity on MRI (Anterior Cruciate Ligament OsteoArthritis Score 0–2) was considered evidence of ACL healing. Outcomes included Knee Injury and Osteoarthritis Outcome Score (KOOS), KOOS patient acceptable symptomatic state (PASS) and treatment failure criteria. Linear mixed models were used to estimate adjusted mean differences (95\% CIs) in patient-reported sport and recreational function (KOOS-Sport/Rec) and quality of life (KOOS-QOL) at 2 and 5 years, between participants with MRI evidence of ACL healing and those who had (1) no evidence of ACL healing, (2) delayed ACLR or (3) early ACLR. Results MRI evidence of ACL healing at 2-year follow-up was observed in 16 of 54 (30\%, 95\% CI 19 to 43\%) participants randomised to optional delayed ACLR. Excluding participants who had delayed ACLR, 16 of 30 (53\%, 36–70\%) participants managed with rehabilitation-alone displayed MRI evidence of ACL healing. Two-year outcomes were better in the healed ACL group (n=16) compared with the non-healed (n=14) (mean difference (95\% CI) KOOS-Sport/Rec: 25.1 (8.6–41.5); KOOS-QOL: 27.5 (13.2–41.8)), delayed ACLR (n=24) (KOOS-Sport/Rec: 24.9 (10.2–39.6); KOOS-QOL: 18.1 (5.4–30.8)) and early ACLR (n=62) (KOOS-Sport/Rec: 17.4 (4.1–30.7); KOOS-QOL: 11.4 (0.0–22.9)) groups. Five-year KOOS-QOL was better in the healed versus non-healed group (25.3 (9.4–41.2)). Of participants with MRI evidence of ACL healing, 63–94\% met the PASS criteria for each KOOS subscale, compared with 29–61\% in the non-healed or reconstructed groups. Conclusions MRI appearance of ACL healing after ACL rupture occurred in one in three adults randomised to initial rehabilitation and one in two who did not cross-over to delayed ACLR and was associated with favourable outcomes. The potential for spontaneous healing of the ACL to facilitate better clinical outcomes may be greater than previously considered. Trial registration number ISRCTN84752559.}, language = {en}, number = {2}, urldate = {2022-11-07}, journal = {British Journal of Sports Medicine}, author = {Filbay, Stephanie Rose and Roemer, Frank W. and Lohmander, L. Stefan and Turkiewicz, Aleksandra and Roos, Ewa M. and Frobell, Richard and Englund, Martin}, month = nov, year = {2022}, pmid = {36328403}, note = {Number: 2 Publisher: BMJ Publishing Group Ltd and British Association of Sport and Exercise Medicine Section: Original research}, keywords = {Magnetic Resonance Imaging, anterior cruciate ligament, osteoarthritis, quality of life, rehabilitation}, pages = {91--98}, }
@article{magnusson_post-covid_2022, title = {Post-covid medical complaints following infection with {SARS}-{CoV}-2 {Omicron} vs {Delta} variants}, volume = {13}, copyright = {2022 The Author(s)}, issn = {2041-1723}, url = {https://www.nature.com/articles/s41467-022-35240-2}, doi = {10.1038/s41467-022-35240-2}, abstract = {The SARS-CoV-2 Omicron (B.1.1.529) variant has been associated with less severe acute disease, however, concerns remain as to whether long-term complaints persist to a similar extent as for earlier variants. Studying 1 323 145 persons aged 18-70 years living in Norway with and without SARS-CoV-2 infection in a prospective cohort study, we found that individuals infected with Omicron had a similar risk of post-covid complaints (fatigue, cough, heart palpitations, shortness of breath and anxiety/depression) as individuals infected with Delta (B.1.617.2), from 14 to up to 126 days after testing positive, both in the acute (14 to 29 days), sub-acute (30 to 89 days) and chronic post-covid (≥90 days) phases. However, at ≥90 days after testing positive, individuals infected with Omicron had a lower risk of having any complaint (43 (95\%CI = 14 to 72) fewer per 10,000), as well as a lower risk of musculoskeletal pain (23 (95\%CI = 2-43) fewer per 10,000) than individuals infected with Delta. Our findings suggest that the acute and sub-acute burden of post-covid complaints on health services is similar for Omicron and Delta. The chronic burden may be lower for Omicron vs Delta when considering musculoskeletal pain, but not when considering other typical post-covid complaints.}, language = {en}, number = {1}, urldate = {2022-12-01}, journal = {Nature Communications}, author = {Magnusson, Karin and Kristoffersen, Doris Tove and Dell’Isola, Andrea and Kiadaliri, Ali and Turkiewicz, Aleksandra and Runhaar, Jos and Bierma-Zeinstra, Sita and Englund, Martin and Magnus, Per Minor and Kinge, Jonas Minet}, month = nov, year = {2022}, note = {Number: 1 Publisher: Nature Publishing Group}, keywords = {Rehabilitation, SARS-CoV-2, Viral infection}, pages = {7363}, }
@article{ebrahimi_associations_2022, title = {Associations of human femoral condyle cartilage structure and composition with viscoelastic and constituent-specific material properties at different stages of osteoarthritis}, volume = {145}, issn = {0021-9290}, url = {https://www.sciencedirect.com/science/article/pii/S0021929022004316}, doi = {10.1016/j.jbiomech.2022.111390}, abstract = {The relationships between structure and function in human knee femoral cartilage are not well-known at different stages of osteoarthritis. Thus, our aim was to characterize the depth-dependent composition and structure (proteoglycan content, collagen network organization and collagen content) of normal and osteoarthritic human femoral condyle cartilage (n = 47) and relate them to their viscoelastic and constituent-specific mechanical properties that are obtained through dynamic sinusoidal testing and fibril-reinforced poroelastic material modeling of stress-relaxation testing, respectively. We characterized the proteoglycan content using digital densitometry, collagen network organization (orientation angle and anisotropy) using polarized light microscopy and collagen content using Fourier transform infrared spectroscopy. In the superficial cartilage (0–10 \% of thickness), the collagen network disorganization and proteoglycan loss were associated with the smaller initial fibril network modulus - a parameter representing the pretension of the collagen network. Furthermore, the proteoglycan loss was associated with the greater strain-dependent fibril network modulus - a measure of nonlinear mechanical behavior. The proteoglycan loss was also associated with greater cartilage viscosity at a low loading frequency (0.005 Hz), while the collagen network disorganization was associated with greater cartilage viscosity at a high loading frequency (1 Hz). Our results suggest that proteoglycan loss and collagen network disorganization reduce the pretension of the collagen network while proteoglycan degradation also increases the nonlinear mechanical behavior of the collagen network. Further, the results also highlight that proteoglycan loss and collagen disorganization increase the viscosity of femoral cartilage, but their contribution to increased viscosity occurs in completely different loading frequencies.}, language = {en}, urldate = {2022-12-01}, journal = {Journal of Biomechanics}, author = {Ebrahimi, Mohammadhossein and Turkiewicz, Aleksandra and Finnilä, Mikko A. J. and Saarakkala, Simo and Englund, Martin and Korhonen, Rami K. and Tanska, Petri}, month = dec, year = {2022}, keywords = {Biomechanics, Collagen fibril network, Fibril-reinforced poroelastic, Finite element modeling, Proteoglycan}, pages = {111390}, }
@article{mahmoudian_early-stage_2021, title = {Early-stage symptomatic osteoarthritis of the knee — time for action}, volume = {17}, copyright = {2021 Springer Nature Limited}, issn = {1759-4804}, url = {https://www.nature.com/articles/s41584-021-00673-4}, doi = {10.1038/s41584-021-00673-4}, abstract = {Osteoarthritis (OA) remains the most challenging arthritic disorder, with a high burden of disease and no available disease-modifying treatments. Symptomatic early-stage OA of the knee (the focus of this Review) urgently needs to be identified and defined, as efficient early-stage case finding and diagnosis in primary care would enable health-care providers to proactively and substantially reduce the burden of disease through proper management including structured education, exercise and weight management (when needed) and addressing lifestyle-related risk factors for disease progression. Efforts to define patient populations with symptomatic early-stage knee OA on the basis of validated classification criteria are ongoing. Such criteria, as well as the identification of molecular and imaging biomarkers of disease risk and/or progression, would enable well-designed clinical studies, facilitate interventional trials, and aid the discovery and validation of cellular and molecular targets for novel therapies. Treatment strategies, relevant outcomes and ethical issues also need to be considered in the context of the cost-effective management of symptomatic early-stage knee OA. To move forwards, a multidisciplinary and sustained international effort involving all major stakeholders is required.}, language = {en}, number = {10}, urldate = {2021-09-06}, journal = {Nature Reviews Rheumatology}, author = {Mahmoudian, Armaghan and Lohmander, L. Stefan and Mobasheri, Ali and Englund, Martin and Luyten, Frank P.}, month = aug, year = {2021}, note = {Number: 10 Bandiera\_abtest: a Cg\_type: Nature Research Journals Primary\_atype: Reviews Publisher: Nature Publishing Group Subject\_term: Epidemiology;Osteoarthritis Subject\_term\_id: epidemiology;osteoarthritis}, pages = {621--632}, }
@article{mason_prevention_2021, title = {Prevention of post-traumatic osteoarthritis at the time of injury: where are we now, and where are we going?}, volume = {39}, copyright = {This article is protected by copyright. All rights reserved.}, issn = {1554-527X}, shorttitle = {Prevention of post-traumatic osteoarthritis at the time of injury}, url = {https://onlinelibrary.wiley.com/doi/abs/10.1002/jor.24982}, doi = {https://doi.org/10.1002/jor.24982}, abstract = {This overview of progress made in preventing post-traumatic osteoarthritis (PTOA) was delivered in a workshop at the Orthopaedics Research Society Annual Conference in 2019. As joint trauma is a major risk factor for OA, defining the molecular changes within the joint at the time of injury may enable the targeting of biological processestoprevent later disease. Animal models have been used to test therapeutic targets to prevent PTOA. Areview of drug treatments for PTOA in rodents and rabbits between 2016 and 2018 revealed eleven systemic interventions,fiverepeated intra-articular or topical interventions and fiveshort-term intra-articular interventions, whichreduced total OARSI scores by 30-50\%, 20-70\% and0-40\% respectively. Standardised study design, reporting of effect size and quality metrics, alongside a ‘whole joint’ approach to assessing efficacywould improve translation ofpromising new drugs. A roadblock to translating preclinical discoveries has been the lack of guidelines on the design and conduct of human trials to prevent PTOA.An international workshop addressing this in 2016 considered inclusion criteria and study design, andadvocated the use ofexperimental medicine studies to triage candidate treatments andthe development ofearly biological and imaging biomarkers.Human trials for prevention of PTOA have testedanakinraafter anterior cruciate ligament rupture and dexamethasone after radiocarpal injury. PTOA offers a unique opportunity for defining early mechanisms of OA to target therapeutically. Progress in trial design andhigh quality preclinical research, and allegiance with patients, regulatory bodies and the pharmaceutical industry, will advance this field. This article is protected by copyright. All rights reserved.}, language = {en}, number = {6}, urldate = {2021-02-15}, journal = {Journal of Orthopaedic Research}, author = {Mason, Deborah and Englund, Martin and Watt, Fiona E.}, year = {2021}, note = {Number: 6 \_eprint: https://onlinelibrary.wiley.com/doi/pdf/10.1002/jor.24982}, keywords = {Clinical, Disease Process, Knee, Pathophysiology, Therapeutics, Treatment}, pages = {1152--1163}, }
@article{kiadaliri_intersectional_2021, title = {Intersectional inequalities and individual heterogeneity in chronic rheumatic diseases: {An} intersectional multilevel analysis}, volume = {73}, copyright = {© 2019, American College of Rheumatology}, issn = {2151-4658}, shorttitle = {Intersectional inequalities and individual heterogeneity in chronic rheumatic diseases}, url = {https://onlinelibrary.wiley.com/doi/abs/10.1002/acr.24109}, doi = {10.1002/acr.24109}, abstract = {Objective To examine how intersections of multiple sociodemographic variables explain the individual heterogeneity in risk of being diagnosed with any of following chronic rheumatic diseases (CRDs): osteoarthritis (OA), gout, rheumatoid arthritis (RA), or spondyloarthritis (SpA). Methods We identified people aged 40-65 years residing in Skåne, Sweden, by 31st December 2013 and having done so from 1st January 2000 (N=342,542). We used Skåne healthcare register to identify those with a diagnosis of the CRD of interest between 1st January 2014 and 31st December 2015 with no previous such diagnosis during 2000-2013. We created 144 intersectional social strata (ISS) using categories of age, gender, education, income, civil status, and immigration. With individuals nested within ISS, we applied multilevel logistic regression models to estimate: 1) variance partition coefficient (VPC) as a measure of discriminatory accuracy of the ISS and 2) predicted absolute risks and 95\% credible intervals for each stratum. Results In overall, 3.5\%, 0.5\%, 0.2\%, and 0.2\% of the study population were diagnosed with OA, gout, RA, and SpA, respectively. The VPC ranged from 16.2\% for gout to 0.5\% for SpA. Gender explained the largest proportion of between-strata variation in risk of RA, gout, and SpA while age was the most important factor for OA. The most between-strata differences in risk of these CRDs were due to the additive main effects. Conclusion Despite meaningful between-strata inequalities in the risk of being diagnosed with CRDs (except SpA), there were substantial within-strata heterogeneities that remains unexplained. There were limited evidence of intersectional interaction effects.}, language = {en}, number = {2}, urldate = {2019-11-18}, journal = {Arthritis Care \& Research}, author = {Kiadaliri, Ali and Englund, Martin}, year = {2021}, note = {Number: 2}, keywords = {Replace full text}, pages = {296--304}, }
@article{van_der_voet_factors_2021, title = {Factors associated with longitudinal change of meniscal extrusion in overweight women without clinical signs of osteoarthritis}, volume = {60}, url = {https://academic.oup.com/rheumatology/advance-article/doi/10.1093/rheumatology/keab228/6166666}, doi = {10.1093/rheumatology/keab228}, abstract = {AbstractObjectives. To identify variables associated with longitudinal change in meniscal extrusion, which might be used as possible targets for knee osteoarthr}, language = {en}, number = {11}, urldate = {2021-04-08}, journal = {Rheumatology}, author = {van der Voet, Jan A. and Wesselius, Daan and Zhang, Fan and Vroegindeweij, Dammis and Oei, Edwin H. and Bierma-Zeinstra, Sita M. A. and Englund, Martin and Runhaar, Jos}, year = {2021}, note = {Number: 11}, pages = {5175--5184}, }
@article{stamatis_infections_2021, title = {Infections are associated with increased risk of giant cell arteritis - a population-based case-control study from {Southern} {Sweden}}, volume = {48}, issn = {0315-162X}, url = {https://doi.org/10.3899/jrheum.200211}, doi = {10.3899/jrheum.200211}, abstract = {OBJECTIVE: To investigate the association of infections with the subsequent development of giant cell arteritis (GCA) in a large population-based cohort from a defined geographic area in Sweden. METHODS: Patients diagnosed with biopsy-confirmed GCA between 2000 and 2016 were identified through the database of the Department of Pathology in Skåne, the southernmost region of Sweden. For each GCA case, 10 controls matched for age, sex, and area of residence were randomly selected from the general population. Using the Skåne Healthcare Register, we identified all infection events prior to the date of GCA diagnosis and index date of controls. With infection as exposure, a conditional logistic regression model was employed to estimate the odds ratio (OR) for developing GCA. The types of infections contracted nearest in time to the GCA diagnosis/index date were identified. RESULTS: A total of 1005 patients with biopsy-confirmed GCA (71\% female) and 10 050 controls were included in the analysis. Infections were more common among patients subsequently diagnosed with GCA compared to controls [51\% vs. 41\%, OR 1.78; 95\% confidence interval (CI) 1.53-2.07]. Acute upper respiratory tract infection (OR 1.77; 95 \%. CI 1.47-2.14), influenza and pneumonia (OR 1.72; 95 \% CI 1.35-2.19), and unspecified infections (OR 5.35; 95 \% CI 3.46-8.28) were associated with GCA. Neither skin nor gastrointestinal infections showed a correlation. CONCLUSION: Infections, especially those of the respiratory tract, were associated with subsequent development of biopsy-confirmed GCA. Our findings support the hypothesis that a range of infections may trigger GCA.}, language = {eng}, number = {2}, journal = {The Journal of Rheumatology}, author = {Stamatis, Pavlos and Turkiewicz, Aleksandra and Englund, Martin and Jönsson, Göran and Nilsson, JanÅke and Turesson, Carl and Mohammad, Aladdin J.}, month = feb, year = {2021}, pmid = {32414956}, note = {Number: 2}, pages = {251--257}, }
@article{karjalainen_quantitative_2021, title = {Quantitative three-dimensional collagen orientation analysis of human meniscus posterior horn in health and osteoarthritis using micro-computed tomography}, volume = {In Press}, issn = {1063-4584, 1522-9653}, url = {https://www.oarsijournal.com/article/S1063-4584(21)00042-X/abstract}, doi = {10.1016/j.joca.2021.01.009}, abstract = {{\textless}h2{\textgreater}Summary{\textless}/h2{\textgreater}{\textless}h3{\textgreater}Objective{\textless}/h3{\textgreater}{\textless}p{\textgreater}Knee osteoarthritis (OA) is associated with meniscal degeneration that may involve disorganization of the meniscal collagen fiber network. Our aims were to quantitatively analyze the microstructural organization of human meniscus samples in 3D using micro-computed tomography (μCT), and to compare the local microstructural organization between OA and donor samples.{\textless}/p{\textgreater}{\textless}h3{\textgreater}Method{\textless}/h3{\textgreater}{\textless}p{\textgreater}We collected posterior horns of both medial and lateral human menisci from 10 end-stage medial compartment knee OA patients undergoing total knee replacement (medial \& lateral OA) and 10 deceased donors without knee OA (medial \& lateral donor). Posterior horns were dissected and fixed in formalin, dehydrated in ascending ethanol concentrations, treated with hexamethyldisilazane (HMDS), and imaged with μCT. We performed local orientation analysis of collagenous microstructure in 3D by calculating structure tensors from greyscale gradients within selected integration window to determine the polar angle for each voxel.{\textless}/p{\textgreater}{\textless}h3{\textgreater}Results{\textless}/h3{\textgreater}{\textless}p{\textgreater}In donor samples, meniscus bundles were aligned circumferentially around the inner border of meniscus. In medial OA menisci, the organized structure of collagen network was lost, and main orientation was shifted away from the circumferential alignment. Quantitatively, medial OA menisci had the lowest mean orientation angle compared to all groups, −24° (95\%CI -31 to −18) vs medial donor and −25° (95\%CI -34 to −15) vs lateral OA.{\textless}/p{\textgreater}{\textless}h3{\textgreater}Conclusions{\textless}/h3{\textgreater}{\textless}p{\textgreater}HMDS-based μCT imaging enabled quantitative analysis of meniscal collagen fiber bundles and their orientations in 3D. In human medial OA menisci, the collagen disorganization was profound with overall lower orientation angles, suggesting collagenous microstructure disorganization as an important part of meniscus degradation.{\textless}/p{\textgreater}}, language = {English}, urldate = {2021-03-27}, journal = {Osteoarthritis and Cartilage}, author = {Karjalainen, V.-P. and Kestilä, I. and Finnilä, M. A. and Folkesson, E. and Turkiewicz, A. and Önnerfjord, P. and Hughes, V. and Tjörnstrand, J. and Englund, M. and Saarakkala, S.}, month = feb, year = {2021}, pmid = {33588085}, note = {Publisher: Elsevier}, }
@article{mohammad_trajectory_2021, title = {Trajectory of healthcare resources utilization in giant cell arteritis – a population-based study}, volume = {48}, copyright = {© 2021 The Journal of Rheumatology}, issn = {0315-162X, 1499-2752}, url = {https://www.jrheum.org/content/early/2021/02/24/jrheum.201131}, doi = {10.3899/jrheum.201131}, abstract = {Objective To estimate the healthcare resource utilization (HRU) in patients with giant cell arteritis (GCA) compared with the general population in southern Sweden. Methods The study sample comprised 653 GCA patients along with ten age-, sex-, and residency-area-matched reference subjects per patient. Data on public and private healthcare consultations and hospitalizations were extracted from the Skåne Healthcare Register. We assessed trajectories of primary and specialist healthcare visit, as well as hospital admissions, and inpatient days from three years before through five years after the date of GCA diagnosis for patients and matched references. HRU was analysed using generalized estimating equations adjusted for sex, age at the index year, calendar year of diagnosis, education, income, marital status, place of birth, and Charlson comorbidity index. Inverse probability weighting was used to account for drop-out during study. Results GCA patients had higher rate of healthcare visits than the references from the year before GCA diagnosis up to four years after diagnosis with the largest relative (rate ratio [95\% CI]: 1.85 [1.68, 2.05]) and absolute (mean difference [95\% CI]: 10.2 [8.1, 12.3] visits per-person) differences in the year of diagnosis. Similar trajectories were observed for primary and specialist healthcare visits. For hospital admissions and inpatient days, the differences disappeared one year after diagnosis date. Conclusion Patients with GCA utilized health care services at a significantly higher rate than a reference population. The increased utilization among Swedish patients with GCA was evident one year before and prolonged up to four years after diagnosis date.}, language = {en}, number = {8}, urldate = {2021-03-08}, journal = {The Journal of Rheumatology}, author = {Mohammad, Aladdin J. and Turkiewicz, Aleksandra and Stamatis, Pavlos and Turesson, Carl and Englund, Martin and Kiadaliri, Ali}, month = mar, year = {2021}, pmid = {33649063}, note = {Number: 8 Publisher: The Journal of Rheumatology Section: Accepted Article}, pages = {1307--1313}, }
@article{magnusson_heritability_2021, title = {The heritability of doctor-diagnosed traumatic and degenerative meniscus tears}, volume = {In Press}, issn = {1063-4584, 1522-9653}, url = {https://www.oarsijournal.com/article/S1063-4584(21)00635-X/abstract}, doi = {10.1016/j.joca.2021.03.005}, abstract = {{\textless}h2{\textgreater}Summary{\textless}/h2{\textgreater}{\textless}h3{\textgreater}Objective{\textless}/h3{\textgreater}{\textless}p{\textgreater}To estimate the genetic contribution to traumatic and degenerative meniscus tears for men and women across the lifespan.{\textless}/p{\textgreater}{\textless}h3{\textgreater}Methods{\textless}/h3{\textgreater}{\textless}p{\textgreater}We linked the Swedish Twin Register with individual-level national healthcare data to form a 30-year, population-wide, longitudinal twin cohort. To study genetic contribution to meniscus tears, we estimated the heritability and familial risk using incident traumatic and degenerative tear diagnostic codes in a cohort of 88,414 monozygotic and dizygotic twin-pairs, aged ≥17 years.{\textless}/p{\textgreater}{\textless}h3{\textgreater}Results{\textless}/h3{\textgreater}{\textless}p{\textgreater}During follow-up, 3,372 (3.8\%) of 88,414 twins were diagnosed with a traumatic or degenerative meniscus tear\textbf{.} The heritability was 0.39 (95\% CI = 0.32–0.47) for men and 0.43 (95\% CI = 0.36–0.50) for women, and did not vary by age. Environmental factors that were unique to each twin in a pair explained a greater proportion of the variance than genetic factors, both for men (0.61, 95\% CI = 0.53–0.68) and women (0.57, 95\% CI = 0.50–0.64). Separate analyses of traumatic vs degenerative meniscus tears yielded similar results.{\textless}/p{\textgreater}{\textless}h3{\textgreater}Conclusion{\textless}/h3{\textgreater}{\textless}p{\textgreater}For the first time, we have estimated the genetic contribution to doctor-diagnosed meniscus tears using a twin study design. We found a relatively low to modest heritability for meniscus tears (∼40\%). The heritability was also fairly stable over the lifespan, and equal in both men and women. Our findings suggest that environmental risk factors are a more important contributor to both traumatic and degenerative doctor-diagnosed meniscus tears than genetic factors.{\textless}/p{\textgreater}}, language = {English}, urldate = {2021-04-01}, journal = {Osteoarthritis and Cartilage}, author = {Magnusson, K. and Turkiewicz, A. and Snoeker, B. and Hughes, V. and Englund, M.}, month = mar, year = {2021}, note = {Publisher: Elsevier}, }
@article{kiadaliri_complex_2021, title = {Complex sociodemographic inequalities in consultations for low back pain: lessons from multilevel intersectional analysis}, volume = {162}, issn = {1872-6623}, shorttitle = {Complex sociodemographic inequalities in consultations for low back pain}, url = {https://doi.org/10.1097/j.pain.0000000000002081}, doi = {10.1097/j.pain.0000000000002081}, abstract = {Sociodemographic inequalities in the occurrence of low back pain (LBP) are well-studied. This study aimed to examine complex sociodemographic inequalities in the risk LBP consultation in the population from a socioeconomical intersectional perspective. Using register data, we identified 458,852 individuals aged 35-75 years residing in Skåne in 2013, with no previous LBP consultation since 2006. We created 108 strata using categories of age, sex, education, income, and nativity. With individuals nested within strata, we modelled the absolute risk (AR) of LBP consultation during 2014 in a series of multilevel logistic regression models. We quantified discriminatory accuracy (DA) of these variables by computing the variance partition coefficient (VPC) and area under the receiver operating characteristic curve (AUC). We identified 13,657 (3.0\%) people with a LBP consultation. The AR ranged from 2.1\% (95\% credible interval: 1.9\%, 2.3\%) among young native men with high education and high income to 4.8\% (4.3\%, 5.5\%) among young foreign-born women with medium education and low income (2.3-fold relative difference). DA of intersectional strata was very low (VPC 1.1\%, (0.7, 1.6); and AUC 0.56, (0.55, 0.56)). Sex (35.6\%) and nativity (19.2\%) had the largest contributions in explaining the initially small between-strata variation in risk of LBP. The low DA of the intersectional strata indicates the existence of limited intersectional inequalities in LBP consultation. Therefore, interventions to reduce LBP risk should be universal rather than targeted to specific socioeconomic groups with a higher average risk. Before planning targeted intervention, other risk factors with higher DA needs to be identified.}, language = {eng}, number = {4}, journal = {Pain}, author = {Kiadaliri, Ali and Merlo, Juan and Englund, Martin}, month = apr, year = {2021}, pmid = {32947540}, note = {Number: 4}, pages = {1135--1143}, }
@article{ryden_proteomill_2021, title = {{ProteoMill}: {Efficient} network-based functional analysis portal for proteomics data}, issn = {1367-4803}, shorttitle = {{ProteoMill}}, url = {https://doi.org/10.1093/bioinformatics/btab373}, doi = {10.1093/bioinformatics/btab373}, abstract = {Functional analysis has become a common approach to incorporate biological knowledge into the analysis of omics data, and to explore molecular events that govern a disease state. It is though only one step in a wider analytical pipeline that typically requires use of multiple individual analysis software. There is currently a need for a well-integrated omics analysis tool that performs all the steps. The ProteoMill portal is developed as an R Shiny application and integrates all necessary steps from data-upload, converting identifiers, to quality control, differential expression and network-based functional analysis into a single fast, interactive easy to use workflow. Further, it maintains annotation data sources up to date, overcoming a common problem with use of outdated information, and seamlessly integrates multiple R-packages for an improved user-experience. The functionality provided in this software can benefit researchers by facilitating the exploratory analysis of proteomics data.ProteoMill is available at https://proteomill.com.}, number = {btab373}, urldate = {2021-05-17}, journal = {Bioinformatics}, author = {Rydén, Martin and Englund, Martin and Ali, Neserin}, month = may, year = {2021}, note = {Number: btab373}, }
@article{dellisola_willingness_2021, title = {Willingness to undergo joint surgery following a first-line intervention for osteoarthritis: data from the {BOA} register}, volume = {73}, issn = {2151-4658}, shorttitle = {Willingness to undergo joint surgery following a first-line intervention for osteoarthritis}, url = {https://doi.org/10.1002/acr.24486}, doi = {10.1002/acr.24486}, abstract = {OBJECTIVE: to assess the proportion of participants reconsidering their willingness to undergo surgery after three and 12 months. Secondary aims are to analyse and compare the characteristics of people willing and unwilling to undergo joint surgery for osteoarthritis (OA) before a first-line intervention; to study the association between pain intensity, walking difficulties, self-efficacy and fear of movement with the willingness to undergo surgery. DESIGN: This is an observational study based on Swedish register data. We included 30,578 people with knee or hip OA who participated in a first-line intervention including education and exercise. RESULTS: People willing to undergo surgery at baseline showed a higher proportion of men (40\% vs 27\%) and more severe symptoms and disability. Respectively, 45\% and 30\% of the people with knee and hip OA who were willing to undergo surgery at baseline became unwilling after the intervention. At the end of the study period (12 months), 35\% and 19\% of those with knee and hip OA, respectively, who were willing to undergo surgery at baseline became unwilling. High pain intensity, walking difficulties, and fear of movement were associated with higher odds of being willing to undergo surgery at both follow-ups while increased self-efficacy showed the opposite association. CONCLUSIONS: A first-line intervention for OA is associated with reduced willingness to undergo surgery with a greater proportion among knee OA than hip OA people. Due to its temporal variability, willingness to undergo surgery should be used with care to deem surgery eligibility.}, language = {eng}, number = {6}, journal = {Arthritis Care \& Research}, author = {Dell'Isola, Andrea and Jönsson, Thèrèse and Rolfson, Ola and Cronström, Anna and Englund, Martin and Dahlberg, Leif}, month = jun, year = {2021}, pmid = {33053273}, note = {Number: 6}, keywords = {Replace full text}, pages = {818--827}, }
@article{kiadaliri_variability_2021, title = {Variability in end-of-life healthcare use in patients with osteoarthritis: a population-based matched cohort study}, issn = {1063-4584}, shorttitle = {Variability in end-of-life healthcare use in patients with osteoarthritis}, url = {https://www.sciencedirect.com/science/article/pii/S1063458421008360}, doi = {10.1016/j.joca.2021.07.001}, abstract = {Purpose To investigate the patterns of healthcare use (HCU) at the last year of life in persons with osteoarthritis (OA). Methods Using linked registers, we identified persons aged≥ 65 years who died during 2003–2014 and were resided in the Skåne region during 5-year prior to death. Among these, we randomly matched decedents with a principal OA diagnosis prior to the last year of life (OA cohort, n = 17,993) with up to 4 comparators without OA by sex, age at death, and year of death (n = 59,945). We measured monthly HCU for each decedent during last year of life and applied two-part regression models to estimate HCU attributable to OA. Group-based trajectory modelling (GBTM) was used to detect distinct trajectories of HCU within the OA cohort. Results During last 12-month of life, each person with OA had, on average, 2.5 (95\% CI 2.2, 2.7) excess healthcare consultations and 1.8 (95\% CI 1.3, 2.2) more inpatient days than those without OA. While both cohorts observed increasing trends in HCU towards death, excess healthcare consultations attributable to OA declined and inpatient days increased as death approached. For both healthcare consultations and inpatient days, GBTM identified four distinct trajectory classes. While underlying cause of death and age were the most important predictors of class membership, the overall predictive accuracy was poor. Conclusion OA was associated with excess HCU especially hospital-based care during the last year of life. However, there seem to be distinct trajectory classes within the OA patient population.}, language = {en}, urldate = {2021-09-06}, journal = {Osteoarthritis and Cartilage}, author = {Kiadaliri, A. and Englund, M.}, month = jul, year = {2021}, keywords = {End of life, Healthcare consultation, Osteoarthritis, Sweden, Trajectory}, }
@article{pihl_less_2021, title = {Less improvement following meniscal repair compared with arthroscopic partial meniscectomy: a prospective cohort study of patient-reported outcomes in 150 young adults at 1- and 5-years’ follow-up}, volume = {92}, issn = {1745-3674}, shorttitle = {Less improvement following meniscal repair compared with arthroscopic partial meniscectomy}, url = {https://doi.org/10.1080/17453674.2021.1917826}, doi = {10.1080/17453674.2021.1917826}, abstract = {Background and purpose — Meniscal repair may reduce long-term risk of knee osteoarthritis compared with arthroscopic partial meniscectomy (APM), whereas patient-reported outcomes may be poorer at short term than for APM. We compared patient-reported outcomes in young adults undergoing meniscal repair or APM up to ∼5 years after surgery.Patients and methods — We included 150 patients aged 18–40 years from the Knee Arthroscopy Cohort Southern Denmark (KACS) undergoing meniscal repair or APM. Between-group differences in change in a composite of 4 of 5 Knee injury and Osteoarthritis Outcome Score (KOOS) subscales (pain, symptoms, sport and recreation, and quality of life—KOOS4) from baseline, 12, and 52 weeks, and a median of 5 years (range 4–6 years) were analyzed using adjusted mixed linear models, with 52 weeks being the primary endpoint.Results — 32 patients had meniscal repair (mean age 26 [SD 6]), and 118 patients underwent APM (mean age 32 [SD 7]). The repair and APM groups improved in KOOS4 from before to 52 weeks after surgery (least square means 7 and 19, respectively; adjusted mean difference –12, [95\% CI –19 to –4] in favor of APM). Both groups improved further from 52 weeks to 5 years after surgery with the difference in KOOS4 scores between the groups remaining similar.Interpretation — Patients having meniscal repair experienced less improvements in patient-reported outcomes from baseline to 52 weeks and 5 years post-surgery. The findings highlight the need for randomized trials comparing these interventions in terms of patient-reported outcomes and knee OA development.}, number = {5}, urldate = {2021-05-17}, journal = {Acta Orthopaedica}, author = {Pihl, Kenneth and Englund, Martin and Christensen, Robin and Lohmander, L. Stefan and Jørgensen, Uffe and Viberg, Bjarke and Fristed, Jakob Vium and Thorlund, Jonas B.}, month = apr, year = {2021}, pmid = {33929284}, note = {Number: 5 Publisher: Taylor \& Francis \_eprint: https://doi.org/10.1080/17453674.2021.1917826}, pages = {589--596}, }
@article{roemer_development_2021, title = {Development of {MRI}-defined structural tissue damage after anterior cruciate ligament injury over 5 years: {The} {KANON} study}, volume = {299}, issn = {0033-8419}, shorttitle = {Development of {MRI}-defined {Structural} {Tissue} {Damage} after {Anterior} {Cruciate} {Ligament} {Injury} over 5 {Years}}, url = {https://pubs.rsna.org/doi/10.1148/radiol.2021202954}, doi = {10.1148/radiol.2021202954}, abstract = {BackgroundMRI is used to evaluate structural joint changes after anterior cruciate ligament (ACL) injury, but no long-term data are available for comparing different treatment approaches.PurposeTo describe structural joint damage with MRI over a 5-year period in the Knee Anterior Cruciate Ligament, Nonsurgical versus Surgical Treatment (KANON) study and to compare frequencies of such tissue damage for a nonsurgical versus a surgical treatment strategy.Materials and MethodsIn this secondary analysis of a prospective trial (ISRCTN 84752559), 119 participants with an acute ACL injury were evaluated. Participants were enrolled from 2002 through 2006, the 2-year follow-up started in 2008, and the 5-year follow-up started in 2011. A 1.5-T MRI examination was performed at baseline and at 2- and 5-year follow-up. MRI scans were read according to a validated scoring instrument. Kruskal-Wallis tests were used to assess whether the frequencies of structural damage differed between the three as-treated groups.ResultsOf 119 participants (mean age, 26 years ± 5 [standard deviation]), 91 men were evaluated. At 2- and 5-year follow-up, respectively, 13\% (15 of 117) and 13\% (15 of 115) of knees showed incident cartilage damage in the medial tibiofemoral joint, 11\% (13 of 117) and 17\% (20 of 115) of knees showed incident cartilage damage in the lateral tibiofemoral joint, and 4\% (five of 117) and 8\% (nine of 115) of knees showed incident cartilage damage in the patellofemoral joint. Osteophyte development was seen in 23\% (27 of 117) and 29\% (33 of 115) of knees in the medial tibiofemoral joint, in 36\% (42 of 117) and 43\% (49 of 115) of knees in the lateral tibiofemoral joint, and in 35\% (41 of 117) and 37\% (42 of 115) of knees in the patellofemoral joint. No major differences between the groups were found for incident or worsening cartilage damage, bone marrow lesions, and osteophytes at 2 or 5 years. The rehabilitation-alone group showed less Hoffa-synovitis at 2 (P = .02) and 5 (P = .008) years.ConclusionYoung adults with anterior cruciate ligament injury showed no major difference in frequency of structural tissue damage on MRI scans at 2 and 5 years regardless of treatment. However, the rehabilitation-alone group had less inflammation at 2 and 5 years.© RSNA, 2021Online supplemental material is available for this article.See also the editorial by Andreisek in this issue.}, number = {2}, urldate = {2021-03-29}, journal = {Radiology}, author = {Roemer, Frank W. and Lohmander, L. Stefan and Englund, Martin and Guermazi, Ali and Åkesson, Anna and Frobell, Richard}, month = may, year = {2021}, note = {Number: 2 Publisher: Radiological Society of North America}, pages = {383--393}, }
@article{snoeker_is_2021, title = {Is meniscal status in the anterior cruciate ligament injured knee associated with change in bone surface area? {An} exploratory analysis of the {KANON} trial}, volume = {29}, issn = {1063-4584, 1522-9653}, shorttitle = {Is meniscal status in the anterior cruciate ligament injured knee associated with change in bone surface area?}, url = {https://www.oarsijournal.com/article/S1063-4584(21)00625-7/fulltext}, doi = {10.1016/j.joca.2021.02.567}, language = {English}, number = {6}, urldate = {2023-05-12}, journal = {Osteoarthritis and Cartilage}, author = {Snoeker, B. a. M. and Bowes, M. A. and Roemer, F. W. and Turkiewicz, A. and Lohmander, L. S. and Frobell, R. B. and Englund, M.}, month = jun, year = {2021}, pmid = {33676015}, note = {Number: 6 Publisher: Elsevier}, keywords = {Anterior cruciate ligament, Bone surface area changes, Meniscus, Osteoarthritis}, pages = {841--848}, }
@article{brown_agreement_2021, title = {Agreement between clinical examination and magnetic resonance imaging in acute knee trauma with hemarthrosis}, issn = {1536-3724}, url = {https://doi.org/10.1097/JSM.0000000000000950}, doi = {10.1097/JSM.0000000000000950}, abstract = {OBJECTIVE: Hemarthrosis after knee trauma often indicates serious joint injury. Few studies have evaluated agreement between clinical examination and findings from magnetic resonance imaging (MRI). We aimed to describe the agreement between acute clinical examination and subacute MRI findings after acute knee trauma with hemarthrosis and the importance of the subspecialty of the examiner. DESIGN: Longitudinal cohort study. Agreement with MRI findings was evaluated by logistic regression. SETTING: Helsingborg hospital. PATIENTS: Thousand one hundred forty-five consecutive patients with hemarthrosis after knee trauma. INTERVENTIONS: Clinical examination and MRI. MAIN OUTCOME MEASURES: agreement between clinical examination and findings from MRI. We considered the radiologist's report as the gold standard. RESULTS: Median time (25th, 75th percentile) from injury to clinical examination was 2 (1, 7) days, and from injury to imaging was 8 (5, 15) days. The overall sensitivity and specificity of clinical examination versus MRI for major ligament injury or lateral patella dislocation (LPD) were 70\% [95\% confidence interval 67-73) and 66\% (61-72), respectively. Orthopedic subspecialist knee had the highest agreement with anterior cruciate ligament rupture (adjusted odds ratios were 1.7 (95\% confidence interval 1.2-2.3), 1.9 (1.2-3.0) and 5.9 (3.7-9.5) for orthopedic trainees, orthopedic subspecialists other, and orthopedic subspecialist knee, respectively]. For other ligament injuries and LPD, we did not find statistically significant differences. CONCLUSIONS: Clinical diagnosis after acute knee injury is relatively unreliable versus MRI findings even when performed by orthopedic specialists. However, the agreement is improved when the examination is performed by an orthopedic knee subspecialist.}, language = {eng}, journal = {Clinical Journal of Sport Medicine: Official Journal of the Canadian Academy of Sport Medicine}, author = {Brown, Jamie Sutherland and Frobell, Richard B. and Isacsson, Anders and Englund, Martin and Olsson, Ola}, month = jun, year = {2021}, pmid = {34117155}, }
@article{ebrahimi_elastic_2021, title = {Elastic, dynamic viscoelastic and model-derived fibril-reinforced poroelastic mechanical properties of normal and osteoarthritic human femoral condyle cartilage}, volume = {49}, issn = {1573-9686}, url = {https://doi.org/10.1007/s10439-021-02838-4}, doi = {10.1007/s10439-021-02838-4}, abstract = {Osteoarthritis (OA) degrades articular cartilage and weakens its function. Modern fibril-reinforced poroelastic (FRPE) computational models can distinguish the mechanical properties of main cartilage constituents, namely collagen, proteoglycans, and fluid, thus, they can precisely characterize the complex mechanical behavior of the tissue. However, these properties are not known for human femoral condyle cartilage. Therefore, we aimed to characterize them from human subjects undergoing knee replacement and from deceased donors without known OA. Multi-step stress-relaxation measurements coupled with sample-specific finite element analyses were conducted to obtain the FRPE material properties. Samples were graded using OARSI scoring to determine the severity of histopathological cartilage degradation. The results suggest that alterations in the FRPE properties are not evident in the moderate stages of cartilage degradation (OARSI 2-3) as compared with normal tissue (OARSI 0-1). Drastic deterioration of the FRPE properties was observed in severely degraded cartilage (OARSI 4). We also found that the FRPE properties of femoral condyle cartilage related to the collagen network (initial fibril-network modulus) and proteoglycan matrix (non-fibrillar matrix modulus) were greater compared to tibial and patellar cartilage in OA. These findings may inform cartilage tissue-engineering efforts and help to improve the accuracy of cartilage representations in computational knee joint models.}, language = {en}, number = {9}, urldate = {2021-09-06}, journal = {Annals of Biomedical Engineering}, author = {Ebrahimi, Mohammadhossein and Finnilä, Mikko A. J. and Turkiewicz, Aleksandra and Englund, Martin and Saarakkala, Simo and Korhonen, Rami K. and Tanska, Petri}, month = aug, year = {2021}, note = {Number: 9}, pages = {2622--2634}, }
@article{xie_association_2021, title = {Association of tramadol vs codeine prescription dispensation with mortality and other adverse clinical outcomes}, volume = {326}, issn = {0098-7484}, url = {https://doi.org/10.1001/jama.2021.15255}, doi = {10.1001/jama.2021.15255}, abstract = {Although tramadol is increasingly used to manage chronic noncancer pain, few safety studies have compared it with other opioids.To assess the associations of tramadol, compared with codeine, with mortality and other adverse clinical outcomes as used in outpatient settings.Retrospective, population-based, propensity score–matched cohort study using a primary care database with routinely collected medical records and pharmacy dispensations covering more than 80\% of the population of Catalonia, Spain (≈6 million people). Patients 18 years or older with 1 or more year of available data and dispensation of tramadol or codeine (2007-2017) were included and followed up to December 31, 2017.New prescription dispensation of tramadol or codeine (no dispensation in the previous year).Outcomes studied were all-cause mortality, cardiovascular events, fractures, constipation, delirium, falls, opioid abuse/dependence, and sleep disorders within 1 year after the first dispensation. Absolute rate differences (ARDs) and hazard ratios (HRs) with 95\% confidence intervals were calculated using cause-specific Cox models.Of the 1 093 064 patients with a tramadol or codeine dispensation during the study period (326 921 for tramadol, 762 492 for codeine, 3651 for both drugs concomitantly), a total of 368 960 patients (184 480 propensity score–matched pairs) were included after study exclusions and propensity score matching (mean age, 53.1 [SD, 16.1] years; 57.3\% women). Compared with codeine, tramadol dispensation was significantly associated with a higher risk of all-cause mortality (incidence, 13.00 vs 5.61 per 1000 person-years; HR, 2.31 [95\% CI, 2.08-2.56]; ARD, 7.37 [95\% CI, 6.09-8.78] per 1000 person-years), cardiovascular events (incidence, 10.03 vs 8.67 per 1000 person-years; HR, 1.15 [95\% CI, 1.05-1.27]; ARD, 1.36 [95\% CI, 0.45-2.36] per 1000 person-years), and fractures (incidence, 12.26 vs 8.13 per 1000 person-years; HR, 1.50 [95\% CI, 1.37-1.65]; ARD, 4.10 [95\% CI, 3.02-5.29] per 1000 person-years). No significant difference was observed for the risk of falls, delirium, constipation, opioid abuse/dependence, or sleep disorders.In this population-based cohort study, a new prescription dispensation of tramadol, compared with codeine, was significantly associated with a higher risk of subsequent all-cause mortality, cardiovascular events, and fractures, but there was no significant difference in the risk of constipation, delirium, falls, opioid abuse/dependence, or sleep disorders. The findings should be interpreted cautiously, given the potential for residual confounding.}, number = {15}, urldate = {2021-10-27}, journal = {JAMA}, author = {Xie, Junqing and Strauss, Victoria Y. and Martinez-Laguna, Daniel and Carbonell-Abella, Cristina and Diez-Perez, Adolfo and Nogues, Xavier and Collins, Gary S. and Khalid, Sara and Delmestri, Antonella and Turkiewicz, Aleksandra and Englund, Martin and Tadrous, Mina and Reyes, Carlen and Prieto-Alhambra, Daniel}, month = oct, year = {2021}, note = {Number: 15}, pages = {1504--1515}, }
@article{magnusson_relationship_2021, title = {Relationship between magnetic resonance imaging features and knee pain over six years in knees without radiographic osteoarthritis at baseline}, volume = {73}, issn = {2151-464X, 2151-4658}, url = {https://onlinelibrary.wiley.com/doi/10.1002/acr.24394}, doi = {10.1002/acr.24394}, abstract = {Objective. To explore whether magnetic resonance imaging (MRI) features suggestive of knee osteoarthritis (OA) are associated with presence of knee pain in possible early-stage OA development. Methods. We included 294 participants from the Osteoarthritis Initiative (mean ± SD age 50 ± 3 years; 50\% women) with baseline Kellgren/Lawrence grade of 0 in both knees, all of whom had received knee MRIs at 4 different time points over 6 years (baseline, 24, 48, and 72 months). Using a linear mixed model (knees matched within individuals), we studied whether MRI features (meniscal body extrusion [in mm], cartilage area loss [score 0–3 9], cartilage full thickness loss [range 0–16], osteophytes [range 0–29], meniscal integrity [range 0–10], bone marrow lesions [BMLs] including bone marrow cysts [range 0–20], Hoffa-or effusion-s ynovitis [absent/present], and popliteal cysts [absent/present]) were associated with knee-s pecific pain as reported on the Knee Injury and Osteoarthritis Outcome Score (KOOS) questionnaire using a 0–100 scale (worst to best). Results. The differences in KOOS knee pain score for a knee with a 1 unit higher score on MRI were the following: meniscal extrusion –1.52 (95\% confidence interval [95\% CI] –2 .35, –0.69); cartilage area loss –0 .23 (95\% CI –0 .48, 0.02); cartilage full thickness loss –1.04 (95\% CI –1.58, –0.50); osteophytes –0.32 (95\% CI –0.61, –0.03); meniscal integrity –0 .28 (95\% CI –0.58, 0.02); BMLs including potential cysts –0.19 (95\% CI –0.55, 0.16); synovitis 0.23 (95\% CI –1.14, 1.60); and popliteal cysts 0.86 (95\% CI –0 .56, 2.29). Conclusion. Meniscal extrusion, full thickness cartilage loss, and osteophytes are associated with having more knee pain. Although these features may be relevant targets for future trials, the clinical relevance of our findings is unclear because no feature was associated with a clinically important difference in knee pain.}, language = {en}, number = {11}, urldate = {2021-11-08}, journal = {Arthritis Care \& Research}, author = {Magnusson, Karin and Turkiewicz, Aleksandra and Kumm, Jaanika and Zhang, Fan and Englund, Martin}, month = nov, year = {2021}, note = {Number: 11}, pages = {1659--1666}, }
@article{dellisola_impact_2021, title = {The impact of first and second wave of {COVID}-19 on knee and hip surgeries in {Sweden}}, volume = {8}, issn = {2197-1153}, url = {https://doi.org/10.1186/s40634-021-00382-7}, doi = {10.1186/s40634-021-00382-7}, abstract = {To investigate the impact of COVID-19 in Sweden on rates of knee and hip surgeries.}, number = {1}, urldate = {2021-09-06}, journal = {Journal of Experimental Orthopaedics}, author = {Dell’Isola, Andrea and Kiadaliri, Ali and Turkiewicz, Aleksandra and Hughes, Velocity and Magnusson, Karin and Runhaar, Jos and Bierma-Zeinstra, Sita and Englund, Martin}, month = aug, year = {2021}, note = {Number: 1}, keywords = {COVID-19, Elective surgeries, Orthopedics}, pages = {60}, }
@article{wolf_what_2021, title = {What are the patient-reported outcomes of trapeziectomy and tendon suspension at long-term follow-up?}, volume = {479}, issn = {0009-921X}, url = {https://journals.lww.com/clinorthop/Abstract/2021/09000/What_Are_the_Patient_reported_Outcomes_of.24.aspx}, doi = {10.1097/CORR.0000000000001795}, abstract = {Background There are multiple options for the treatment of thumb carpometacarpal joint osteoarthritis (CMC1 OA), with evidence for pain relief and improved function. Although simple trapeziectomy has the lowest complication risk, tendon suspension of the first metacarpal and interposition is still the most commonly used surgical procedure in patients with CMC1 OA. Although there are several reports of good short-term results after trapeziectomy and tendon suspension-interposition arthroplasty, few studies have evaluated long-term outcomes. This study is one of the largest and longest follow-up evaluations of a cohort of patients with CMC1 OA who were treated with trapeziectomy and suspension-interposition arthroplasty, capturing 96\% of the original cohort for evaluation. Questions/purposes (1) After trapeziectomy and tendon suspension surgery, what are the long-term, patient-reported outcomes and clinical measurements (strength and ROM); and in unilateral procedures, how do these parameters compare with those of the contralateral hand that was not operated on? (2) What is the mean subsidence (unloaded trapezial space), and does pinch strength correlate with the amount of subsidence? Methods From 1998 to 2005, 130 patients underwent trapeziectomy and abductor pollicis longus (APL) suspension-interposition arthroplasty for CMC1 OA at one orthopaedic department. During this period, 15 patients were treated with CMC1 arthrodesis and four were treated with implant arthroplasty, for a total of 149 patients. The surgeons used APL suspensionplasty for most patients, based on age and expected postoperative function; they also employed this procedure to avoid hardware or implant failure issues. The 100 living patients were asked to participate in this retrospective study, 96\% (96) of whom were enrolled. The mean age at surgery was 58 ± 7 years. The patients completed a two-item thumb pain scale (modified from the SF-36 body pain scale), a hand pain VAS (average level of pain experienced over the week preceding measurement), and the 11-item QuickDASH. Patient-reported outcomes data were obtained from all 96 patients, and 83\% (80) of patients underwent bilateral hand radiography and a physical examination at a mean follow-up of 17 ± 2.4 years. We calculated outcome data for each patient, and in 39 patients with unilateral surgery and intact contralateral CMC1 joint, we compared the operated side with the contralateral side. We compared our outcome data with that from the Swedish National Quality Registry for Hand Surgery (HAKIR), noting comparable outcomes for pain and QuickDASH scores. Results At long-term follow-up after trapeziectomy and APL suspension surgery, the mean thumb pain score was 19 ± 26, hand pain VAS score 23 ± 25, and QuickDASH score 26 ± 21. In the patients with unilateral surgery and intact contralateral CMC1 joint, the thumb pain score for the operated side was lower than the contralateral side, specifically 19 ± 25 compared with 29 ± 30 (mean difference -9.8 [95\% CI -19.5 to -0.2]; p = 0.045); hand pain VAS score was 24 ± 23 versus 30 ± 25 (mean difference -6.1 [95\% CI -15.2 to 3.1]; p = 0.19), and the QuickDASH score was 27 ± 19. Grip strength showed no differences between the operated and contralateral sides (mean 16.7 ± 7.3 kg versus 16.6 ± 6.9 kg, mean difference 0.1 [95\% CI -1.6 to 1.8]; p = 0.90), while pinch was different (4.4 ± 1.4 versus 5.0 ± 1.5 kg, mean difference -0.6 [95\% CI -0.9 to -0.3]; p = 0.001). The mean trapezial space was 4.4 ± 2.2 mm, and there was no association between the trapezial space and pinch strength (0.07 kg [95\% CI -0.04 to 0.18] per mm of space; p = 0.17). Conclusion The finding of comparable pain and function between operated and unoperated sides at long-term follow-up suggests that trapeziectomy and tendon suspension-interposition arthroplasty provides predictable outcomes, and surgeons can use these data to counsel patients that surgery can potentially return them to comparable use. However, as patients often have asymptomatic radiographic OA on the contralateral side, future studies are needed to examine the impact of asymptomatic disease on function. Level of Evidence Level IV, therapeutic study.}, language = {en-US}, number = {9}, urldate = {2021-09-06}, journal = {Clinical Orthopaedics and Related Research®}, author = {Wolf, Jennifer Moriatis and Turkiewicz, Aleksandra and Englund, Martin and Karlsson, Jon and Arner, Marianne and Atroshi, Isam}, month = sep, year = {2021}, note = {Number: 9}, pages = {2009--2018}, }
@article{kiadaliri_osteoarthritis_2021, title = {Osteoarthritis and risk of hospitalization for ambulatory care sensitive conditions: {A} general population-based cohort study}, volume = {60}, issn = {1462-0324}, shorttitle = {Osteoarthritis and risk of hospitalization for ambulatory care sensitive conditions}, url = {https://doi.org/10.1093/rheumatology/keab161}, doi = {10.1093/rheumatology/keab161}, abstract = {To determine the association between osteoarthritis (OA) and risk of hospitalization for ambulatory care sensitive conditions (HACSCs).We included all individuals aged 40–85 years who resided in Skåne, Sweden on 31st December 2005 with at least one healthcare consultation during 1998–2005 (n = 515 256). We identified those with a main diagnosis of OA between January 1, 1998 and December 31, 2016. People were followed from January 1st 2006 until an HACSC, death, relocation outside Skåne, or December 31st 2016 (whichever occurred first). OA status was treated as a time-varying covariate (those diagnosed before January 1, 2006 considered as exposed for whole study period). We assessed relative (hazard ratios (HRs) using Cox proportional hazard model) and absolute (hazard difference using additive hazard model) effects of OA on HACSCs adjusted for potential confounders.Crude incidence rates of HACSCs were 239 (95\% CI 235, 242) and 151 (150, 152) per 10 000 person-years among OA and non-OA persons, respectively. The OA persons had an increased risk of HACSCs (HR [95\% CI] 1.11 [1.09, 1.13]) and its subcategories of medical conditions except chronic obstructive pulmonary disease (HR [95\% CI] 0.86 [0.81, 0.90]). There were 20 (95\% CI 16, 24) more HACSCs per 10 000 person-years in OA compared with non-OA persons. While HRs for knee and hip OA were generally comparable, only knee OA was associated with increased risk of hospitalization for diabetes.OA is associated with an increased risk of HACSCs, highlighting the urgent need to improve outpatient care for OA patients.}, number = {9}, urldate = {2021-02-18}, journal = {Rheumatology}, author = {Kiadaliri, Ali and Englund, Martin}, month = sep, year = {2021}, note = {Number: 9}, pages = {4340--4347}, }
@article{macri_importance_2021, title = {Importance of patellofemoral and tibiofemoral cartilage lesions on trajectory of self-reported outcomes in patients at high risk of knee {OA}: 4–6 years follow-up of patients undergoing meniscal surgery}, volume = {29}, issn = {1063-4584}, shorttitle = {Importance of patellofemoral and tibiofemoral cartilage lesions on trajectory of self-reported outcomes in patients at high risk of knee {OA}}, url = {https://www.sciencedirect.com/science/article/pii/S1063458421008086}, doi = {10.1016/j.joca.2021.06.002}, abstract = {Objective We evaluated whether patient-reported outcome trajectories (i.e., changes over time) differed by intraoperative compartmental cartilage lesion pattern over 4–6 years following arthroscopic meniscal surgery. Methods In this ancillary study of the Knee Arthroscopy Cohort Southern Denmark cohort, we intraoperatively categorized cartilage lesions as isolated patellofemoral, isolated tibiofemoral, or combined patellofemoral/tibiofemoral. Participants completed the Knee injury and Osteoarthritis Outcome Score (KOOS) pre-operatively, at 3 and 12 months, and at 4–6 years post-operatively and reported overall satisfaction at final follow-up. Our main outcome was KOOS4 (grand mean of four subscale means). We evaluated whether KOOS4 scores changed over time according to cartilage lesion patterns using adjusted mixed linear regression. We also estimated probability of treatment satisfaction using logistic regression. Results Of 630 participants with complete cartilage scores, 280 (44\%) were women, mean (standard deviation) age was 49 (13) years, and BMI was 27.3 (4.4) kg/m2. KOOS4 scores at baseline were slightly lower in all lesion groups compared to the no lesion group, yet only the combined group was statistically significantly lower. KOOS4 trajectories were similar across cartilage lesion patterns, but by final follow-up, adjusted mean KOOS4 scores were 6.8 (95\% CI 2.2, 11.4) to 9.8 (1.1, 18.5) points lower in groups with cartilage lesions compared to the no lesion group. Probability of patient-reported satisfaction did not differ statistically by group. Conclusions Though KOOS4 scores were slightly lower in groups with arthroscopically assessed cartilage lesions compared to the no lesion group, trajectories were similar across all groups.}, language = {en}, number = {9}, urldate = {2021-09-06}, journal = {Osteoarthritis and Cartilage}, author = {Macri, E. M. and Culvenor, A. G. and Englund, M. and Pihl, K. and Varnum, C. and Knudsen, R. and Lohmander, L. S. and Thorlund, J. B.}, month = sep, year = {2021}, note = {Number: 9}, keywords = {Arthroscopic meniscal surgery, Patellofemoral joint, Patient-reported outcomes, Tibiofemoral joint}, pages = {1291--1295}, }
@article{swain_temporal_2021, title = {Temporal relationship between osteoarthritis and comorbidities: a combined case control and cohort study in the {UK} primary care setting}, volume = {60}, issn = {1462-0332}, shorttitle = {Temporal relationship between osteoarthritis and comorbidities}, url = {https://doi.org/10.1093/rheumatology/keab067}, doi = {10.1093/rheumatology/keab067}, abstract = {OBJECTIVE: To determine the burden of comorbidities in osteoarthritis (OA) and their temporal relationships in the UK. METHODS: The Clinical Practice Research Datalink (CPRD) GOLD was used to identify people with incident OA and age, gender and practice matched non-OA controls from UK primary care. Controls were assigned the same index date as matched cases (date of OA diagnosis). Associations between OA and 49 individual comorbidities and multimorbidity (≥2 comorbidities excluding OA) both before and after OA diagnosis were estimated, adjusting for covariates, using odds ratios (aOR) and hazard ratios (aHR) respectively. RESULTS: During 1997-2017, we identified 221 807 incident OA cases and 221 807 matched controls. Of 49 comorbidities examined, 38 were associated with OA both prior to, and following, the diagnosis of OA, and 2 (dementia and SLE) were associated with OA only following the diagnosis of OA. People with OA had higher risk of developing heart failure (aHR 1.63; 95\% CI 1.56-1.71), dementia (aHR 1.62; 95\% CI 1.56-1.68), liver diseases (aHR 1.51; 95\% CI 1.37-1.67), irritable bowel syndrome (aHR 1.51; 95\% CI 1.45-1.58), gastrointestinal bleeding (aHR 1.49; 95\% CI 1.39-1.59), 10 musculoskeletal conditions and 25 other conditions following OA diagnosis. The aOR for multimorbidity prior to the index date was 1.71 (95\% CI 1.69-1.74), whereas the aHR for multimorbidity after the index date was 1.29 (95\% CI 1.28-1.30). CONCLUSIONS: People with OA are more likely to have other chronic conditions both before and after the OA diagnosis. Further study on shared aetiology and causality of these associations is needed.}, language = {eng}, number = {9}, journal = {Rheumatology (Oxford, England)}, author = {Swain, Subhashisa and Coupland, Carol and Mallen, Christian and Kuo, Chang Fu and Sarmanova, Aliya and Bierma-Zeinstra, Sita M. A. and Englund, Martin and Prieto-Alhambra, Daniel and Doherty, Michael and Zhang, Weiya}, month = sep, year = {2021}, pmid = {33506862}, note = {Number: 9}, keywords = {Osteoarthritis, burden, comorbidity, multimorbidity, temporal association}, pages = {4327--4339}, }
@article{battista_experience_2021, title = {Experience of the {COVID}-19 pandemic as lived by patients with hip and knee osteoarthritis: an {Italian} qualitative study}, volume = {11}, copyright = {© Author(s) (or their employer(s)) 2021. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.. http://creativecommons.org/licenses/by-nc/4.0/This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/.}, issn = {2044-6055, 2044-6055}, shorttitle = {Experience of the {COVID}-19 pandemic as lived by patients with hip and knee osteoarthritis}, url = {https://bmjopen.bmj.com/content/11/10/e053194}, doi = {10.1136/bmjopen-2021-053194}, abstract = {Objective To examine the experience of the COVID-19 pandemic as lived by people with hip and knee osteoarthritis (OA), in Italy. Design A qualitative study based on semi-structured interviews. Setting Urban and suburban areas in northern Italy. Participants A total of 11 people with OA were enrolled through a purposeful sampling and completed the study. Primary outcome measure The experience of Italian people with OA during the COVID-19 pandemic. Results Four themes were brought to the forefront from the analysis of the interviews. (1) Being Stressed for the Limited Social Interactions and for the Family Members at High Risk of Infection, as the interviewees were frustrated because they could not see their loved ones or felt a sense of apprehension for their relatives. (2) Recurring Strategies to Cope with the Pandemic such as an active acceptance towards the situation. (3) Being Limited in the Possibility of Undergoing OA Complementary Treatments and Other Routine Medical Visits. (4) Being Unaware of the Importance of Physical Activity as First-Line Interventions which was an attitude already present before the pandemic. Conclusion The COVID-19 pandemic and related restrictions impacted the quality of life and the care of individuals with hip and knee OA. The social sphere seemed to be the most hindered. However, the interviewees developed a good level of acceptance to deal with the pandemic. When it came to their care, they faced a delay of routine medical visits not related to OA and of other complementary treatments (eg, physical therapies) to manage OA. Finally, a controversial result that emerged from these interviews was that first-line interventions for OA (ie, therapeutic exercise) was not sought by the interviewees, regardless of the restrictions dictated by the pandemic. Policy-making strategies are thus necessary to support the awareness of the importance of such interventions.}, language = {en}, number = {10}, urldate = {2021-10-31}, journal = {BMJ Open}, author = {Battista, Simone and Dell'Isola, Andrea and Manoni, Mattia and Englund, Martin and Palese, Alvisa and Testa, Marco}, month = oct, year = {2021}, pmid = {34706962}, note = {Number: 10 Publisher: British Medical Journal Publishing Group Section: Rheumatology}, keywords = {COVID-19, adult orthopaedics, health economics, health policy, musculoskeletal disorders, quality in health care}, pages = {e053194}, }
@article{mollestam_association_2021, title = {Association of clinically relevant carpal tunnel syndrome with type of work and level of education: a general-population study}, volume = {11}, copyright = {2021 The Author(s)}, issn = {2045-2322}, shorttitle = {Association of clinically relevant carpal tunnel syndrome with type of work and level of education}, url = {https://www.nature.com/articles/s41598-021-99242-8}, doi = {10.1038/s41598-021-99242-8}, abstract = {Carpal tunnel syndrome (CTS) is a common cause of work disability. The association with occupational load and education level has not been established in general-population studies. The purpose of this study was to investigate the association of clinically relevant CTS with work and education. From the Healthcare Register of Skane region (population 1.2 million) in southern Sweden we identified all individuals, aged 17–57 years, with first-time physician-made CTS diagnosis during 2004–2008. For each case we randomly sampled 4 referents, without a CTS diagnosis, from the general population matched by sex, age, and residence. We retrieved data about work and education from the national database. The study comprised 5456 individuals (73\% women) with CTS and 21,667 referents. We found a significant association between physician-diagnosed CTS and type of work and level of education in both women and men. Compared with white-collar workers, the odds ratio (OR) for CTS among blue-collar workers was 1.67 (95\% CI 1.54–1.81) and compared with light work, OR in light-moderate work was 1.37 (1.26–1.50), moderate work 1.70 (1.51–1.91), and heavy manual labor 1.96 (1.75–2.20). Compared with low-level education, OR for CTS in intermediate level was 0.82 (0.76–0.89) and high-level 0.48 (0.44–0.53). In women and men there is significant association with a dose–response pattern between clinically relevant CTS and increasing manual work load and lower education level. These findings could be important in design and implementation of preventive measures.}, language = {en}, number = {1}, urldate = {2021-10-12}, journal = {Scientific Reports}, author = {Möllestam, Kamelia and Englund, Martin and Atroshi, Isam}, month = oct, year = {2021}, note = {Bandiera\_abtest: a Cc\_license\_type: cc\_by Cg\_type: Nature Research Journals Number: 1 Primary\_atype: Research Publisher: Nature Publishing Group Subject\_term: Diseases;Medical research;Risk factors Subject\_term\_id: diseases;medical-research;risk-factors}, pages = {19850}, }
@article{folkesson_proteomic_2020, title = {Proteomic characterization of the normal human medial meniscus body using data-independent acquisition mass spectrometry}, volume = {38}, issn = {1554-527X}, url = {https://doi.org/10.1002/jor.24602}, doi = {10.1002/jor.24602}, abstract = {Recent research suggests an important role of the meniscus in the development of knee osteoarthritis. We, therefore, aimed to analyze the proteome of the normal human meniscus body, and specifically to gain new knowledge on global protein expression in the different radial zones. Medial menisci were retrieved from the right knees of 10 human cadaveric donors, from which we cut a 2 mm radial slice from the mid-portion of the meniscal body. This slice was further divided into three zones: inner, middle, and peripheral. Proteins were extracted and prepared for mass spectrometric analysis using data-independent acquisition. We performed subsequent data searches using Spectronaut Pulsar and used fixed-effect linear regression models for statistical analysis. We identified 638 proteins and after statistical analysis, we observed the greatest number of differentially expressed proteins between the inner and peripheral zones (163 proteins) and the peripheral and middle zones (136 proteins), with myocilin being the protein with the largest fold-change in both comparisons. Chondroadherin was one of eight proteins that differed between the inner and middle zones. Functional enrichment analyses showed that the peripheral one-third of the medial meniscus body differed substantially from the two more centrally located zones, which were more similar to each other. This is probably related to the higher content of cells and vascularization in the peripheral zone, whereas the middle and inner zones of the meniscal body appear to be more similar to hyaline cartilage, with high levels of extracellular matrix proteins such as aggrecan and collagen type II.}, language = {eng}, number = {8}, journal = {Journal of Orthopaedic Research: Official Publication of the Orthopaedic Research Society}, author = {Folkesson, Elin and Turkiewicz, Aleksandra and Rydén, Martin and Hughes, Harini Velocity and Ali, Neserin and Tjörnstrand, Jon and Önnerfjord, Patrik and Englund, Martin}, month = aug, year = {2020}, pmid = {31989678}, note = {Number: 8}, keywords = {data-independent acquisition, meniscus, proteomics}, pages = {1735--1745}, }
@article{kiadaliri_trajectory_2020, title = {Trajectory of excess healthcare consultations, medication use, and work disability in newly diagnosed knee osteoarthritis: a matched longitudinal register-based study}, volume = {In Press}, issn = {1522-9653}, shorttitle = {Trajectory of excess healthcare consultations, medication use, and work disability in newly diagnosed knee osteoarthritis}, url = {https://doi.org/10.1016/j.joca.2020.12.008}, doi = {10.1016/j.joca.2020.12.008}, abstract = {PURPOSE: To estimate the excess healthcare use and work disability attributable to knee osteoarthritis (OA) in the first 5 years following diagnosis. METHODS: Among individual aged 40-80 years who resided in Skåne on 31st December 2008, we identified those with a main diagnosis of knee OA during 2009-2014 and no previous diagnosis of any OA from 1998 (n = 16,888). We created a comparison cohort matched (1:1) by sex, age, and municipality from individuals with no OA diagnosis (at any site) during 1998-2016. We compared healthcare use and net disability days for 60 months following diagnosis between the two groups. We applied a survival-adjusted regression technique controlling for sociodemographic characteristics as well as pre-diagnosis outcome and comorbidity. RESULTS: The estimated 5-year incremental effects of knee OA per-patient were 16.8 (95\% CI: 15.8, 17.7) healthcare consultations, 0.7 (0.4, 1.1) inpatient days, 420 (372, 490) defined daily dose of prescribed medications, and 21.8 (15.2, 30.0) net disability days. Primary care consultations constituted about 73\% of the excess healthcare consultations. Most of these incremental effects occurred in the first year after diagnosis. Better survival in the knee OA group accounted for 0.7 (95\% CI: 0.5, 0.8) and 1.4 (0.7, 2.6) of the excess healthcare consultations and net disability days, respectively. Both estimated total and incremental resources use were generally greater for women than men with knee OA. CONCLUSION: Knee OA was associated with considerable excess healthcare use and work disability independent of pre-diagnosis resources use, comorbidity, and sociodemographic characteristics.}, language = {eng}, journal = {Osteoarthritis and Cartilage}, author = {Kiadaliri, A. and Englund, M.}, month = dec, year = {2020}, pmid = {33359251}, keywords = {Healthcare consultation, Incremental analysis, Knee osteoarthritis, Sweden, Work disability}, }
@article{snoeker_does_2020, title = {Does early anterior cruciate ligament reconstruction prevent development of meniscal damage? {Results} from a secondary analysis of a randomised controlled trial.}, volume = {54}, copyright = {© Author(s) (or their employer(s)) 2020. No commercial re-use. See rights and permissions. Published by BMJ.}, issn = {1473-0480 0306-3674}, url = {https://doi.org/10.1136/bjsports-2019-101125}, doi = {10.1136/bjsports-2019-101125}, abstract = {OBJECTIVES: To determine development of new and worsening meniscal damage over 5 years after acute anterior cruciate ligament (ACL) injury comparing rehabilitation plus early ACL reconstruction ('early-ACLR') versus rehabilitation with optional delayed ACL reconstruction ('optional-delayed-ACLR'). METHODS: We used knee MRIs from the only randomised controlled trial in the field including 121 young adults. One musculoskeletal radiologist read baseline and 5-year follow-up images using the Anterior Cruciate Ligament Osteoarthritis Score (ACLOAS). We defined development (ie, new and worsening) of meniscal damage both dichotomously and as a sum score representing severity (based on the reclassified ACLOAS meniscus grades). In the full analysis set, we analysed development of meniscal damage (yes/no) with logistic regression and severity with zero-inflated Poisson regression and adjusted for age, sex and baseline meniscal damage. RESULTS: Over 5 years, new or worsening meniscal damage developed in 45\% of subjects with early-ACLR and in 53\% of subjects with optional-delayed-ACLR. The relative risk for development of meniscal damage on knee level was 1.3 (95\% CI 0.9 to 1.9) in optional-delayed-ACLR versus early-ACLR. For medial and lateral meniscal damage, respectively, the relative risks were 2.1 (95\% CI 1.1 to 3.9) and 1.0 (95\% CI 0.6 to 1.5). The mean severity score was 1.5 higher (more severe damage) on knee level in optional-delayed-ACLR versus early-ACLR (95\% CI 1.1 to 1.9) among those with meniscal damage at 5 years. For medial and lateral meniscal damage, respectively, the corresponding scores were 1.7 (95\% CI 1.2 to 2.5) and 1.1 (95\% CI 0.8 to 1.4). CONCLUSION: A strategy of early-ACLR may reduce development of medial meniscal damage following acute ACL injury. For the lateral meniscus, ACLR seems neither to be protective nor to increase the risk of damage. TRIAL REGISTRATION NUMBER: ISRCTN 84752559.}, language = {eng}, number = {10}, journal = {British journal of sports medicine}, author = {Snoeker, Barbara A. and Roemer, Frank W. and Turkiewicz, Aleksandra and Lohmander, Stefan and Frobell, Richard B. and Englund, Martin}, month = may, year = {2020}, pmid = {31653779}, note = {Number: 10 Place: England}, keywords = {*Time-to-Treatment, ACL, Adult, Anterior Cruciate Ligament Injuries, Anterior Cruciate Ligament Injuries/rehabilitation/*surgery, Anterior Cruciate Ligament Reconstruction, Anterior Cruciate Ligament Reconstruction/*methods, Female, Humans, Magnetic Resonance Imaging, Male, Postoperative Complications, Risk Factors, Tibial Meniscus Injuries, Tibial Meniscus Injuries/diagnostic imaging/*prevention \& control, Time-to-Treatment, Young Adult, knee, knee surgery, meniscus, randomised controlled trial}, pages = {612--617}, }
@article{snoeker_risk_2020, title = {Risk of knee osteoarthritis after different types of knee injuries in young adults: a population-based cohort study}, volume = {54}, issn = {1473-0480}, shorttitle = {Risk of knee osteoarthritis after different types of knee injuries in young adults}, url = {https://doi.org/10.1136/bjsports-2019-100959}, doi = {10.1136/bjsports-2019-100959}, abstract = {OBJECTIVES: To estimate the risk of clinically diagnosed knee osteoarthritis (OA) after different types of knee injuries in young adults. METHODS: In a longitudinal cohort study based on population-based healthcare data from Skåne, Sweden, we included all persons aged 25-34 years in 1998-2007 (n=149 288) with and without diagnoses of knee injuries according to International Classification of Diseases (ICD)-10. We estimated the HR of future diagnosed knee OA in injured and uninjured persons using Cox regression, adjusted for potential confounders. We also explored the impact of type of injury (contusion, fracture, dislocation, meniscal tear, cartilage tear/other injury, collateral ligament tear, cruciate ligament tear and injury to multiple structures) on diagnosed knee OA risk. RESULTS: We identified 5247 persons (mean (SD) age 29.4 (2.9) years, 67\% men) with a knee injury and 142 825 persons (mean (SD) age 30.2 (3.0) years, 45\% men) without. We found an adjusted HR of 5.7 (95\% CI 5.0 to 6.6) for diagnosed knee OA in injured compared with uninjured persons during the first 11 years of follow-up and 3.4 (95\% CI 2.9 to 4.0) during the following 8 years. The corresponding risk difference (RD) after 19 years of follow-up was 8.1\% (95\% CI 6.7\% to 9.4\%). Cruciate ligament injury, meniscal tear and fracture of the tibia plateau/patella were associated with greatest increase in risk (RD of 19.6\% (95\% CI 13.2\% to 25.9\%), 10.5\% (95\% CI 6.4\% to 14.7\%) and 6.6\% (95\% CI 1.1\% to 12.2\%), respectively). CONCLUSION: In young adults, knee injury increases the risk of future diagnosed knee OA about sixfold with highest risks found after cruciate ligament injury, meniscal tear and intra-articular fracture.}, language = {eng}, number = {12}, journal = {British Journal of Sports Medicine}, author = {Snoeker, Barbara and Turkiewicz, Aleksandra and Magnusson, Karin and Frobell, Richard and Yu, Dahai and Peat, George and Englund, Martin}, month = jun, year = {2020}, pmid = {31826861}, note = {Number: 12}, keywords = {Adult, Anterior Cruciate Ligament Injuries, Anterior Cruciate Ligament Injuries/complications, Cartilage, Articular, Cartilage, Articular/injuries, Contusions, Contusions/complications, Female, Fracture Dislocation, Fracture Dislocation/complications, Humans, Knee Injuries, Knee Injuries/*complications, Longitudinal Studies, Male, Osteoarthritis, Knee, Osteoarthritis, Knee/*epidemiology/etiology, Risk Factors, Sweden, Sweden/epidemiology, Tibial Fractures, Tibial Fractures/complications, Tibial Meniscus Injuries, Tibial Meniscus Injuries/complications, Time Factors, Young Adult, fracture, knee ACL, knee injuries, meniscus, osteoarthritis}, pages = {725--730}, }
@article{einarsson_relating_2020, title = {Relating {MR} relaxation times of ex vivo meniscus to tissue degeneration through comparison with histopathology}, volume = {2}, issn = {2665-9131}, url = {https://www.sciencedirect.com/science/article/pii/S2665913120300509}, doi = {10.1016/j.ocarto.2020.100061}, abstract = {Background Quantitative magnetic resonance imaging (MRI), e.g. relaxation parameter mapping, may be sensitive to structural and compositional tissue changes, and could potentially be used to non-invasively detect and monitor early meniscus degeneration related to knee osteoarthritis. Objective To investigate MR relaxation times as potential biomarkers for meniscus degeneration through comparisons with histopathology. Methods We measured MR relaxation parameters in the posterior horn of 40 menisci (medial and lateral) at a wide range of degenerative stages. T1, T2 and T2∗ were mapped using standard and ultrashort echo time sequences at 9.4 T and compared to gold standard histology using Pauli's histopathological scoring system, including assessment of surface integrity, collagen organization, cellularity and Safranin-O staining. Results All three relaxation times increased with total Pauli score (mean difference per score (95\% CI) for T2∗: 0.62 (0.37, 0.86), T2: 0.83 (0.53, 1.1) and T1: 24.7 (16.5, 32.8) ms/score). Clear associations were seen with scores of surface integrity (mean difference per score for T2∗: 3.0 (1.8, 4.2), T2: 4.0 (2.5, 5.5) and T1: 116 (75.6, 156) ms/score) and collagen organization (mean difference between highest and lowest score for T2∗: 5.3 (1.6, 8.9), T2: 6.1 (1.7, 11) and T1: 204 (75.9, 332) ms). The results were less clear for the remaining histopathological measures. Conclusions MR relaxation times T1, T2 and T2∗ of ex vivo human menisci are associated with histologically verified degenerative processes, in particular related to surface integrity and collagen organization. If confirmed in vivo, MR relaxation times may thus be potential biomarkers for meniscus degeneration.}, language = {en}, number = {2}, urldate = {2021-03-27}, journal = {Osteoarthritis and Cartilage Open}, author = {Einarsson, Emma and Svensson, Jonas and Folkesson, Elin and Kestilä, Iida and Tjörnstrand, Jon and Peterson, Pernilla and Finnilä, Mikko A. J. and Hughes, H. Velocity and Turkiewicz, Aleksandra and Saarakkala, Simo and Englund, Martin}, month = jun, year = {2020}, note = {Number: 2}, keywords = {Ex vivo, Histology, MRI, Meniscus, Osteoarthritis, Relaxation times}, pages = {100061}, }
@article{wolski_early_2020, title = {Early tibial subchondral bone texture changes after arthroscopic partial meniscectomy in knees without radiographic {OA}: {A} prospective cohort study}, volume = {38}, issn = {1554-527X}, shorttitle = {Early tibial subchondral bone texture changes after arthroscopic partial meniscectomy in knees without radiographic {OA}}, url = {https://doi.org/10.1002/jor.24593}, doi = {10.1002/jor.24593}, abstract = {Arthroscopic partial meniscectomy (APM) may lead to changes in underlying trabecular bone (TB) structure potentially promoting the development of knee joint osteoarthritis. Our aim was to investigate if there are early changes occurring in tibial subchondral TB texture in the leg undergoing medial APM compared with the unoperated non-injured contra-lateral leg. The bone texture was measured as the medial-to-lateral ratio of fractal dimensions (FD) calculated for regions selected on weight-bearing anteroposterior tibiofemoral x-rays. Twenty-one subjects before and 12 months after APM were included from 374 patients scheduled for unilateral medial APM. The medial-to-lateral ratio was calculated for horizontal, vertical, and roughest FDs respectively. Higher FD means higher bone roughness. Each FD was calculated over a range of scales using a variance orientation transform method. Mean values of medial-to-lateral horizontal FD calculated for APM knees at follow-up were higher than those at baseline. For unoperated knees the values were lower. The difference in the horizontal FD change from baseline to follow-up between APM and contra-lateral legs was 0.028 (95\% CI, 0.004-0.052). The bone roughness changes may reflect the increase in peak knee adduction moment (KAM) and KAM impulse during walking reported for the same cohort in a previous study. They may also reflect early signs of osteoarthritis development and thus, we speculate that individuals with increased bone texture roughness ratio after APM might be at higher risk of knee osteoarthritis development.}, language = {eng}, number = {8}, journal = {Journal of Orthopaedic Research: Official Publication of the Orthopaedic Research Society}, author = {Wolski, Marcin and Thorlund, Jonas B. and Stachowiak, Gwidon W. and Holsgaard-Larsen, Anders and Creaby, Mark W. and Jørgensen, Gitte M. and Englund, Martin and Podsiadlo, Pawel}, month = aug, year = {2020}, pmid = {31965586}, note = {Number: 8}, keywords = {fractal analysis, meniscectomy, osteoarthritis, tibiofemoral}, pages = {1819--1825}, }
@article{sihvonen_arthroscopic_2020, title = {Arthroscopic partial meniscectomy for a degenerative meniscus tear: a 5 year follow-up of the placebo-surgery controlled {FIDELITY} ({Finnish} {Degenerative} {Meniscus} {Lesion} {Study}) trial}, volume = {54}, issn = {1473-0480}, shorttitle = {Arthroscopic partial meniscectomy for a degenerative meniscus tear}, url = {https://doi.org/10.1136/bjsports-2020-102813}, doi = {10.1136/bjsports-2020-102813}, abstract = {OBJECTIVES: To assess the long-term effects of arthroscopic partial meniscectomy (APM) on the development of radiographic knee osteoarthritis, and on knee symptoms and function, at 5 years follow-up. DESIGN: Multicentre, randomised, participant- and outcome assessor-blinded, placebo-surgery controlled trial. SETTING: Orthopaedic departments in five public hospitals in Finland. PARTICIPANTS: 146 adults, mean age 52 years (range 35-65 years), with knee symptoms consistent with degenerative medial meniscus tear verified by MRI scan and arthroscopically, and no clinical signs of knee osteoarthritis were randomised. INTERVENTIONS: APM or placebo surgery (diagnostic knee arthroscopy). MAIN OUTCOME MEASURES: We used two indices of radiographic knee osteoarthritis (increase in Kellgren and Lawrence grade ≥1, and increase in Osteoarthritis Research Society International (OARSI) atlas radiographic joint space narrowing and osteophyte sum score, respectively), and three validated patient-relevant measures of knee symptoms and function (Western Ontario Meniscal Evaluation Tool (WOMET), Lysholm, and knee pain after exercise using a numerical rating scale). RESULTS: There was a consistent, slightly greater risk for progression of radiographic knee osteoarthritis in the APM group as compared with the placebo surgery group (adjusted absolute risk difference in increase in Kellgren-Lawrence grade ≥1 of 13\%, 95\% CI -2\% to 28\%; adjusted absolute mean difference in OARSI sum score 0.7, 95\% CI 0.1 to 1.3). There were no relevant between-group differences in the three patient-reported outcomes: adjusted absolute mean differences (APM vs placebo surgery), -1.7 (95\% CI -7.7 to 4.3) in WOMET, -2.1 (95\% CI -6.8 to 2.6) in Lysholm knee score, and -0.04 (95\% CI -0.81 to 0.72) in knee pain after exercise, respectively. The corresponding adjusted absolute risk difference in the presence of mechanical symptoms was 18\% (95\% CI 5\% to 31\%); there were more symptoms reported in the APM group. All other secondary outcomes comparisons were similar. CONCLUSIONS: APM was associated with a slightly increased risk of developing radiographic knee osteoarthritis and no concomitant benefit in patient-relevant outcomes, at 5 years after surgery. TRIAL REGISTRATION: ClinicalTrials.gov (NCT01052233 and NCT00549172).}, language = {eng}, number = {22}, journal = {British Journal of Sports Medicine}, author = {Sihvonen, Raine and Paavola, Mika and Malmivaara, Antti and Itälä, Ari and Joukainen, Antti and Kalske, Juha and Nurmi, Heikki and Kumm, Jaanika and Sillanpää, Niko and Kiekara, Tommi and Turkiewicz, Aleksandra and Toivonen, Pirjo and Englund, Martin and Taimela, Simo and Järvinen, Teppo and {FIDELITY (Finnish Degenerative Meniscus Lesion Study) Investigators}}, month = nov, year = {2020}, pmid = {32855201}, note = {Number: 22}, keywords = {meniscus, osteoarthritis}, pages = {1332--1339}, }
@article{magnusson_high_2020, title = {High genetic contribution to anterior cruciate ligament rupture: {Heritability} {\textasciitilde}69}, volume = {In Press}, issn = {1473-0480}, shorttitle = {High genetic contribution to anterior cruciate ligament rupture}, url = {https://doi.org/10.1136/bjsports-2020-102392}, doi = {10.1136/bjsports-2020-102392}, abstract = {OBJECTIVES: We aimed to determine the lifetime genetic risk for anterior cruciate ligament (ACL) rupture. METHODS: We used a twin study approach, linking the Swedish Twin Register with national healthcare data to form a 30 year, population wide, longitudinal twin cohort. We studied ACL rupture in this cohort of 88 414 identical and fraternal twin pairs, aged ≥17 years, to determine the familial risk and heritability of ACL rupture. RESULTS: The incidence rate of ACL rupture was 70 (95\% CI 66 to 74) per 100 000 person years. The familial risk, which is the excess risk ratio (RR) of the second twin having ACL rupture given that the first twin has had such a rupture, was higher in identical twin pairs (RR=8.6, 95\% CI 6.2 to 11.0) than in fraternal twin pairs (RR=1.9, 95\% CI 0.9 to 3.0). The overall heritability of ACL rupture was high, 69\% (95\% CI 47 to 91), increasing from 60\% at age 17 years to 80\% at age 60 years. Women and men had similar familial risk and heritability of ACL rupture. CONCLUSION: The genetic contribution to ACL rupture of {\textasciitilde}69\% is high and suggests strong familial clustering. If clinicians recognise the high genetic risk of such injury, they may be better able to counsel athletes whose near relatives have had ACL rupture.}, language = {eng}, journal = {British Journal of Sports Medicine}, author = {Magnusson, Karin and Turkiewicz, Aleksandra and Hughes, Velocity and Frobell, Richard and Englund, Martin}, month = dec, year = {2020}, pmid = {33288618}, keywords = {ACL, contact sports, epidemiology, genetics, injury prevention}, }