https://flore.unifi.it/bitstream/2158/1072092/1/GBD%20Lancet%202015.pdf

Global, regional, and national incidence, prevalence, and years lived with disability for 301 acute and chronic diseases and injuries in 188 countries, 1990-2013: a systematic analysis for the Global Burden of Disease Study 2013

Sex, Gender, and Pain: A Review of Recent Clinical and Experimental Findings

Osteoarthritis (OA) is the most common form of arthritis and a major cause of pain and disability in older adults (1) Often OA is referred to as degenerative joint disease “(DJD)” This is a misnomer because OA is not simply a process of wear and tear but rather abnormal remodeling of joint tissues driven by a host of inflammatory mediators within the affected joint The most common risk factors for OA include age, gender, prior joint injury, obesity, genetic predisposition, and mechanical factors, including malalignment and abnormal joint shape (2, 3) Despite the multifactorial nature of OA, the pathological changes seen in osteoarthritic joints have common features that affect the entire joint structure resulting in pain, deformity and loss of function

The pathologic changes seen in OA joints (Figures 1 and ​and2)2) include degradation of the articular cartilage, thickening of the subchondral bone, osteophyte formation, variable degrees of synovial inflammation, degeneration of ligaments and, in the knee, the menisci, and hypertrophy of the joint capsule There can also be changes in periarticular muscles, nerves, bursa, and local fat pads that may contribute to OA or the symptoms of OA The findings of pathological changes in all of the joint tissues are the impetus for considering OA as a disease of the joint as an organ resulting in “joint failure” In this review, we will summarize the key features of OA in the various joint tissues affected and provide an overview of the basic mechanisms currently thought to contribute to the pathological changes seen in these tissues






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Figure 1


Sagittal inversion recovery (A–C) and coronal fast spin echo (D–F) images illustrating the magnetic resonance imaging findings of osteoarthritis (A) reactive synovitis (thick white arrow), (B) subchondral cyst formation (white arrow), (C) bone marrow edema (thin white arrows), (D) partial thickness cartilage wear (thick black arrow), (E–F) full thickness cartilage wear (thin black arrows), subchondral sclerosis (arrowhead) and marginal osteophyte formation (double arrow) Image courtesy of Drs Hollis Potter and Catherine Hayter, Hospital for Special Surgery, New York, NY

https://onlinelibrary.wiley.com/doi/pdf/10.1002/art.34453

Osteoarthritis: A Disease of the Joint as an Organ

2016 AHA/ACC Guideline on the Management of Patients With Lower Extremity Peripheral Artery Disease: A Report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines

Risk factors for onset of osteoarthritis of the knee in older adults: a systematic review and meta-analysis.

OBJECTIVE To investigate determinants of the onset and progression of knee pain in a population-based sample of people aged > or = 50 yrs. METHODS Prospective cohort study of 2982 people registered with three general practices in North Staffordshire, UK. Using questionnaire surveys at baseline and 3 yrs, demographic, knee-related and general health factors were assessed for their relationship with onset of new knee pain, and progression from non-severe to severe knee pain. RESULTS Response rates were 77% (baseline) and 75% (follow-up). Baseline factors significantly associated with onset of knee pain were knee injury [odds ratio (OR) 1.6, 95% CI 1.2, 2.2], depression (OR 1.4, 95% CI 1.1, 1.8), widespread pain (OR 1.5, 95% CI 1.1, 1.9 compared with no pain) and younger age. Onset of severe knee pain was associated most strongly with obesity (OR 2.9, 95% CI 1.7, 5.1) and physical limitations (OR 2.5, 95% CI 1.5, 4.1), and with widespread pain, older age, female gender and comorbidity. The strongest independent predictors of progression from non-severe to severe knee pain were chronicity (OR 3.1, 95% CI 2.1, 4.6), previous use of health care (OR 2.2, 95% CI 1.5, 3.3) and obesity (OR 2.1, 95% CI 1.2, 3.6). CONCLUSION In addition to a focus on obesity, there is potential for primary prevention of knee pain by tackling knee injuries and treating depression. Other factors are likely to determine whether the knee pain then progresses. An area for future research is the ineffectiveness of current health care in halting or reversing progression of knee pain at a population level.

Predictors of onset and progression of knee pain in adults living in the community. A prospective study

Aerobic exercise versus combined exercise therapy in women with fibromyalgia syndrome: a randomized controlled trial.

https://www.jvascsurg.org/article/S0741-5214(10)02623-6/pdf

Upper- versus lower-limb aerobic exercise training on health-related quality of life in patients with symptomatic peripheral arterial disease.

Objective: To investigate whether consulting a general practicioner (GP) in the 3 years after reporting knee pain is linked to better knee pain outcomes (reduced presence or severity of knee pain) at the end of the 3 year period. Methods: We undertook a population-based cohort study linking baseline (2000) and follow-up (2003) surveys to primary care medical records. The cohort comprised 1577 adults aged 50 and over registered at 3 general practices in North Staffordshire, UK, who reported knee pain in a baseline survey. The main outcome measures were self-reported prevalence of knee pain and severity of knee pain in the follow-up survey. The relationship between consultation and future knee pain status was adjusted for an individual’s propensity to consult given related demographic and health-related factors. Results: In persons who consulted for knee pain, 91% reported knee pain at 3 years, compared with 73% of those who did not consult (adjusted odds ratio (OR) 2.25; 95% CI 1.56 to 3.26). Among persons reporting severe knee pain or disability at baseline (n = 669), those who consulted for knee pain were more likely to report severe knee pain or disability at 3 years than those who did not consult (82% v 65%, adjusted OR 1.93; 95% CI 1.27 to 2.93). Conclusions: Older adults with knee pain continue to have persistent problems regardless of whether they consult primary care or not. Further research is needed to identify more effective means of reducing the burden of knee pain in the community.

http://repository.keele.ac.uk:8080/intralibrary/open_virtual_file_path/i09n51021t/Jinks3.pdf

Milisa Blagojevic

Papers

Risk factors for onset of osteoarthritis of the knee in older adults: a systematic review and meta-analysis.

Predictors of onset and progression of knee pain in adults living in the community. A prospective study

Aerobic exercise versus combined exercise therapy in women with fibromyalgia syndrome: a randomized controlled trial.

Upper- versus lower-limb aerobic exercise training on health-related quality of life in patients with symptomatic peripheral arterial disease.

The influence of consulting primary care on knee pain in older people: a prospective cohort study