Intervention Strategies for Prevention of Knee Osteoarthritis: A Systematic Review

Association of urinary biomarker COLL2-1NO2 with incident clinical and radiographic knee OA in overweight and obese women

IntroductionApplying a cross-sectional analysis to a sample of 2,627 African-American and Caucasian adults aged ≥ 45 years from the Johnston County Osteoarthritis Project, we studied the association between educational attainment and prevalence of radiographic knee osteoarthritis and symptomatic knee osteoarthritis.MethodsAge- and race-adjusted associations between education and osteoarthritis outcomes were assessed by gender-stratified logistic regression models, with additional models adjusting for body mass index, knee injury, smoking, alcohol use, and occupational factors.ResultsIn an analysis of all participants, low educational attainment (<12 years) was associated with higher prevalence of four knee osteoarthritis outcomes (unilateral and bilateral radiographic and symptomatic osteoarthritis). Women with low educational attainment had 50% higher odds of having radiographic knee osteoarthritis and 65% higher odds of symptomatic knee osteoarthritis compared with those with higher educational attainment (≥ 12 years), by using fully adjusted models. In the subset of postmenopausal women, these associations tended to be weaker but little affected by adjustment for hormone replacement therapy. Men with low educational attainment had 85% higher odds of having symptomatic knee osteoarthritis by using fully adjusted models, but the association with radiographic knee osteoarthritis was explained by age.ConclusionsAfter adjustment for known risk factors, educational attainment, as an indicator of socioeconomic status, is associated with symptomatic knee osteoarthritis in both men and women and with radiographic knee osteoarthritis in women.

ObjectivesIn the context of the scarcity of biomarkers for knee osteoarthritis (OA), we examined the associations of prevalent and incident OA with the expression levels of serum miRNAs in subjects with and without OA.MethodsWith a next-generation sequencing approach, we compared the miRome expression of 10 women with knee OA and 10 age-matched healthy subjects. By real-time qPCR, we analyzed the expression levels of 19 miRNAs at baseline selecting 43 women with prevalent knee OA (Kellgren Lawrence score of 2/3), 23 women with incident knee OA over a 4-year follow-up and 67 healthy subjects without prevalent or incident OA matched for age and body mass index.ResultsSerum miR-146a-5p was significantly increased in the group of prevalent knee OA compared with controls (relative quantification (RQ); median [Interquartile range] 1.12 [0.73; 1.46] vs 0.85 [0.62; 1.03], p = 0.015). The likelihood of prevalent knee OA was significantly increased (odds ratio [95% confidence interval (CI)] 1.83 [1.21–2.77], p = 0.004) for each quartile increase in serum miR-146a-5p. The women with miR-146a-5p levels above the median (0.851) had a higher risk of prevalent knee OA compared to those below the median [95% CI] 4.62 [1.85–11.5], p = 0.001. Moreover, we found a significant association between the baseline level of serum miR-186-5p and the risk of incident knee OA (Q4 vs Q1–3; odds ratio [95% CI] 6.13 [1.14–32.9], p = 0.034).ConclusionWe showed for the first time that miR-146a-5p and miR-186-5p are significantly associated with prevalent and incident knee OA, respectively.

Sex- and osteoarthritis-related differences in muscle co-activation during weight-bearing tasks

Disclosure: M. Ayman: None. S. Manikonda: None. Background: Osteoarthritis (OA) is a leading cause of disability worldwide, particularly affecting the knee joint. Total knee replacement (TKR) remains a common intervention for patients with advanced OA. Obesity: is a well-established risk factor for the development and progression of knee OA, as excess weight places additional stress on weight-bearing joints, exacerbating symptoms. Thus, weight loss is a primary therapeutic target for managing knee OA and reducing the need for surgical intervention. While weight loss is known to reduce symptoms of OA and delay or avoid the need for TKR, pharmacological interventions like Ozempic (semaglutide), a GLP-1 receptor agonist used for weight management, may offer a promising approach. This systematic review and meta-analysis aim to evaluate whether Ozempic: leads to significant reductions in TKR procedures in patients with osteoarthritis. Methods: We systematically reviewed studies evaluating the effects of Ozempic on weight loss and knee OA symptoms, particularly focusing on any association with reduced TKR requirements. Eligible studies were identified from databases including PubMed, Cochrane, and Scopus. Both randomized controlled trials (RCTs) and observational studies were included. Data on weight loss, OA symptoms, and TKR procedures were extracted and analyzed. Results: Of the 12 studies that met inclusion criteria, 8 were RCTs, and 4 were observational studies. Ozempic significantly reduced body weight in OA patients (mean weight loss of 10-18%) over periods ranging from 12 to 52 weeks. OA symptom scores, including pain and functional outcomes, improved in 75% of studies, with a 30-45% reduction in symptoms. The meta-analysis revealed a 25% reduction in the likelihood of TKR procedures in Ozempic-treated patients, compared to controls. Clinical Implications Given the substantial healthcare burden of OA and TKR surgeries, Ozempic: represents a promising pharmacologic intervention for reducing the need for surgical procedures in obese OA patients. The observed weight loss and symptom improvements could offer an alternative to surgery, improving patient outcomes and reducing healthcare costs Conclusion: Ozempic appears to be effective in reducing body weight and improving OA symptoms, potentially delaying or reducing the need for TKR in patients with OA. Further large-scale trials are needed to confirm these findings and assess the long-term benefits of Ozempic for OA management. Presentation: Saturday, July 12, 2025

Osteoarthritis (OA) is a major public health problem.It is one of the major causes of impaired function that reduces quality of life (QOL) worldwide.Therapeutic exercise is the first line of treatment that can reduce pain, enhance physical function, and improve quality of life as well as save time and cost.To evaluate the effect of implement of exercises functional program on knee osteoarthritis in women.Quazi experimental study design was utilized in this study Tools: Tool(I): Women's interview questionnaire sheet, Tool (II): Exercises functional program and Tool (III): Physical Health Status Assessment Results: The studied sample (study and control) their age ranged from 50-60 years and not working (77.5% and 60%) respectively and body mass index for (study and control group the highest percent were obese (42.5% and 52.5%) respectively.There are statistical significance difference of all items of knowledge and physical health status assessment in pre and post implementation of program.provide educational program for women with knee osteoarthritis that about diet, exercises, weight reduction and medication

Knee joint distraction as treatment for osteoarthritis: a systematic review and meta-analysis

Applicability of trials in rheumatoid arthritis and osteoarthritis: A systematic review and meta-analysis of trial populations showing adequate proportion of women, but underrepresentation of elderly people

We examined single-nucleotide polymorphisms (SNPs) across the tumour necrosis factor receptor superfamily member 11B (TNFRSF11B) gene and knee OA. We identified alleles in a VNTR region in intron 3 that was observed exclusively in women OA cases (P = 0.007, Pc = 0.042). Our results reveal that a previously unreported association between a VNTR genotype in TNFRSF11B and knee OA in women.

Background: The literature suggests that women with knee osteoarthritis (OA) perceive greater disability and a lower functional level before total knee arthroplasty (TKA) and undergo surgery at a later stage of the disease than men, which could lead to worse postoperative outcomes (1). These differences have been attributed to differences in the interpretation of symptoms between men and women (2), yet little is known about expectations of the postoperative outcomes of TKA. Objectives: To compare the duration of symptoms before TKA and the preoperative expectations of postoperative outcomes of TKA between men and woman. Methods: Preoperative data from a multicenter cohort study on outcomes of primary TKA were used. Preoperatively, patients were asked to indicate the duration of symptoms to TKA ( 10 years). The Hospital for Special Surgery (HSS) Knee Replacement Expectations Survey was used to obtain information on expectations regarding postoperative pain relief, mobility and daily activities and improvement of quality of life (score range 0-100), with lower scores indicating higher expectations. In addition, the Knee injury and Osteoarthritis Outcome Score (KOOS), pain (Numeric Rating Scale, NRS), comorbidities and work-status were gathered. Differences between men and women regarding the duration of symptoms and preoperative expectations were examined by the means of the Chi-Square test and independent t-test and difference with the 95% Confidence interval (CI) respectively. Results: A total of 1543 patients, 556 men (mean age 71 (SD 8), 32.3% paid employment) and 987 women (mean age 71 (SD 9), 20.3% paid employment) were included. Women had more pain preoperatively than men, 5.3 (SD 3) versus 4.3 (SD 3) at rest and 7.1 (SD 2) versus 6.2 (SD 3) during activity, respectively. Furthermore, men scored better on each KOOS subscale compared to women. Overall the duration of symptoms was longer in men than women: 10 years: 31.5% versus 20.7%. Finally, women had significantly higher expectations of postoperative TKA outcomes than men, 67.4 (SD 19) and 70.2 (SD 19), respectively (Mean Difference; 2.79, 95% CI 0.84-4.75). Conclusion: Preoperatively, men reported a longer duration of symptoms and had lower expectations of TKA outcomes than women. However, men seemed to perceive less symptoms and restrictions in daily activities despite a longer duration of symptoms.

Metabolic syndrome, accumulation of its components and risk of knee and hip replacement for osteoarthritis in community-dwelling older adults

Using time-driven activity-based costing (TDABC), we sought to compare the total facility costs, comprising supply and personnel costs during the episode of care for the index procedure, in patients with isolated medial compartmental knee osteoarthritis (OA) undergoing unicompartmental knee arthroplasty (UKA) versus total knee arthroplasty (TKA). We conducted a retrospective analysis of 100 UKAs and 100 TKAs from 2019 to 2022. From a larger sample of 4899 TKAs and 137 UKAs, patients with isolated medial OA (Kellgren-Lawrence Grade <2 in other compartments) were radiographically identified. Demographic data included age, sex and body mass index, with comorbidities controlled using the Charlson comorbidity index. Facility costs were calculated using TDABC and standardized in cost units (CUs), a metric for comparing costs across procedures. Multiple regression analysis was used to assess the independent effect of TKA versus UKA on facility costs. TKA patients had similar operative times (TKA vs. UKA: 1.01×, p = 0.783) and supply costs (1.00×, p = 0.866), where 'x' denotes the relative cost ratio. However, TKA was associated with higher personnel costs (260.0 vs. 222.5 CUs [1.17×], p < 0.001) and total facility costs, both including (706.3 vs. 667.5 CUs [1.06×], p = 0.007) and excluding implants (353.8 vs. 312.5 CUs [1.13×], p < 0.001). Adjusted for demographics and comorbidities, TKA had increased facility costs, including (32.2 CUs, 95% confidence interval [CI]: 2.9-61.5, p = 0.031) and excluding implants (37.8 CUs, 95% CI: 15.2-60.3, p = 0.001). TDABC analysis revealed higher total facility costs for the index procedure in TKA, suggesting UKA may be a cost-saving alternative for isolated medial compartment knee OA. Level III, retrospective comparative study.

Objective. The objective of the present study is to identify dietary nutrients associated with joint space narrowing (JSN) and osteophytosis at the knee in a population-based cohort of the Research on Osteoarthritis/osteoporosis Against Disability (ROAD) study.Methods. From the baseline survey of the ROAD study, 827 participants (305 men and 522 women) in a rural cohort were analyzed. Dietary nutrient intakes for the last month were assessed by a self-administered brief diet history questionnaire. Minimum joint space width (mJSW) and osteophyte area (OPA) in the medial compartment of the knee were measured using a knee osteoarthritis (OA) computer-aided diagnostic system.Results In men, there were no associations of dietary nutrient intakes with mJSW or OPA. In women, vitamins K, B1, B2, B6, and C were associated with mJSW after adjustment for age, body mass index, and total energy (p < 0.05). Vitamins E, K, B1, B2, niacin, and B6 were significantly associated with OPA (p < 0.05) in women. Vitamins K, B and C may have a protective role against knee OA in women and might lead to disease-modifying treatments.Conclusions. The present study revealed that low dietary intake of vitamins K, B, and C are associated with JSN and osteophytosis in women.

BackgroundOsteoarthritis (OA) frequently affects multiple joints including the knees and hands. Currently, it is unknown which patients with knee OA have the highest risk to progress, and how these patients...

Purpose The current literature lacks sufficient information about improvements in gait patterns and function after total knee arthroplasty (TKA) and whether patients return to full function. This study evaluated change in gait, performance-based function, and self-reported function 1 year after TKA in patients with symptomatic knee osteoarthritis and how these aspects interrelate.MethodsA total of 28 patients (64 % female) with knee osteoarthritis, with a mean age of 66 (±7) years, and 25 age- and gender-matched controls participated in this prospective cohort study. Three-dimensional gait analysis generated comprehensive measures of kinematic and kinetic gait deviations, respectively. Participants completed the Five Times Sit-to-Stand (5STS) test, and the self-reported questionnaire Knee Injury and Osteoarthritis Outcome Score (KOOS), at baseline prior to surgery and 1 year after TKA.ResultsKinetic gait deviations of both the operated and non-operated limb persisted in patients with knee osteoarthritis at 1 year after surgery, while kinematic gait patterns were comparable to controls. Performance on the 5STS and KOOS scores in patients with knee osteoarthritis improved significantly 1 year after surgery (effect size 0.5–1.5), but did not reach the level of controls. Ten patients with knee osteoarthritis (36 %) exceeded the minimally detectable change on the 5STS.ConclusionMeasures of overall gait patterns and the 5STS revealed improvements in function 1 year after TKA, but were not restored to the level of healthy controls. Based on change in 5STS performance, we identified patients with substantial improvements in gait patterns. Self-reported measures of function could not detect differences between patients improving in 5STS performance and those who did not. These findings highlight the use of the 5STS in clinical practice since improvement on this test seems to follow the reduction in gait pattern deviations.Level of evidenceII.