Pain during walking and ascending stairs before hyaluronic acid injection was common in patients with knee osteoarthritis: a qualitative study

Background/aim: Knee osteoarthritis (OA) is a common pathology characterized by degeneration of the articular cartilage. The aim of the research was to ask patients how they decided to make the injection, what treatments they received, their complaints prior to and after the injection and how they feel at the moment, and whether they are currently exercising or not. Thus, to demonstrate the patients' outcomes with their own expression. Materials and methods: A total of 92 knee OA patients completed semistructured interviews, which included six open-ended questions. Results: A total of 92 patients (66 female, 26 male) aged between 36 and 95 years (mean 65.511.14) were included. Before the injection, the majority of the OA patients had pain complaints when walking (72.8%) and stair climbing (70.7%). One to four years after intraarticular injection, 45.2% of patients felt a decrease in their complaints. The majority of patients did not consider diet and exercise as a treatment option. In addition, almost all patients declared that they decided on hyaluronic acid injection treatment with the physician's recommendation. Conclusion: Pain during walking and stair climbing before hyaluronic acid injection was common in knee OA patients. Overall the patients felt a decrease in the symptoms after injection. Patients did not consider diet and exercise as a treatment option despite the recommendation by a physician.

Mean femoral cartilage thickness is higher in athletes as compared with sedentary individuals.

PURPOSE: It is unclear how high-intensity physical activity (HIPA) affects the knee joint, specifically the femoral cartilage (FC). Therefore, the aims of this study were to evaluate FC thickness via ultrasound among elite athletes involved in different types of HIPA, and to determine whether there is a correlation between serum cartilage oligomeric matrix protein (sCOMP) and rectus femoris (RF) thickness. METHOD: A total of 132 male individuals participated in this study and were assigned to two groups, the sedentary (n = 43, 23.9 ± 3.7) and athlete groups (n = 89, 22.7 ± 4.6), which did not significantly differ in age. The athletes were elite and performed HIPA during sports such as volleyball (n = 20), soccer (n = 21), basketball (n = 28), and weightlifting (n = 20). RF thickness and three (mid-point) measurements were obtained for each knee. The mean FC thickness for each knee was defined as the sum of the medial, lateral condyles, and intercondylar areas. Blood samples for sCOMP analyses were also obtained. RESULTS: All the measurements of the FC of both knees were significantly higher in the athletes than in the sedentary individuals (p < 0.001 and p = 0.001). The mean right and left FC values were also higher in the athletes (p < 0.001). Multiple linear regression analysis showed that participation in sporting activities was a significant predictor associated with the right and left mean FC thickness (p < 0.001 for both). No significant differences in the sCOMP levels were found between the two groups. CONCLUSION: It was found that the mean FC was higher among athletes than among sedentary individuals. As a result, it is suggested that sports' participation is an independent factor associated with the right and left mean FC thickness. LEVEL OF EVIDENCE: III.

Do Plantar Pressure and Loading Patterns Vary with Joint Hypermobility in Young Females?

BACKGROUND: Joint hypermobility is a connective tissue disorder that increases joint range of motion. Plantar pressure and foot loading patterns may change with joint hypermobility. We aimed to analyze static plantar pressure in young females with and without joint hypermobility. METHODS: Joint laxity in 27 young females was assessed cross sectionally using the Beighton and Horan Joint Mobility Index. Participants were divided into the hypermobility (score, 4-9) and no hypermobility (score, 0-3) groups according to their scores. Static plantar pressure and forces were recorded using a pedobarographic mat system. RESULTS: Higher peak pressures (P = .01) and peak pressure gradients (P = .025) were observed in the nondominant foot in the hypermobility group. According to the comparison of dominant and nondominant feet in each group, the hypermobility group showed significantly higher peak pressures (P = .046), peak pressure gradients (P = .041), and total force values (P = .028) in the nondominant foot. CONCLUSIONS: The plantar pressure and loading patterns vary in young females with joint hypermobility. Evaluation of plantar loading as an injury prevention tool in individuals with joint hypermobility syndrome can be suggested.

Effects of hyperlipidemia on patellar tendon stiffness: A shear wave elastography study.

BACKGROUND: Recent studies presented that increased adiposity and hyperlipidemia may cause tendon pathology. The aim of this study was to evaluate the effect of hyperlipidemia on the patellar tendon stiffness by shear wave elastography. METHODS: A total of 51 participants (19 female, 32 male) were included. Participants were divided into two groups, according to their low-density lipoprotein levels, as the study group (hyperlipidemia, n = 24) and the control group (non-hyperlipidemia, n = 27). The patellar tendon and rectus femoris muscle shear wave velocities were measured by shear wave elastography. FINDINGS: Patellar tendon shear wave velocities was 5.02 (SD: 0.78) m/s in the control group and 5.98 (SD: 1.19) m/s in the hyperlipidemia group (ES = 0.95, P = .001). There was a positive moderate statistically significant correlation between patellar tendon shear wave velocity and low-density lipoprotein (r = 0.432, p < .002). In the multiple linear regression analysis, only low-density lipoprotein was found as a significant predictor of patellar tendon shear wave velocity (CI: 0.005-0.028, P = .007). INTERPRETATION: We evaluated the effects of hyperlipidemia and body mass index on patellar tendon mechanical properties with shear wave elastography. We found that the blood low-density lipoprotein level had an impact on patellar tendon stiffness independently of body mass index. Accordingly, it is important to evaluate individuals' low-density lipoprotein levels when examining risk factors for tendon pathology.

Evaluation of Muscle Injuries in Professional Football Players: Does Coach Replacement Affect the Injury Rate?

OBJECTIVES: To assess the incidence and characteristics of muscle injuries in professional football players and to assess if coach dismissal may be related with muscle injuries within 1-month period from the dismissal. DESIGN: Prospective cohort study during 3 consecutive seasons. SETTING: Turkish Super League football teams. PARTICIPANTS: One hundred eighteen male football players. MAIN OUTCOME MEASURES: Data on time-loss muscle injuries confirmed using magnetic resonance imaging were recorded, including type, body part, duration, and lay-off time, and training session and match exposure times. The muscle injury rate was evaluated at 2 weeks and 30 days after coach dismissal. RESULTS: In total, 124 muscle injuries were recorded, with injury incidences of 2.3 muscle injuries per 1000 hours of exposure overall, 1.2 in training sessions, and 13.6 in matches. Injury time loss ranged from 3 to 67 days (median, 13 days). Eighteen percent of the injuries (n = 23) were recurrent; no association was found between recurrence rate and the player's age or position (P = 0.15, P = 0.27, respectively). Recurrent injuries caused more severe injuries (26.1%, P = 0.02) and longer median lay-off time (P = 0.01). During the study, teams A and B replaced 7 and 3 coaches, respectively. The injury incidence increased to 5.3 per 1000 hours of exposure in the 2 weeks after the coach dismissal, and decreased to 4.5 within 1 month of coach dismissal. CONCLUSION: Given the link between coach dismissal and increased rates of muscle strain injuries, increased attentiveness to preventing muscle injuries during coaching transitions and to the impact of new training regimens is required by trainers and medical teams.

Trabecular bone score of postmenopausal women is positively correlated with bone mineral density and negatively correlated with age and body mass index.

OBJECTIVE: Trabecular bone score (TBS), an indirect evaluation of skeletal microarchitecture, is calculated from dual-energy X-ray absorptiometry (DXA). This study aimed to determine the mean TBS values in healthy postmenopausal women and overall association between TBS and demographic features, bone mineral density (BMD) of the lumbar spine and femoral neck, and BMD to body mass index (BMI) ratio of the lumbar spine. METHODS: Fifty-three postmenopausal healthy women were enrolled. The BMD of the lumbar spine and femoral neck was measured by DXA. Anteroposterior lumbar spine acquisitions were used to calculate the TBS for L1 to L4. RESULTS: The mean BMD of the lumbar spine and femoral neck was 0.945 ±â€Š0.133 and 0.785 ±â€Š0.112 g/cm, respectively. The mean TBS was 1.354 ±â€Š0.107. There was a significant positive moderate correlation between TBS and total lumbar BMD to BMI ratio (r = 0.595, P < 0.001), and significant positive weak correlations between TBS and BMD of the lumbar spine (r = 0.347, P = 0.011) as well as between TBS and femoral neck (r = 0.305, P = 0.026), whereas significant negative moderate correlations were observed between TBS and age (r = -0.393, P = 0.004) as well as between TBS and BMI (r = -0.333, P = 0.015). CONCLUSIONS: TBS values of postmenopausal women were negatively correlated with age and BMI, and positively with BMD and BMD to BMI ratio.

Thirty Minutes of Running Exercise Decreases T2 Signal Intensity but Not Thickness of the Knee Joint Cartilage: A 3.0-T Magnetic Resonance Imaging Study.

OBJECTIVE: Recent studies showed a potential of magnetic resonance imaging (MRI), which can be used as an additional tool for diagnosing cartilage degeneration in the early stage. We designed a cross-sectional study in order to evaluate knee joint cartilage adaptation to running, using 3.0-T MRI equipped with the 3-dimensional turbo spin echo (VISTA = Volume ISotropic Turbo spin echo Acquisition) software. By this thickness (mm) and signal intensity (mean pixel value) can be quantified, which could be closely related to the fluid content of the knee joint cartilage, before and after running. METHODS: A total of 22 males, aged 18 to 35 years, dominant (right) and nondominant (left) knees were assessed before and after 30 minutes of running. Cartilage thickness and signal intensity of surfaces of the patella, medial and lateral femoral and tibial condyles were measured. RESULTS: Cartilage thickness of the lateral condyle decreased at the dominant knee, while it increased at the medial tibial plateau. Signal intensity decreased at all locations, except the lateral patella in both knees. The most obvious decrease in signal intensity (10.6%) was at the medial tibial plateau from 949.8 to 849.0 of the dominant knee. CONCLUSION: There was an increase in thickness measurements and decrease in signal intensity in medial tibial plateau of the dominant knee after 30 minutes of running. This outcome could be related to fluid outflow from the tissue. Greater reductions in the medial tibial plateau cartilage indicate greater load sharing by these areas of the joint during a 30-minute running.

Acute long-distance trail running increases serum IL-6, IL-15, and Hsp72 levels.

Interleukin-6 (IL-6), IL-15, and heat shock protein 72 (Hsp72) are molecules that have significant metabolic effects on glucose and fat metabolism and a cell's stress response. The aim of this study is to determine serum levels of these molecules in runners after a long-distance trail run. Serum IL-15 levels after such endurance events have not been investigated yet. Blood samples were collected from 37 athletes (11 female, 26 male) before and after a 35-km trail run, with a total climb of 940 m. Serum was obtained from the samples, and IL-6, IL-15, and Hsp72 levels were measured from using the sandwich ELISA method. The athletes completed the race in 308.3 ± 37.4 min on average. After the race, the mean serum IL-6, IL-15, and Hsp72 concentrations increased 13.2-fold, 2.22-fold, and 1.6-fold, respectively (p < 0.001, p < 0.001, and p = 0.039, respectively). This is the first study to demonstrate the increase in serum IL-15 levels following an acute endurance exercise. In addition to IL-15, we report that IL-6 and soluble Hsp72 levels also increased significantly following a 35-km trail run. Since these molecules are involved in regulating glucose and fat metabolism, significant increases of IL-6, IL-15, and soluble Hsp72 may have health benefits that may be associated with long-distance trail runs, which are becoming more popular worldwide.