Intra-articular Hymovis injection for managing hip OA in active sportsmen. A 24-month observational retrospective clinical investigation

BackgroundHip Osteoarthitis (OA) risk is sport-specific and depends on frequency, intensity, and type of mechanic stress the hip is subjected to. This retrospective observational study aims to investigate the safety and performance of Hymovis (HYADD-4) injection, a hexadecyl (C-16) HA-derivative, when used to manage symptomatic hip OA in active middle-aged sportsmen over a 24-month observation period.MethodsThe retrospective analysis included clinical records of active sportsmen, aged between 40 and 65 years, and suffering from symptomatic Kellgren-Lawrence grade II to III hip OA, treated with two (24 mg/3 ml) Hymovis injections, two weeks apart, every 3–4 months, for two years. When available, data on MRI examination were included in the analysis as well as Heidelberg Sports Activity Score (HAS) and Copenhagen Hip and Groin Outcome Score (HAGOS) questionnaires.ResultsThirty patients (56.4 ± 7.3 years) were included in the study, sixteen cyclists and 14 tennis players. For all patients, HAS and most HAGOS scores improved significantly (p < 0.05) at the first control visit (4 months) and further improved over time. For all other scores an important clinical benefit was experienced by more than 50% of participants. No adverse events were recorded.ConclusionTreatment of hip OA in active sportsmen with Hymovis seems a safe and effective approach for the management of OA symptoms, by potentially protecting cartilage and subchondral bone from further damage.     

基于信息化的社区骨关节炎患者多学科管理模式构建及应用研究

背景 骨关节炎致残、致畸率高，可合并多种身心疾病，但早期症状不明显。当前社区骨关节炎的管理存在管治不协调、方法不健全、制度不完善等问题。 目的 构建并评价基于信息化的社区骨关节炎多学科管理模式，以促进对社区骨关节炎患者的管理，改善患者疾病预后。 方法 首先构建社区骨关节炎患者的多学科管理模式，包含基于危险因素分层的患者分级管理流程、多学科管理团队及其诊治分工，然后构建基于信息化的多学科管理流程，并完成信息软件开发。选取2019年7月至2020年7月在上海市定海、大桥社区卫生服务中心全科门诊，以及杨浦区中心医院骨科门诊就诊的膝骨关节炎患者80例为研究对象，采用随机数表法将其分为普通组和多学科组，各40例。普通组采用常规治疗模式，多学科组在此基础上进行基于信息化的多学科管理。分别于治疗前和治疗12周后评估两组患者的视觉模拟评分法（VAS）评分、西安大略麦克马斯特大学（WOMAC）骨关节炎指数、关节炎生活质量测量量表（AIMS2）评分、健康素养管理量表（HeLMS）评分、体质指数（BMI）。 结果 治疗前，多学科组和普通组膝骨关节炎患者的VAS评分、WOMAC骨关节炎指数、AIMS2评分、HeLMS评分、BMI比较，差异均无统计学意义（P>0.05）；治疗12周后，多学科组和普通组膝骨关节炎患者的VAS评分、WOMAC骨关节炎指数低于治疗前，AIMS2总分、HeLMS总分高于治疗前，差异有统计学意义（P<0.05）；治疗12周后，多学科组患者AIMS2总分、HeLMS总分高于普通组，VAS评分、WOMAC骨关节炎指数、BMI均低于普通组，差异有统计学意义（P<0.05）。 结论 对膝骨关节炎患者实施基于信息化的社区骨关节炎患者多学科管理模式，可有效减轻患者的关节疼痛和体质量，提高患者的日常生活能力和健康素养，改善患者的生活质量，延缓患者的病情进展。     

基于全球视角的中国骨关节炎疾病负担分析

目的 掌握我国30岁以上人群骨关节炎的疾病负担现状与趋势，发现重点人群，为制定骨关节炎综合防制策略提供科学依据。方法 利用全球疾病负担数据库2019（GBD 2019），对中国30岁以上人群按照性别、年龄分组描述骨关节炎的发病率、患病率、伤残损失健康生命年（Years lived with disability, YLD），并与全球和日本、印度进行比较，分析1990—2019年骨关节炎的疾病负担与其变化趋势。作图使用GraphPad Prism 8软件。结果 2019年，中国骨关节炎患病人数约1.33亿，所致YLD约472.49万人年，占中国全因YLD的3.07%，占全球骨关节炎导致YLD的24.93%；其发病率高峰在50～54岁年龄组，各年龄段女性发病率均约为男性的1.5倍。1990—2019年，中国骨关节炎发病率、患病率、YLD率均呈逐年上升趋势，2019年依次为750.96/10万、9337.15/10万、224.78/10万，较1990年分别增加93.62%、113.53%、116.13%，均远超同期日本、印度及全球的增幅；年龄标准化后的以上指标显示，中国骨关节炎疾病负担低于日本、高于印度、接近全球平均水平。结论 随着人口老龄化程度的加深，1990—2019年我国30岁以上人群骨关节炎疾病负担越来越重，一级预防重点人群为35岁以下和未患病人群，尤其是女性，可见制定科学有效的骨关节炎综合防制方案已迫在眉睫。     

Methods improvement for diagnostics and treatment of inflammatory diseases in the temporomandibular joint

PurposeThe article subject relevance is conditioned by poor knowledge of the aetiology and pathogenesis of inflammatory diseases in this area. The purpose of this study was to identify the most rational approach to solving the issues of improving methods for treating arthritis and arthrosis.MethodsThe leading approach was the combination of the analysis results concerning the clinical examination of dental patients of various age groups with the logical construction of conclusions drawn from the research results. The paper presented the clinical examination data of patients with TMJ pathologies of various age groups and described the methods of their treatment.ResultsThe results include the main effective methods identification for the diagnostics and treatment of inflammatory diseases in the temporomandibular joint and the main prospects for improving these methods in the future, with the aim of a general expansion of ideas regarding the possibilities of diagnostics and treatment of such diseases.ConclusionThe study value lies in the possibility of using its results in practical dentistry to bring practical improvements to the currently available methods for diagnostics and treatment of inflammatory TMJ diseases.     

Gut microbiota and osteoarthritis management: An expert consensus of the European society for clinical and economic aspects of osteoporosis,osteoarthritis and musculoskeletal diseases (ESCEO)

The prevalence of osteoarthritis (OA) increases not only because of longer life expectancy but also because of the modern lifestyle, in particular physical inactivity and diets low in fiber and rich in sugar and saturated fats, which promote chronic low-grade inflammation and obesity. Adverse alterations of the gut microbiota (GMB) composition, called microbial dysbiosis, may favor metabolic syndrome and inflammaging, two important components of OA onset and evolution. Considering the burden of OA and the need to define preventive and therapeutic interventions targeting the modifiable components of OA, an expert working group was convened by the European Society for Clinical and Economic Aspects of Osteoporosis, Osteoarthritis and Musculoskeletal Diseases (ESCEO) to review the potential contribution of GMB to OA. Such a contribution is supported by observational or dietary intervention studies in animal models of OA and in humans. In addition, several well-recognized risk factors of OA interact with GMB. Lastly, GMB is a critical determinant of drug metabolism and bioavailability and may influence the response to OA medications. Further research targeting GMB or its metabolites is needed to move the field of OA from symptomatic management to individualized interventions targeting its pathogenesis.