Abstract：
OBJECTIVE:Physical activity (PA) in the US knee osteoarthritis (OA) population is low, despite well-established health benefits. PA program implementation is often stymied by sustainability concerns. We sought to establish parameters that would make a short-term (3-year efficacy) PA program a cost-effective component of long-term OA care. METHOD:Using a validated computer microsimulation (Osteoarthritis Policy Model), we examined the long-term clinical (e.g., comorbidities averted), quality of life (QoL), and economic impacts of a 3-year PA program, based upon the SPARKS (Studying Physical Activity Rewards after Knee Surgery) Trial, for inactive knee OA patients. We determined the cost, efficacy, and impact of PA on QoL and medical costs that would make a PA program a cost-effective addition to OA care. RESULTS:Among the 14 million with knee OA in the US, >4 million are inactive. Participation of 10% in the modeled PA program could save 200 cases of cardiovascular disease, 400 cases of diabetes, and 6,800 quality-adjusted life-years (QALYs). The program had an incremental cost-effectiveness ratio (ICER) of $16,100/QALY. Tripling PA program cost ($860/year) raised the ICER to $108,300/QALY; varying QoL benefits from PA yielded ICERs of $8,800/QALY-$99,900/QALY; varying background cost savings from PA did not qualitatively impact ICERs. Offering the PA program to any adults with knee OA (not only inactive) yielded $31,000/QALY. CONCLUSION:A PA program with 3-year efficacy in the knee OA population carried favorable long-term clinical and economic benefits. These results offer justification for policymakers and payers considering a PA intervention incorporated into knee OA care.
journal_name
Osteoarthritis Cartilagejournal_title
Osteoarthritis and cartilageauthors
Silva GS,Sullivan JK,Katz JN,Messier SP,Hunter DJ,Losina Edoi
10.1016/j.joca.2020.01.017subject
Has Abstractpub_date
2020-06-01 00:00:00pages
735-743issue
6eissn
1063-4584issn
1522-9653pii
S1063-4584(20)30902-Xjournal_volume
28pub_type
杂志文章abstract：OBJECTIVE:To investigate the biosynthetic response of elderly human femoral head articular cartilage to mechanical stimulation in vitro and its variation with site. METHOD:Full-depth cartilage biopsies of articular cartilage were removed from defined sites on 10 femoral heads from patients aged 68-95 years. Cartilage ...
journal_title：Osteoarthritis and cartilage
pub_type： 杂志文章
doi：10.1016/j.joca.2005.07.002
更新日期：2005-12-01 00:00:00
abstract：OBJECTIVES:Based on the concept of a systemic predisposition for articular cartilage calcification (CC), the aim of this study was to determine the prevalence and amount of bilateral CC of hip and knee joints in an unselected sample cohort by high-resolution digital contact radiography (DCR) and to analyze the associat...
journal_title：Osteoarthritis and cartilage
pub_type： 杂志文章
doi：10.1016/j.joca.2016.06.020
更新日期：2016-12-01 00:00:00
abstract：OBJECTIVE:miR-122 stimulates proliferation of growth plate chondrocytes whereas miR-451 stimulates terminal differentiation and matrix turnover. Here, we examined the potential of these microRNA as regulators of articular chondrocytes using an in vitro model of osteoarthritis. METHODS:miR-122 and miR-451 presence in r...
journal_title：Osteoarthritis and cartilage
pub_type： 杂志文章
doi：10.1016/j.joca.2020.09.004
更新日期：2021-01-01 00:00:00
abstract：OBJECTIVE:Infrapatellar fat pad of patients with osteoarthritis (OA) contains multipotent and highly clonogenic adipose-derived stem cells that can be isolated by low invasive methods. Moreover, nuclear and cytoplasmic cellular extracts have been showed to be effective in induction of cell differentiation and reprogram...
journal_title：Osteoarthritis and cartilage
pub_type： 杂志文章
doi：10.1016/j.joca.2012.10.007
更新日期：2013-01-01 00:00:00
abstract：OBJECTIVE:To elucidate variations in tissue ultrastructure and incidence of pathology between fibromodulin (FM)-null mice and wild-type (WT) animals. DESIGN:FM-null and WT siblings from different age groups were compared. Serial sections were made through paraffin-embedded whole knees and investigated histologically. ...
journal_title：Osteoarthritis and cartilage
pub_type： 杂志文章
doi：10.1053/joca.2002.0527
更新日期：2002-10-01 00:00:00
abstract：:The significance of activating proteins (AP-1), c-fos, c-jun and jun B relative to the AP-1 responsive metallothionein, collagenase and stromelysin gene expression in the pathophysiology of osteoarthritis (OA) was investigated. The 'early' c-fos, c-jun and jun-B mRNAs were ubiquitously expressed in normal and OA human...
journal_title：Osteoarthritis and cartilage
pub_type： 杂志文章
doi：10.1016/s1063-4584(05)80085-8
更新日期：1993-07-01 00:00:00
abstract：OBJECTIVE:One of the main open questions in chondrocyte transplantation is the fate of the implanted cells in vivo. We intended to establish prerequisites for such studies in animal models and to show the feasibility of this approach in rabbits. Isolated articular chondrocytes were retrovirally marked using green fluor...
journal_title：Osteoarthritis and cartilage
pub_type： 杂志文章
doi：10.1053/joca.2001.0486
更新日期：2002-02-01 00:00:00
abstract：OBJECTIVE:This study examined the effects of reduced and elevated weight bearing on post-traumatic osteoarthritis (PTOA) development, locomotor joint kinematics, and degree of voluntary activity in rats following medial meniscal transection (MMT). DESIGN:Twenty-one adult rats were subjected to MMT surgery of the left ...
journal_title：Osteoarthritis and cartilage
pub_type： 杂志文章
doi：10.1016/j.joca.2019.08.001
更新日期：2019-12-01 00:00:00
abstract：OBJECTIVE:Ankle fracture patients were used as a model to study the long-term effect of the removal of joint loading on knee cartilage quality in human subjects. DESIGN:The knees of 10 patients with ipsilateral ankle fractures were investigated using delayed gadolinium-enhanced magnetic resonance imaging of cartilage ...
journal_title：Osteoarthritis and cartilage
pub_type： 杂志文章
doi：10.1016/j.joca.2014.04.021
更新日期：2014-07-01 00:00:00
abstract：:A major objective of this article is to examine the research implications of recently available genome-wide expression profiles of cartilage from human osteoarthritis (OA) joints. We propose that, when viewed in the light of extensive earlier work, this novel data provides a unique opportunity to reorient the design o...
journal_title：Osteoarthritis and cartilage
pub_type： 杂志文章,评审
doi：10.1016/j.joca.2015.03.027
更新日期：2015-11-01 00:00:00
abstract：:Objective To determine whether meniscal cells can express a TGFbeta(1)transgene delivered by a retroviral vector, and respond to the gene product by increasing matrix synthesis. Methods Monolayer cultures of human and canine meniscal cells were infected with retroviruses carrying either a human TGFbeta(1)cDNA or marke...
journal_title：Osteoarthritis and cartilage
pub_type： 杂志文章
doi：10.1053/joca.1999.0300
更新日期：2000-07-01 00:00:00
abstract：OBJECTIVE:Varus thrust visualized during walking is associated with a greater medial knee load and an increased risk of medial knee osteoarthritis (OA) progression. Little is known about how varus thrust presence determined by visual observation relates to quantitative gait kinematic data. We hypothesized that varus th...
journal_title：Osteoarthritis and cartilage
pub_type： 杂志文章
doi：10.1016/j.joca.2013.08.007
更新日期：2013-11-01 00:00:00
abstract：OBJECTIVES:This study investigates the long-term changes of the periarticular bone, including cancellous bone and the subchondral plate, in an anterior cruciate ligament (ACL)-transected cat for post-traumatic osteoarthritis (OA). These periarticular bone changes are related to the health of all knee tissues including ...
journal_title：Osteoarthritis and cartilage
pub_type： 杂志文章
doi：10.1016/j.joca.2004.11.004
更新日期：2005-03-01 00:00:00
abstract：OBJECTIVE:Cam hip shape morphology is a recognised cause of femoroacetabular impingement (FAI) and is associated with hip osteoarthritis. Our aim was to systematically review the available epidemiological evidence assessing the prevalence of cam hip shape morphology in the general population and any studied subgroups i...
journal_title：Osteoarthritis and cartilage
pub_type： 杂志文章,评审
doi：10.1016/j.joca.2015.12.020
更新日期：2016-06-01 00:00:00
abstract：OBJECTIVE:To define for the first time the transcriptomes of normal and end-stage osteoarthritis (OA) hip cartilage. MATERIALS AND METHODS:RNA was isolated from cartilage within 2h of joint replacement surgery. Gene expression was analyzed using Agilent GeneSpring GX 11 following hybridization to Illumina Human HT-12 ...
journal_title：Osteoarthritis and cartilage
pub_type： 杂志文章
doi：10.1016/j.joca.2012.05.006
更新日期：2012-09-01 00:00:00
abstract：OBJECTIVE:To assess the effectiveness of short-wave diathermy (SWD) treatment in the management of knee osteoarthritis (KOA) and to assess whether the effects are related to the induction of a thermal effect. METHODS:A systematic literature search was conducted in PubMed, CINAHL, PEDro, EMBASE, SPORTdiscus and Scholar...
journal_title：Osteoarthritis and cartilage
pub_type： 杂志文章,meta分析,评审
doi：10.1016/j.joca.2012.05.005
更新日期：2012-09-01 00:00:00
abstract：INTRODUCTION:Pain is the most common symptom in knee osteoarthritis (OA), a leading cause of chronic disability, and a major source of the disability attributable to OA in general. Pain severity in knee OA is variable, ranging from barely perceptible to immobilizing. The knee lesions that contribute to pain severity ha...
journal_title：Osteoarthritis and cartilage
pub_type： 杂志文章
doi：10.1016/j.joca.2006.03.015
更新日期：2006-10-01 00:00:00
abstract：OBJECTIVE:The quantitative interpretation of hip cartilage magnetic resonance imaging (MRI) has been limited by the difficulty of identifying and delineating the cartilage in a three-dimensional (3D) dataset, thereby reducing its routine usage. In this paper a solution is suggested by unfolding the cartilage to planar ...
journal_title：Osteoarthritis and cartilage
pub_type： 杂志文章
doi：10.1016/j.joca.2014.08.012
更新日期：2014-10-01 00:00:00
abstract：OBJECTIVE:Cartilage swelling is an early event in osteoarthritis (OA). However, the response of chondrocytes to increased tissue hydration is unknown. This work studied the volume and morphology of living in situ human chondrocytes as a function of cartilage degeneration. METHODS:The tibial plateaus from knee joints o...
journal_title：Osteoarthritis and cartilage
pub_type： 杂志文章
doi：10.1016/s1063-4584(02)00369-2
更新日期：2003-04-01 00:00:00
abstract：OBJECTIVE:The purpose of the current study was to investigate the feasibility of applying defect-size femoral implants for the treatment of localized cartilage defects in a 1-year follow-up model. METHODS:In 13 goats, a medial femoral condyle defect was created in both knees. Defects were randomly treated by immediate...
journal_title：Osteoarthritis and cartilage
pub_type： 杂志文章
doi：10.1016/j.joca.2009.10.009
更新日期：2010-03-01 00:00:00
abstract：OBJECTIVE:To study the effect of intra-articular injection of meloxicam (Mobic) on the development of osteoarthritis (OA) in rats and examine concomitant changes in nociceptive behavior and the expression of mitogen-activated protein kinases (MAPKs) in articular cartilage chondrocytes. METHODS:OA was induced in Wistar...
journal_title：Osteoarthritis and cartilage
pub_type： 杂志文章
doi：10.1016/j.joca.2013.09.005
更新日期：2013-12-01 00:00:00
abstract：OBJECTIVE:To assess the influence of pre-operative X-ray changes on the response to total knee joint replacement (TKR). METHODS:We included patients from one centre who underwent primary TKR (n = 478) for osteoarthritis in 2006 and 2007. The International Knee Society score (IKSS) and short form health survey were col...
journal_title：Osteoarthritis and cartilage
pub_type： 杂志文章
doi：10.1016/j.joca.2012.05.015
更新日期：2012-10-01 00:00:00
abstract：OBJECTIVE:The effects of mechanical deformation of intact cartilage tissue on chondrocyte biosynthesis in situ have been well documented, but the mechanotransduction pathways that regulate such phenomena have not been elucidated completely. The goal of this study was to examine the effects of tissue deformation on the ...
journal_title：Osteoarthritis and cartilage
pub_type： 杂志文章
doi：10.1016/j.joca.2004.08.004
更新日期：2004-12-01 00:00:00
abstract：OBJECTIVE:Substantial changes in articular cartilage composition and mechanical properties occur during the development of osteoarthritis (OA). While softening in the initial stage is reported and sometimes used as an indicator of early OA, there is a lack of data relating the macroscopic appearance of cartilage to its...
journal_title：Osteoarthritis and cartilage
pub_type： 杂志文章
doi：10.1016/j.joca.2005.06.008
更新日期：2005-11-01 00:00:00
abstract：OBJECTIVE:To study the effect of 17β-estradiol (E2) and the superficial zone (SFZ) on cell death and proteoglycan degradation in articular cartilage after a single injurious compression in vitro. METHOD:Cartilage explants from the femoropatellar groove of 2 year old cows with or without the SFZ were cultured serum-fre...
journal_title：Osteoarthritis and cartilage
pub_type： 杂志文章
doi：10.1016/j.joca.2013.07.007
更新日期：2013-11-01 00:00:00
abstract：:To highlight methodological challenges in the design and conduct of randomized trials of surgical interventions and to propose strategies for addressing these challenges. This paper focuses on three broad areas: enrollment; intervention; and assessment including implications for analysis. For each challenge raised in ...
journal_title：Osteoarthritis and cartilage
pub_type： 杂志文章,评审
doi：10.1016/j.joca.2015.02.024
更新日期：2015-05-01 00:00:00
abstract：OBJECTIVE:As cartilage loss and bone marrow lesions (BMLs) are associated with knee joint pain and structural worsening, this study assessed whether non-invasive estimates of articular contact stress may longitudinally predict risk for worsening of knee cartilage morphology and BMLs. DESIGN:This was a longitudinal coh...
journal_title：Osteoarthritis and cartilage
pub_type： 杂志文章
doi：10.1016/j.joca.2012.05.013
更新日期：2012-10-01 00:00:00
abstract：OBJECTIVE:Marked differences exist between human knee and ankle joints regarding risks and progression of osteoarthritis (OA). Pathomechanisms of degenerative joint disease may therefore differ in these joints, due to differences in tissue structure and function. Focusing on structural issues, which are design goals fo...
journal_title：Osteoarthritis and cartilage
pub_type： 杂志文章
doi：
更新日期：2013-12-01 00:00:00
abstract：OBJECTIVE:To correlate osteochondral repair assessed by validated macroscopic scoring systems with established semiquantitative histological analyses in an ovine model and to test the hypothesis that important macroscopic individual categories correlate with their corresponding histological counterparts. METHODS:In th...
journal_title：Osteoarthritis and cartilage
pub_type： 杂志文章
doi：10.1016/j.joca.2016.10.014
更新日期：2017-04-01 00:00:00
abstract：OBJECTIVE:The effect of mechanical injury on chondrocyte viability and matrix degradation was studied. It was proposed that mechanical injury to human cartilage explants results in chondrocyte apoptosis with associated loss of glycosaminoglycans. DESIGN:Full thickness human cartilage explants, 5 mm in diameter were su...
journal_title：Osteoarthritis and cartilage
pub_type： 杂志文章
doi：10.1053/joca.2001.0468
更新日期：2001-11-01 00:00:00
