Factors That Affect Knee Structure In Healthy Women
Funder
National Health and Medical Research Council
Funding Amount
$199,176.00
Summary
Osteoarthritis (OA) has the largest impact of any chronic disease on burden of disease borne in later life, affecting women more often than men. The importance of OA has been acknowledged by its listing within musculoskeletal disease, the 7th health priority in Australia. It is 4 times as common in women as in men.Treatments which slow or prevent OA progressing are limited, so prevention must play a key role. With increasing disease severity, joint cartilage is lost. We have recently developed a ....Osteoarthritis (OA) has the largest impact of any chronic disease on burden of disease borne in later life, affecting women more often than men. The importance of OA has been acknowledged by its listing within musculoskeletal disease, the 7th health priority in Australia. It is 4 times as common in women as in men.Treatments which slow or prevent OA progressing are limited, so prevention must play a key role. With increasing disease severity, joint cartilage is lost. We have recently developed a method to measure joint cartilage from magnetic resonance imaging (MRI) scans which is able to assess the severity of structural changes in the knee. Using this method will allow us to assess 2 issues: 1) Obesity is the only identified modifiable risk factor for knee OA. However, the mechanism is poorly understood. Weight loss programs may be more effective at reducing the risk of OA if they are combined with programs aimed at maintaining muscle mass. 2) Bone is important in development of Knee OA, but its role is poorly understood. Understanding how bone metabolism relates to risk of knee OA may allow us to prevent disease. Bone is more likely to respond to pharmacological manipulation than cartilage. Thus it may prove a more effective target for intervention than cartilage. The Geelong Osteoporosis Study was begun in 1994 to study bone health in Australian women (urban and rural). Much information relevant to the risk of OA has been collected over the past decade. By performing MRI of the knee now and in 2 years time, we will determine the effect of different measures of obesity and bone metabolism on structural change at the knee which predisposes to OA. Since both of these factors (obesity and bone metabolism) are potentially modifiable, this study may offer new avenues of prevention and therapy in knee OA. This has the potential to promote a better quality of life as people age and to reduce the economic burden of knee OA in the community.Read moreRead less
The Effect Of Weight Loss On The Risk Of Knee Osteoarthritis And Potential Modification By Biomechanical Factors
Funder
National Health and Medical Research Council
Funding Amount
$475,388.00
Summary
Osteoarthritis (OA) has the largest impact of any chronic disease on burden of disease borne in later life. This has been acknowledged by its listing as the 7th health priority in Australia. Knee OA is the most common reason for a joint replacement, thus imposing a huge financial burden to the community. Treatments which slow-prevent OA progressioning are limited and so prevention must play a key role. Obesity is the most significant, potentially modifiable risk factor for knee OA. The combinati ....Osteoarthritis (OA) has the largest impact of any chronic disease on burden of disease borne in later life. This has been acknowledged by its listing as the 7th health priority in Australia. Knee OA is the most common reason for a joint replacement, thus imposing a huge financial burden to the community. Treatments which slow-prevent OA progressioning are limited and so prevention must play a key role. Obesity is the most significant, potentially modifiable risk factor for knee OA. The combination of the current epidemic of obesity in Western countries and the aging of the population is likely to have a synergistic effect on the prevalence and incidence of knee OA. Despite the consistent relationship between obesity and OA, little work has been done on the relationship between obesity and biomechanical factors such as knee angle and muscle mass and how these may interact with obesity and weight loss in modifying the risk of knee OA. It may be that weight loss programs could be more effective at reducing the risk of OA if they are combined with programs aimed at correcting muscle weakness and malalignment. This has the potential to promote a better quality of life as people age and to reduce the economic burden of knee OA in the community.Read moreRead less
A Prospective Study To Identify The Mechanical Causes And Methods For Early Detection Of Knee Osteoarthritis
Funder
National Health and Medical Research Council
Funding Amount
$431,000.00
Summary
Knee osteoarthritis is a great cost to society, financially and in quality of life. Anti-inflammatory drugs are commonly used to treat the symptoms, but many people receive joint replacements to stop pain and improve function. We need to prevent osteoarthritis, but the causes for this common disease are largely unknown. Animal studies have shown two particular mechanical factors that cause osteoarthritis, which are seen in the walking and running, or gait, patterns of some people. We call these ....Knee osteoarthritis is a great cost to society, financially and in quality of life. Anti-inflammatory drugs are commonly used to treat the symptoms, but many people receive joint replacements to stop pain and improve function. We need to prevent osteoarthritis, but the causes for this common disease are largely unknown. Animal studies have shown two particular mechanical factors that cause osteoarthritis, which are seen in the walking and running, or gait, patterns of some people. We call these pathological gait patterns as they impose larger-than-normal forces on the knee's articular surfaces. We measure these knee forces with our new computer knee model coupled with data that we measure in a gait analysis laboratory. These forces may cause knee osteoarthritis in humans, but this is still unknown. Currently there is no simple medical test to detect the early onset of knee osteoarthritis. The bones in the knee are one of the first structures to show osteoarthritic changes. Using our new computerised analysis of high definition X-ray of the knee we can identify subtle differences in the knee due to osteoarthritis. This will be compared with changes to joint assessed using MRI. Osteoarthritis develops slowly in normal people, so to study progression of knee osteoarthritis we need a human population that has a higher risk of developing the disease. Partial meniscectomy in the knee is a common surgery performed to improve knee function in those who have suffered a knee meniscus injury. However, partial meniscectomy patients have a high risk of developing knee osteoarthritis. Therefore, using partial meniscectomy patients we are investigating if pathological gait patterns cause knee osteoarthritis, measuring the development of the disease with our new X-ray methods. With the gait analysis methods we can also identify the movements that characterise these pathological gait patterns so we can formulate rehabilitation programmes to help prevent knee osteoarthritis.Read moreRead less
Young Adults With Old Knees: Prevalence Of Early-onset Knee Osteoarthritis Following Anterior Cruciate Ligament Reconstruction And Exploration Of Clinical Risk Factors
Funder
National Health and Medical Research Council
Funding Amount
$107,204.00
Summary
Knee osteoarthritis (OA) is common after anterior cruciate ligament reconstruction (ACLR). Little is known about OA development and progression in the early stages of disease, less than five years post-ACLR. This study aims to evaluate the development and presence of OA from at five years post-ACLR and to explore factors that can determine who is likely to have worsening of early-onset OA. This information can be used to develop treatments that may be used to slow OA progression.
Role Of Musculoskeletal Biomechanical Factors In Cartilage Loss In Those Who Undergo Partial Medial Menisectomy.
Funder
National Health and Medical Research Council
Funding Amount
$654,530.00
Summary
The novel outcomes from our project are that we will identify whether musculoskeletal-biomechanical factors that can be modified are associated with adverse cartilage changes in a subgroup of individuals with an increased risk of developing knee OA, those who have undergone an APM. The findings of this research are timely and of major international significance as there is increasing attention being paid to preventing OA rather than merely treating the signs and symptoms. Our state-of-the-art me ....The novel outcomes from our project are that we will identify whether musculoskeletal-biomechanical factors that can be modified are associated with adverse cartilage changes in a subgroup of individuals with an increased risk of developing knee OA, those who have undergone an APM. The findings of this research are timely and of major international significance as there is increasing attention being paid to preventing OA rather than merely treating the signs and symptoms. Our state-of-the-art measure of cartilage changes will allow us to detect those at risk much sooner than traditional measures using radiographs. The measures are also leading edge internationally. We chose these specific factors to investigate as there is evidence that they can be modified with appropriate interventions. For example, static joint alignment could be modified with foot orthoses [Crenshaw, 2000 #1016], muscle weakness can be addressed with strength programs and mechanical loading across the knee could be reduced via weight loss programs or techniques to alter gait patterns. Currently, formal supervised post-operative rehabilitation is not routinely prescribed following APM because it is considered a routine procedure. If our research identifies risk factors for increased cartilage loss then we will be able to develop appropriate intervention strategies for individuals following an APM. These interventions can then be formally tested as to their effectiveness in reducing adverse cartilage changes using randomised controlled trials. In particular, this could lead to changes in current post-operative clinical practice for this patient group. Ultimately, this could reduce the risk of OA in the future and the resultant personal and societal costs of this condition.Read moreRead less
ENDOGENOUS PAIN RELIEF IN HEALTHY AND OSTEOARTHRITIC PATIENTS
Funder
National Health and Medical Research Council
Funding Amount
$509,926.00
Summary
Pain has a detrimental impact on ones quality of life and a significant financial impact on the community. Given this, there is a substantial effort aimed at developing pain relieving compounds. One way in which our own brain can provide complete pain relief is via a mechanism called diffuse noxious inhibitory control. We currently do not know how this mechanism works and the aim of this investigation is to explore this mechanism in healthy and osteoarthritis patients use human brain imaging.
Anterior Cruciate Ligament Reconstruction (ACLR) And Neuromuscular Training
Funder
National Health and Medical Research Council
Funding Amount
$99,248.00
Summary
Anterior Cruciate Ligament Reconstructive (ACLR) following ACL rupture is a successful surgery that improves stability of the knee joint. However, evidence is emerging that despite undergoing reconstructive surgery, osteoarthritis of the knee joint is prevalent in the proceeding years. The proposed research aims to improve biomechanical abnormalities by providing a neuromuscular intervention. This could lead to a more optimal biomechanical pattern which could reduce the degenerative changes occu ....Anterior Cruciate Ligament Reconstructive (ACLR) following ACL rupture is a successful surgery that improves stability of the knee joint. However, evidence is emerging that despite undergoing reconstructive surgery, osteoarthritis of the knee joint is prevalent in the proceeding years. The proposed research aims to improve biomechanical abnormalities by providing a neuromuscular intervention. This could lead to a more optimal biomechanical pattern which could reduce the degenerative changes occurring within the knee of ACLR patients.Read moreRead less
This research program aims to utilise three new clinical trials to treat pain from osteoarthritis of the knee and hand. These treatments use existing medications, but for new indications. This project will determine if these treatments reduce pain and slow structural changes over two years of treatment. It also has the potential to develop the first treatment for osteoarthritis which changes the natural course of the disease rather than merely treating symptoms.
Does Low Dose Amitriptyline Reduce Pain In Knee Osteoarthritis? A Double Blind, Randomised, Pragmatic, Placebo Controlled Clinical Trial Of Amitriptyline In Addition To Usual Care
Funder
National Health and Medical Research Council
Funding Amount
$413,704.00
Summary
Pain is the main problem for people with osteoarthritis, a common form of arthritis. This pain is not controlled well. Pain comes from structural changes in the joint. However, after time, some people develop pain due to changes in the nervous system, called pain sensitisation. This is not affected by usual treatments. Amitriptyline is used to treat pain sensitisation. This study is a randomised trial to see whether amitriptyline, relieves pain in people with knee osteoarthritis over 3 months.