ORCID Profile
0000-0002-1082-6098
Current Organisations
Universidade Federal da Paraíba
,
Liverpool Hospital
,
University of Sydney
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Publications
Does Age Influence the Risk of Incident Knee Osteoarthritis After a Traumatic Anterior Cruciate Ligament Injury?
Publisher: SAGE Publications
Date: 21-07-2016
Abstract: The development of radiographic knee osteoarthritis (OA) after an anterior cruciate ligament (ACL) rupture has long been studied and proven in the adolescent population. However, similar exhaustive investigations have not been conducted in mature-aged athletes or in older populations. To identify whether an older adult population had an increased risk of incident radiographic knee OA after a traumatic knee injury compared with a young adult population. Cohort study Level of evidence, 3. Patients with ACL ruptures who underwent primary reconstruction were enrolled in a prospective, longitudinal single-center study over 15 years. The adult cohort was defined as participants aged ≥35 years who had a knee injury resulting in an ACL tear, the adolescent-young cohort suffered similar knee injuries and were aged ≤25 years, and a third cohort of participants aged 26 to 34 years who suffered a knee injury was included to identify the existence of any age-related dose-response relationship for the onset of radiographic knee OA. A Kaplan-Meier survival analysis was employed to determine the occurrence of incident radiographic OA across the study populations at 2, 5, 10, and 15 years after reconstruction. Significance at each time point was analyzed using chi-square tests. A total of 215 patients, including 112 adolescents (mean age, 20.4 years 50.9% female), 71 patients aged 26 to 34 years (mean age, 29.2 years 42.3% female), and 32 adults (mean age, 40.2 years 59.4% female), were assessed for International Knee Documentation Committee (IKDC) grading on knee radiographs. It was found that 53.0% and 77.8% of adults at a respective 10 and 15 years after reconstruction had an IKDC grade of B or greater compared with 17.7% and 61.6% of the adolescent-young cohort. Chi-square testing found that adults developed OA earlier than adolescents at 5 and 10 years after reconstruction ( P = .017 and P .0001, respectively). However, survival analysis did not demonstrate that adults were more likely to develop radiographic knee OA at 15 years after reconstruction compared with the adolescent-young cohort ( P = .4). The age at which an ACL injury is sustained does not appear to influence the rate of incident radiographic knee OA, although mature-aged athletes are likely to arrive at the OA endpoint sooner.
Stepped care approach for medial tibiofemoral osteoarthritis (streamline)
Publisher: Elsevier BV
Date: 04-2018
Stepped care approach for medial tibiofemoral osteoarthritis
Publisher: Elsevier BV
Date: 04-2017
Effectiveness of Stepped‐Care Intervention in Overweight and Obese Patients With Medial Tibiofemoral Osteoarthritis: A Randomized Controlled Trial
Publisher: Wiley
Date: 26-03-2021
DOI: 10.1002/ACR.24148
Abstract: To test the effectiveness of a 32-week, stepped-care intervention on disease remission rates in overweight and obese patients with medial tibiofemoral osteoarthritis (OA) compared to controls. In this randomized controlled trial, eligible participants were ≥50 years of age with a body mass index of ≥28 kg/m Disease remission at 32 weeks was achieved by 18 of 68 (26%) in the control group and 32 of 82 (39%) in the stepped-care group (difference 12.6% [95% confidence interval -2.3, 27.4], P = 0.10). The stepped-care group showed an improvement in pain and function between baseline and 20 weeks. While functional improvement was maintained at 32 weeks, pain levels tended to get worse between weeks 20 and 32. The proposed intervention did not promote a significant difference in the rate of disease remission in comparison to the control group for overweight or obese patients with medial tibiofemoral OA.
Metabolic risk factors, physical activity and physical fitness in azorean adolescents: a cross-sectional study
Publisher: Springer Science and Business Media LLC
Date: 06-04-2011
Stepped care approach for medial tibiofemoral osteoarthritis (STrEAMline): protocol for a randomised controlled trial
Publisher: BMJ
Date: 12-2017
DOI: 10.1136/BMJOPEN-2017-018495
Abstract: Current guidelines recommend tailored interventions to optimise knee osteoarthritis (OA) management. However, models of care still have a ‘one size fits all’ approach, which is suboptimal as it ignores patient heterogeneity. This study aims to compare a stepped care strategy with standard care for overweight and obese persons with medial tibiofemoral OA. Participants will be randomised into two groups (85 each). The intervention will receive a diet and exercise programme for 18 weeks in the first step of the study. Disease remission will then be assessed using the Patient Acceptable Symptom State (PASS). PASS is defined as the highest level of symptom beyond which patients consider themselves well and takes into account pain intensity, patient’s global assessment of disease activity and degree of functional impairment. In the second step, participants in remission will continue with diet and exercise. If remission is not achieved, participants will be assigned in a hierarchical order to cognitive behavioural therapy, knee brace or muscle strengthening for 12 weeks. The intervention will be decided based on their clinical presentation for symptoms of depression and varus malalignment. Participants without depression or varus malalignment will undertake a muscle strengthening programme. The control group will receive educational material related to OA management. Main inclusion criteria are age ≥50 years, radiographic medial tibiofemoral OA, body mass index (BMI) ≥28 kg/m 2 , knee pain ≥40 (Visual Analogue Scale, 0–100), PASS (0–100) for pain and global assessment, and 31 for functional impairment. Outcomes will be measured at 20-week and 32-week visits. The primary outcome is disease remission at 32 weeks. Other outcomes include functional mobility patient-reported outcomes BMI waist-hip ratio quadriceps strength symptoms of depression, anxiety and stress and knee range of motion. The analysis will be performed according to the intention-to-treat principle. The local ethics committee approved this protocol (HREC/14/HAWKE/381). Dissemination will occur through presentations at international conferences and publication in peer-reviewed journals. ACTRN12615000227594.
Related Organisations
Related Funding Activities
No related grants have been discovered for José Cazuza Farias Júnior.