Train High Eat Low for Osteoarthritis study (THE LO study): protocol for a randomized controlled trial.

Introduction: Osteoarthritis (OA) is one of the most prevalent chronic conditions among older adults, with the medial tibio-femoral joint being most frequently affected. The knee adduction moment is recognized as a surrogate measure of the medial tibio-femoral compartment joint load and therefore represents a valid intervention target. This article provides the rationale and methodology for THE LO study (Train High, Eat Low for Osteoarthritis), which is a randomized controlled trial that is investigating the effects of a unique, targeted lifestyle intervention in overweight/obese adults with symptomatic medial knee OA.

Obesity & osteoarthritis.

The most significant impact of obesity on the musculoskeletal system is associated with osteoarthritis (OA), a disabling degenerative joint disorder characterized by pain, decreased mobility and negative impact on quality of life. OA pathogenesis relates to both excessive joint loading and altered biomechanical patterns together with hormonal and cytokine dysregulation. Obesity is associated with the incidence and progression of OA of both weight-bearing and non weight-bearing joints, to rate of joint replacements as well as operative complications.

Current evidence for osteoarthritis treatments.

Osteoarthritis (OA) is the most common form of arthritis and the leading cause of chronic disability among older people. The burden of the disease is expected to rise with an aging population and the increasing prevalence of obesity. Despite this, there is as yet no cure for OA.

Cartilage defects are associated with physical disability in obese adults.

Objective: To describe the associations between physical disability measures and knee cartilage defects in obese adults.

Methods: One hundred and eleven obese subjects were recruited from laparoscopic adjustable gastric banding or exercise/diet weight loss programmes. All subjects completed disease-specific (WOMAC) and general health status (SF-36) questionnaires, and were assessed for range of knee motion, tibiofemoral alignment and quadriceps strength.

Influence of BMI on health-related quality of life: comparison between an obese adult cohort and age-matched population norms.

The aim of this study was to determine health-related quality of life and fatigue measures in obese subjects and to compare scores with age- and gender-matched population norms. A total of 163 obese subjects were recruited from laparoscopic-adjustable gastric banding or exercise and diet weight loss programs between March 2006 and December 2007. All subjects completed the Medical Outcomes Study Short Form 36 (SF-36), Assessment of Quality of Life (AQoL), and Multidimensional Assessment of Fatigue (MAF) questionnaires.

Delayed gadolinium-enhanced magnetic resonance imaging of cartilage: clinical associations in obese adults.

Objective: Delayed gadolinium-enhanced magnetic resonance imaging (MRI) of cartilage (dGEMRIC) is used to assess cartilage glycosaminoglycan distribution. Our aim was to determine the relationships between self-reported pain and disability, clinical variables, and serum leptin, and dGEMRIC indices in obese subjects with and without clinical knee osteoarthritis (OA).

Methods: Seventy-seven subjects were recruited from laparoscopic adjustable gastric banding or exercise and diet-weight loss programs.

Obesity and the musculoskeletal system.

Purpose Of Review: To describe recent developments highlighting the effects and mechanisms of obesity and weight loss on the musculoskeletal system.

Recent Findings: The global epidemic of obesity has far-reaching effects on the musculoskeletal system and associated conditions such as osteoarthritis, rheumatoid arthritis, spondyloarthropathy, and fibromyalgia. Obesity increases the need for, and reduces the health outcomes from, joint replacement surgery, which has enormous implications for societal economic burden.

Predictors of clinical response to intraarticular Hylan injections -- a prospective study using synovial fluid measures, clinical outcomes, and magnetic resonance imaging.

Objective: To evaluate synovial fluid (SF) and clinical and imaging predictors of clinical response in patients receiving intraarticular Hylan GF-20 injections.

Methods: Thirty-two patients with mild to moderate osteoarthritis (OA) of the knee [OsteoArthritis Research Society International (OARSI) grades I-II] were followed over 6 months. SF and clinical and radiographic measures were assessed.

Reconstructive hand surgery for scleroderma joint contractures.

Systemic scleroderma can cause significant hand deformity and functional impairment. Surgery is often avoided due to the perceived risks of wound healing. The most common surgical procedures have been digital sympathectomy, arthrodesis or arthroplasty of the proximal interphalangeal (PIP) or both, and metacarpophalangeal (MCP) joints.

Magnetic resonance imaging in Löfgren's syndrome: demonstration of periarthritis.

In Löfgren's syndrome, pain and swelling commonly involves the ankle joints. In this prospective case series, the magnetic resonance imaging findings of ankle joint involvement are described. Extensive subcutaneous and soft tissue oedema was commonly seen around the ankles.

Magnetic resonance imaging in pachydermodactyly.

The magnetic resonance imaging (MRI) findings of a teenage boy with pachydermodactyly are described. The findings include fusiform soft tissue swelling around the proximal interphalangeal joints of the hands, with sparing of the tendons and ligaments. There was no capsular involvement and no evidence of periosteal reaction.