Rheum Round-up: Exercises for Joint Pain, Pills over PT for Knee OA, and more

Here are the top stories covered by DocWire News this week in the Rheumatology section. In this edition, read about the best exercises for joint pain relief, how sound can be used to differentiate healthy knees versus osteoarthritic ones, the incidence of surgical site infections in ambulatory surgical centers, what providers are most likely to recommend for knee osteoarthritis (OA) treatment, and the effects of sprifermin on knee OA patients.

To patients with joint pain, exercise may sound counterintuitive, but the truth is it’s beneficial. Exercise, in conjunction with an approved treatment plan, can help relieve pain symptoms caused by conditions such as arthritis. Exercise can strengthen your muscles and bones, help with weight management, and improve your balance, to name a few benefits. The Centers for Disease Control and Prevention’s guidelines suggest incorporating four different activity types into your routine, all of which have different benefits: low-impact aerobic activities, muscle-strengthening exercises, flexibility exercises, and balance exercises.

Researchers of a new study have discovered that the use of certain audio signals may be able to differentiate knees with osteoarthritis (OA) from healthy ones. The technique involves the use of acoustic emission (AE). AE is defined as “a naturally occurring phenomenon within materials … [and] the transient elastic waves that result from a sudden strain energy release within a material due to the occurrence of microstructural changes. If enough energy is released, audible sounds are produced.”

A study analyzed current trends in the treatment of knee OA. Per the findings, the rate of nonsteroidal anti-inflammatory drugs and narcotics prescriptions is on the rise, while lifestyle recommendations are on the decline. Final analysis included 2,297 physician visits pertaining to knee OA (~67 [±4] million weighted-visits). Among orthopedist visits, there was a decline in physical therapist (PT) recommendation (158/1,000 to 88/1,000) as well as lifestyle recommendation (184/1,000 to 86/1,000) rates; meanwhile, there was an increase in the rates of prescriptions for NSAIDs (132/1,000 to 278/1,000) and narcotics (77/1,000 to 236/1,000) overtime (P < 0.05). Among primary care physicians, there were no significant changes in rates of lifestyle and PT recommendations or narcotics use, but NSAIDs prescriptions increased significantly (221/1,000 to 498/1,000, P < 0.05). Treatment recommendations were correlated with practice type, location, and type of provider seen.

Sprifermin may improve total femorotibial joint cartilage thickness in patients with symptomatic radiographic knee OA compared to placebo, although the clinical significance is not clear. Of 549 eligible patients, 474 completed two-year follow-up. Two-year changes in total femorotibial joint cartilage thickness compared to placebo were 0.05 mm for 100 μg of sprifermin administered every six months, 0.04 mm for 100 μg of sprifermin every 12 months, 0.02 mm for 30 μg of sprifermin every six months, and 0.01 mm for 30 μg of sprifermin every 12 months. Mean absolute changes in total Western Ontario and McMaster Universities Osteoarthritis Index scores, compared to placebo, did not significantly differ in the 100 μg of sprifermin administered every six or 12 months or 30 μg of sprifermin every six or 12 months groups. The most common adverse event related to treatment was arthralgia.

The incidence of surgical site infections (SSIs) following orthopedic surgery performed in ambulatory surgical centers (ASCs) is low; however, certain patients may be at higher risk. Final analysis included 22,267 surgeries; average patient age was 42.6 ± 17.3 years, and the patient population was 54% male. About one-third (32%) of surgeries were performed at the knee/leg; the other most frequently documented surgical sites were the hand (25%), shoulder (18%), foot/ankle (10%), and elbow (5%). Arthroscopic partial meniscectomy, carpal tunnel release, arthroscopic rotator cuff repair, anterior cruciate ligament reconstruction, and meniscal repair were the most common procedures performed. In total, 71 patients (0.32%) sustained an SSI. The following factors were independently associated with SSI: anatomic area, anesthesia type, age ≥70, diabetes mellitus, and tourniquet time.