Roop Bhushan Kalia

Background: Knee osteoarthritis (KOA) is a progressive degenerative joint disorder characterized by chronic pain, functional limitation, and impaired quality of life. Emerging evidence indicates that radiographic severity alone inadequately explains symptom burden, thereby highlighting the contribution of biomechanical and psychosocial determinants to functional disability. The objective is to investigate the interrelationship of age, foot progression angle (FPA), and psychological distress with functional disability measured using the WOMAC Index in patients with knee osteoarthritis. Methods: A cross-sectional observational study was conducted among 108 patients aged 45–70 years with unilateral or bilateral knee osteoarthritis graded using the Kellgren–Lawrence grading system. Functional disability was evaluated using the WOMAC Index, psychological distress using the PHQ-9 and GAD-7, and resilience using the Brief Resilience Scale. Foot progression angle was assessed during gait analysis. Pearson correlation and multivariate linear regression analyses were performed. Results: Advancing age and greater deviations in foot progression angle were significantly associated with worsening WOMAC-derived functional disability. Psychological distress exhibited weak-to-moderate positive correlations with WOMAC outcome, whereas resilience demonstrated an inverse relationship. Multivariate regression analysis identified foot progression angle and psychological distress as independent contributors to functional limitation beyond the effects of radiographic severity. Conclusions: Functional impairment in knee osteoarthritis extends beyond radiographic disease severity and appears to be influenced by gait biomechanics and psychosocial factors. A comprehensive multidimensional assessment may improve individualized rehabilitation and long-term functional outcomes.

Knee osteoarthritis (OA) is no longer viewed solely as a degenerative disorder, but as a mechanically driven disease in which aberrant joint loading dictates both symptom progression and structural decline. Within this framework, the foot progression angle (FPA) has emerged as a clinically accessible and modifiable biomechanical parameter that may influence medial knee joint loading.

Background: A prominent chronic musculoskeletal condition that is linked to pain, disability, and a lower quality of life is knee osteoarthritis (KOA). A biopsychosocial paradigm, which holds that psychological factors have a major impact on pain perception and functional limitation, is supported by emerging research. This model suggests a reciprocal relationship between emotional and physical health. Objective of the study was to evaluate gender-based variations across radiographic severity classes and to look into the relationship between pain intensity, functional impairment, and psychological distress in people with KOA. Methods: A cross-sectional observational study was conducted among 108 patients diagnosed with KOA. The WOMAC (modified CRD Pune version) was used to assess clinical severity, while the GAD-7 and PHQ-9 were used to assess anxiety and depressive symptoms. Pain-stress correlations were evaluated using Pearson's correlation, and male and female participants with Kellgren-Lawrence (K/L) grades II and III were compared using independent-samples t-tests. Results: Clinically significant patterns were found despite the lack of statistical significance (p>0.05). Increased psychological discomfort, especially depressive symptoms, was linked to higher WOMAC scores. In female participants, there was a somewhat favorable correlation between the severity of symptoms and depression (r=0.374, p=0.333), but anxiety exhibited mild correlations in both sexes. Pain, stiffness, function, and overall WOMAC ratings did not differ significantly based on sex across K/L grades (all p>0.05). These results point to a clinically significant connection between emotional discomfort and pain burden. Conclusions: According to the study, there might be a reciprocal relationship between psychological distress and chronic pain, supporting a biopsychosocial view of KOA. Routine rehabilitation that incorporates psychological evaluation may improve patient results and encourage more thorough, patient-centered care.

Osteoarthritis (OA) is a complex condition that involves immunological, metabolic, and inflammatory processes, as well as mechanical deterioration. Even in the absence of overt infection, recent developments in molecular diagnostics have revealed that synovial fluid, synovial tissue, and articular cartilage from patients with OA contain bacterial DNA and other microbial components. These results cast doubt on the conventional theory of joint sterility and raise the possibility that the gut–joint axis plays a role in disease etiology. In accordance with the PRISMA-style methodology, this narrative review summarizes the most recent human data on microbial DNA detection in joint tissues, investigates mechanisms of innate immune activation and microbial translocation, and assesses their clinical implications. Microbial markers in OA joints differ from those in healthy controls. They are associated with inflammatory mediators such as lipopolysaccharide (LPS), according to observational, cross-sectional, and emerging interventional studies. Toll-like receptor (TLR)-mediated pathways may be activated by microbial components, leading to cartilage degradation and synovitis. Causality remains unknown despite encouraging results due to methodological flaws and potential contamination biases. Gaining insight into the role of microbes in OA could lead to the development of new biomarkers and treatments targeting the microbiome.

Purpose This study evaluated the relationship between fixed flexion deformity (FFD), hip range of motion (ROM), and dynamic spinopelvic parameters, and explored factors associated with early postoperative sacral slope (SS) mobility in patients with advanced hip arthritis undergoing total hip arthroplasty (THA). Methods In this prospective study, 45 patients with unilateral hip arthritis and FFD undergoing primary THA were evaluated preoperatively and at three months postoperatively. Clinical assessments included the Thomas test, hip ROM, Harris Hip Score (HHS), and Visual Analogue Scale (VAS) for pain. Radiographic measurements in standing and sitting positions included pelvic incidence, sacral slope, pelvic tilt, ante-inclination (AI), and pelvic–femoral angle. Spinopelvic mobility was defined by the change in sacral slope (ΔSS) between standing and sitting positions. Results The mean age was 56.2 years. Mean FFD improved from 16.4° preoperatively to 0° postoperatively, while hip flexion increased from 72.5° to 114.1°. Preoperatively, 11% of patients exhibited a stiff spinopelvic pattern, 63% had normal mobility, and 26% were hypermobile. Following THA, spinopelvic mobility shifted toward a more physiological distribution. Preoperative FFD correlated positively with ΔSS (r = 0.45, p = 0.002). Exploratory multivariable regression analysis identified preoperative hip ROM (β = − 0.35, p = 0.012) and preoperative dynamic change in AI (β = 0.31, p = 0.026) as significant independent factors associated with postoperative ΔSS. Conclusion Correction of FFD through THA improves spinopelvic mobility and promotes pelvic realignment. Preoperative hip ROM and dynamic AI were independently associated with early postoperative SS mobility in this exploratory analysis; larger studies are required to validate these associations and determine their clinical significance.

Knee osteoarthritis (OA) is a disease characterized by cellular energy dysregulation, in which structural joint deterioration and chronic pain are caused by mitochondrial dysfunction. OA is now recognized as a multifactorial condition caused by disturbed cellular homeostasis, metabolic imbalance, and typical biological processes of aging, notably mitochondrial dysfunction. However, it was once thought to be caused by mechanical wear and cartilage degradation

Globally, knee osteoarthritis (KOA) is an important contributor to pain, limited mobility, and long-term disability. Conventional assessment methods still primarily rely on radiographic results, subjective complaint reporting, and episodic clinical examination, despite advancements in musculoskeletal rehabilitation. However, the dynamic biomechanical dysfunction that underlies discomfort, instability, and increasing functional loss in people with KOA is often missed by these methods.

Traditionally thought of as a degenerative joint condition, knee osteoarthritis (OA) is now more widely understood as a chronic low-grade inflammatory and metabolic disease, with systemic factors like food having a major impact on the disease's start, progression, and severity of symptoms. The growing notion of "metabolic OA " underscores how dietary inflammation affects joint health.