Andrea Dell'Isola

Lund University | LU · Department of Orthopaedics

Background Knee Osteoarthritis (KOA) is a heterogeneous pathology characterized by a complex and multifactorial nature. It has been hypothesised that these differences are due to the existence of underlying phenotypes representing different mechanisms of the disease. Methods The aim of this study is to identify the current evidence for the existenc...

Objective We wanted to determine if higher compliance with American College of Sports Medicine (ACSM) exercise prescription guidelines influences exercise outcomes in knee osteoarthritis (OA). Methods We conducted a systematic review. We searched the Cochrane Central Register of Controlled Trials, MEDLINE, and Embase up to January 4, 2024, for ran...

Osteoarthritis is one of the most common musculoskeletal diseases and increases the risk of severe cardiovascular disease, like heart attack and stroke. In some individuals, osteoarthritis and cardiovascular disease will co-occur. This co-occurrence might be due to shared risk factors, for example high age, lifestyle factors and/or a shared genetic...

Hybrid e-learning offered flexibility for students who could not attend in-person classes during the COVID-19 pandemic, but its effectiveness in teaching chest physiotherapy remains to be determined. This retrospective case-control study assessed physiotherapy students’ academic performance and satisfaction with a hybrid classroom approach adopted...

Background This study aimed to explore the awareness, experiences, and beliefs of individuals with osteoarthritis (OA) regarding their healthcare management, along with assessing their overall satisfaction levels. Methods A cross‐sectional online survey was conducted in Italy, Sweden, and Russia, rigorously developed based on OA international guid...

Objectives To identify multimorbidity trajectories over 20 years among incident osteoarthritis (OA) individuals and OA-free matched references. Methods Cohort study using prospectively collected healthcare data from the Skåne region, Sweden (~1.4 million residents). We extracted diagnoses for OA and 67 common chronic conditions. We included indivi...

Objective To investigate the associations between rheumatic and musculoskeletal diseases (RMDs) and incident dementia using population register‐based data. Methods This nested case‐control study was conducted based on a cohort of residents in the Skåne region, Sweden, aged 50 years and older in 2009 without doctor‐diagnosed dementia during 1998 to...

Background Associations of osteoarthritis (OA) with different comorbidities have gained attention recently. However, there is no literature on the congruency across different large primary care settings. Objectives We examined the associations of OA with 61 different comorbidities diagnosed before and after the first diagnosis of OA in four differ...

Background Osteoarthritis (OA) and metabolic conditions are major causes of disability. A growing hypothesis posits the presence of a metabolic OA phenotype where the co-occurrence of OA and metabolic conditions may worsen joint symptoms and overall health. The heightened complexity of the disease status may thus influence the choice of treatments...

Background Osteoarthritis (OA) burdens individuals and healthcare systems across Europe. With limited curative options, symptom management becomes pivotal, yet underdiagnosis and varied healthcare professional education in OA prevail. The role of individuals in their care and the impact of their willingness, beliefs, and perceived barriers are crit...

Purpose (the aim of the study): Satisfaction measures have been recommended as a core component for evaluating treatment outcomes in os-teoarthritis (OA). People with comorbid metabolic conditions and OA need to rely on multiple interventions and may have a suboptimal response to treatments that can result in subsequent low satisfaction with OA car...

Objective To explore sex and age differences in Patient-Reported Outcomes Measures (PROMs) and adherence to digital osteoarthritis (OA) self-management intervention. Methods A register-based study with data from an OA digital self-management intervention. PROMs and adherence were collected at baseline and/or 3-month follow-up: 'pain intensity' in...

Background Several systematic reviews (SRs), with and without meta-analyses, have investigated the use of wearable devices to improve physical activity, and there is a need for frequent and updated syntheses on the topic. Objective We aimed to evaluate whether using wearable devices increased physical activity and reduced sedentary behaviour in ad...

Abstract Objective: To examine income-related inequality changes in the outcomes of an osteoarthritis (OA) first-line intervention. Design: Retrospective cohort study. Setting: Swedish health care system. Participants: We included 115,403 people (age: 66.2§9.7 years; females 67.8%; N=115,403) with knee (67.8%) or hip OA (32.4%) recorded in the “Swe...

Aim To investigate temporal trends in primary care visits, physiotherapy visits, dispensed non-steroidal anti-inflammatory drugs (NSAIDs) and opioids in knee osteoarthritis (OA) patients who have and have not undergone knee replacement. Methods We analysed 5665 OA patients from the Skåne Healthcare Register, Sweden, who underwent knee replacement...

To investigate the association between chronic inflammatory rheumatic diseases (CIRD) and drug use disorder (DUD). Individuals aged ≥ 30 years in 2009 that met the following conditions were included: residing in the Skåne region, Sweden, with at least one healthcare contact in person and no history of DUD (ICD-10 codes F11-F16, F18-F19) during 1998...

Purpose (i) To report the prevalence of participants to a first-line intervention for OA in Sweden using over-the-counter (OTC) and/or prescribed NSAIDs; (ii) To estimate the accuracy of dispensed prescriptions of NSAIDs recorded in a Swedish health-care register to capture the use of NSAID considering clinician-report as reference standard. Metho...

Background: In education, lecturers play a crucial role in facilitating students’ learning process. However, only a few studies explored which lecturers’ characteristics can facilitate this process in higher education for rehabilitation healthcare professionals. Starting from students’ perspectives, our qualitative study investigated the lecturers’...

Aim: To study the association between within-person changes in patient-reported outcomes (PROMs) and wish for joint surgery during participation in a digital first-line intervention comprising exercise and education for knee/hip osteoarthritis (OA). Methods: Retrospective observational registry study. Participants enrolled between 01/06/2018 and...

Background Previous evidence showed that Healthcare Professionals (HPs) working with rheumatic and musculoskeletal diseases (RMD) from Mediterranean countries have higher educational needs than Northern-European ones [1]. Hence, it is necessary to find new strategies to improve their training. Course leaders (CLs) are the responsible of the quality...

Objective To explore how lifestyle and demographic, socioeconomic, and disease‐related factors are associated with supervised exercise adherence in an osteoarthritis (OA) management program and the ability of these factors to explain exercise adherence. Methods A cohort register‐based study on participants from the Swedish Osteoarthritis Registry...

Background/Aims Osteoarthritis (OA) management programmes have been lately developed to tackle the osteoarthritis burden. Though beneficial, OA management programmes can be less effective on people in lower socioeconomic positions and widen the possible pre-existing inequalities gap (‘intervention-generated inequalities’). In Sweden, an OA manageme...

Purpose: To determine the relative importance of factors influencing adherence to a digital self-management intervention for hip/knee osteoarthritis. Methods: We collected data on the digital intervention's (known as Joint Academy ®) participants between January 2019 and September 2021 with data on adherence, defined as the percentage of completed...

AIM: To study the association between within-person changes in patient-reported outcomes (PROMs) and wish for joint surgery during participation in a digital first-line intervention comprising exercise and education for knee/hip osteoarthritis (OA).

Use of non-surgical treatments in patients with knee osteoarthritis who do, and do not, advance to knee replacement (KR): a 10-year population-based study OA

Aims: (i) To report the prevalence of prescription and OTC NSAID users among people undergoing a first-line intervention for OA in Sweden. (ii) To estimate the accuracy of Non-Steroidal Anti-Inflammatory Drugs (NSAIDs) dispensed prescriptions recorded in a healthcare register in capturing NSAID use for osteoarthritis (OA) defined by self-report.

Objective: General practitioners (GP) are often the first medical professionals to treat musculoskeletal complaints. Yet the impact of COVID-19 on primary care utilisation for musculoskeletal complaints is largely unknown. This study quantifies the impact of the pandemic on primary care utilisation for musculoskeletal complaints and specifically o...

Aim To examine the associations between individual- and disease-related factors and the odds of reaching a clinically relevant pain reduction in people with knee and/or hip osteoarthritis (OA) who underwent a first-line self-management program. Materials and methods An observational registry-based study including people with knee (n = 18,871) and...

Objective Treatment adherence is suggested to be associated with greater improvement in patient outcomes. Despite the growing use of digital therapeutics in osteoarthritis management, there is limited evidence of person-level factors influencing adherence to these interventions in real-world settings. We aimed to determine the relative importance o...

Objectives: To explore clustering of comorbidities among patients with a new diagnosis of osteoarthritis (OA) and estimate the 10-year mortality risk for each identified cluster. Methods: This is a population-based cohort study of individuals with first incident diagnosis of OA of the hip, knee, ankle/foot, wrist/hand, or 'unspecified' site betw...

Objective To compare the prevalence and timing of knee surgery (including meniscal, ligamentous, synovial, and osteotomy) in the 10 years prior to primary total knee replacement (TKR) between England and Sweden. Methods This was a population‐based, case–control study within England and southern Sweden using electronic health care databases. Patien...

The SARS-CoV-2 Omicron (B.1.1.529) variant has been associated with less severe acute disease, however, concerns remain as to whether long-term complaints persist to a similar extent as for earlier variants. Studying 1 323 145 persons aged 18-70 years living in Norway with and without SARS-CoV-2 infection in a prospective cohort study, we found tha...

Importance Digital care platforms have been introduced, but there is limited evidence for their efficacy compared with traditional face-to-face treatment modalities. Objective To compare mean pain reduction among individuals with osteoarthritis (OA) of the knee or hip who underwent face-to-face vs digital first-line intervention. Design, Setting,...

Background: A wide range of response strategies have been implemented by different countries to slow the spread of the COVID-19 outbreak. While the effects of these strategies in the general population have been investigated, less is known about the effects of these strategies on those with pre-existing comorbid conditions including rheumatic and m...

Objective To estimate the risk of developing comorbidities in patients after physician‐diagnosed knee or hip osteoarthritis (OA). Methods This was a cohort study using Swedish longitudinal health care register data; we studied residents in the Skåne region age ≥35 years on January 1, 2010 who were free from diagnosed hip or knee OA (n = 548,681)....

Objective This study aimed at exploring the perspectives and experiences of patients with neck pain by synthesizing all available qualitative studies. Methods A systematic, qualitative meta-summary and meta-synthesis was conducted following the 5-step methodology proposed by Sandelowski and Barroso. A systematic search of 9 electronic databases wa...

Background: Osteoarthritis (OA) patients are more likely to have other comorbidities (Swain, Sarmanova et al. 2020). Improving the understanding of comorbidity profiles of OA patients may lead to improvement in their clinical care. Objectives: To identify sub-groups in patients diagnosed with hip OA using patterns of comorbidity. Methods: Routinely...

Background: People with osteoarthritis (OA) are at higher risk of developing a wide array of comorbidities. Whether the use of non-steroidal anti-inflammatory drugs (NSAIDs) contributes to the increased risk of some incident comorbidities remains unknown. Objectives: To examine the contribution of NSAIDs in the development of a wide range of comorb...

Objective To examine whether persons infected with the SARS-CoV-2 omicron variant have an altered risk of post-covid complaints and healthcare use when compared to 1) persons testing negative, and 2) persons with delta. Design Prospective cohort study with 126 days follow-up and a time-to-event approach. Setting A registry-based study including N...

Background Primary knee replacement (KR) is an effective intervention for end-stage knee osteoarthritis (OA). However, there are no definitive recommendations for the timing at which patients should receive this surgery, potentially resulting in differences in referral patterns depending on geographical area or the clinicians‘ preferences. Objecti...

Background International clinical practice guidelines for the management of osteoarthritis (OA) 1 2 recommend exercise, education and diet as first-line interventions since they are safe, low cost and reported to be effective, in reducing OA pain and disability, regardless of the severity of the disease. However, these treatments require high level...

Aim To study the risk of receiving a new (incident) osteoarthritis (OA) diagnosis in different joint sites based on conditions diagnosed in the 20 years prior the OA diagnosis. Methods We used register data for the entire population of the Skåne region (Sweden) to perform a nested case-control study. The outcome was newly diagnosed (incident) OA i...

Introduction Osteoarthritis (OA) is one of the leading chronic conditions in the older population. People with OA are more likely to have one or more other chronic conditions than those without. However, the temporal associations, clusters of the comorbidities, role of analgesics and the causality and variation between populations are yet to be in...

Purpose: Emerging evidence suggests that osteoarthritis (OA) may be associated with an increased risk of dementia. However, little is known about the implication of incipient dementia on healthcare use among people with OA. In this study we investigated the associations between incipient dementia and healthcare consultations, hospital admissions an...

Introduction Despite the publication of clinical practice guidelines, the quality of the care process as experienced by patients with osteoarthritis (OA) appears suboptimal. Hence, this study investigates how patients with OA experience their disease and care process, highlighting potential elements that can enhance or spoil it, to optimise their q...

Objective To investigate whether the first wave of the COVID-19 pandemic impacted healthcare consultations (HCC) and hospitalization among people with and without osteoarthritis (OA). Methods Using register data, we included individuals aged ≥35 years residing in Skåne region, Sweden, during 2009–2019 with (n = 123,523) and without (n = 552,412) a...

Objectives To investigate the role of osteoarthritis (OA) in the incidence of musculoskeletal, metabolic, cardiovascular, digestive, neuro-psychological, kidney and other comorbidities/adverse events after (i) incident non-steroidal anti-inflammatory drug (NSAID) initiation and (ii) NSAID discontinuation. Methods We used register data for the popu...

Objectives To describe and compare trends in the frequency of opioid prescribing/dispensing in English and Swedish patients with osteoarthritis prior to total knee replacement (TKR). Methods 49,043 patients from an English national database (Clinical Practice Research Datalink) and 5,955 patients from the Swedish Skåne Healthcare register undergoi...

Purpose To investigate the impact of COVID-19 in Sweden on rates of knee and hip surgeries. Methods We used healthcare data for the population of the southernmost region in Sweden (1.4 million inhabitants). We did an interrupted time-series analysis to estimate changes in rates and trends of joint replacements (JR), arthroscopies, and fracture sur...

Currently, the coronavirus disease 2019 (COVID-19) severely influences physiotherapy education which is based mostly on face-to-face teaching. Thus, educators have been compelled to adapt their pedagogical approaches moving to digital education. In this commentary, we debate on digital education highlighting its effectiveness, the users’ perspectiv...

Objective To examine the experience of the COVID-19 pandemic as lived by people with hip and knee osteoarthritis (OA), in Italy. Design A qualitative study based on semi-structured interviews. Setting Urban and suburban areas in northern Italy. Participants A total of 11 people with OA were enrolled through a purposeful sampling and completed th...

Objectives To describe the prevalence of comorbidities in a population referred to standardised first-line intervention (patient education and exercise) for hip and knee osteoarthritis (OA), in comparison with the general population. Furthermore, we aimed to evaluate if eventual differences were associated with socioeconomic inequalities. Design R...

Background During COVID-19 pandemic, physiotherapy lecturers faced the challenge of rapidly shifting from face-to-face to online education. This retrospective case-control study aims to compare students’ satisfaction and performances shown in an online course to a control group of students who underwent the same course delivered face-to-face in the...

Co-existence of comorbidities is common among individuals with osteoartritis, but the association remains still largely unknown. In this observational register-based study we describe comorbidities in a specified osteoarthritis population; patients who had been referred to participate in a nationwide standardized first-line intervention for hip and...