Five-year prognosis and impact of adolescent knee pain: a prospective population-based cohort study of 504 adolescents in Denmark

Rathleff, Michael Skovdal; Holden, Sinéad; Straszek, Christian Lund; Olesen, Jens Lykkegaard; Jensen, Martin Bach; Roos, Ewa M.

doi:10.1136/bmjopen-2018-024113

Cited by 57 publications

(65 citation statements)

References 22 publications

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“…Musculoskeletal (MSK) pain can start early in life [1][2][3] and increases throughout adolescence [2,4,5]. Furthermore, knee pain [6,7], spinal pain [8] and MSK pain in general [2,9] have been shown to be recurrent conditions, and multi-site pain may exist already in adolescence [10][11][12]. Holden et al categorised adolescents into four classes describing their pain experience and demonstrated that multi-site pain was more common than pain in a single region [10].…”

Section: Introductionmentioning

confidence: 99%

“…MSK pain in children may have a negative impact on sports participation [ 13 – 15 ], and physical activity in childhood is important for childhood and later health [ 16 ], highlighting the importance of optimizing MSK health. In addition, MSK problems in children have been linked to psychological distress [ 17 , 18 ], poor relations with peers [ 5 , 19 ], absence from school [ 13 ], puberty [ 20 , 21 ] and decreased quality of life [ 7 , 10 , 22 ]. To improve our understanding in this important area, and to learn when and how to intervene, we need more basic epidemiological knowledge about the occurrence and distribution of MSK problems in early life.…”

Section: Introductionmentioning

confidence: 99%

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Musculoskeletal pain distribution in 1,000 Danish schoolchildren aged 8–16 years

et al. 2020

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Background: Knowledge about the occurrence and distribution of musculoskeletal problems in early life is needed. The objectives were to group children aged 8 to 16 according to their distribution of pain in the spine, lower-and upper extremity, determine the proportion of children in each subgroup, and describe these in relation to sex, age, number-and length of episodes with pain. Method: Data on musculoskeletal pain from about 1,000 Danish schoolchildren was collected over 3 school years (2011 to 2014) using weekly mobile phone text message responses from parents, indicating whether their child had pain in the spine, lower extremity and/or upper extremity. Result are presented for each school year individually. Results: When pain was defined as at least 1 week with pain during a school year, Danish schoolchildren could be divided into three almost equally large groups for all three school years: Around 30% reporting no pain, around 40% reporting pain in one region, and around 30% reporting pain in two or three regions. Most commonly children experienced pain from the lower extremities (~60%), followed by the spine (~30%) and the upper extremities (~23%). Twice as many girls reported pain in all three sites compared to boys (10% vs. 5%) with no other statistically significant sex or age differences observed. When pain was defined as at least 3 weeks with pain during a schoolyear, 40% reported pain with similar patterns to those for the more lenient pain definition of 1 week. Conclusion: Danish schoolchildren often experienced pain at more than one pain site during a schoolyear, and a significantly larger proportion of girls than boys reported pain in all three regions. This could indicate that, at least in some instances, the musculoskeletal system should be regarded as one entity, both for clinical and research purposes.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Musculoskeletal pain distribution in 1,000 Danish schoolchildren aged 8–16 years

et al. 2020

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“…Further prospective research is needed to validate this finding, including studies with a clinical follow-up evaluation to determine if pain is indeed related to current OSD. However, we previously demonstrated in a follow-up study that very few adolescents without knee pain during adolescence developed knee pain at 5-year follow-up, 17 which would make it unlikely that the high proportion reporting knee pain at follow-up in the current study is unrelated to their history of OSD. These findings may have important implications for the evidence-based information that patients are given in the secondary care sector.…”

Section: Discussionmentioning

confidence: 62%

“…4,8,12,23 In fact, participants reported an OSD symptom duration of 90 months for those still experiencing knee pain, with 42.9% reporting daily knee pain. This risk of continued knee pain is slightly higher than that reported for patellofemoral pain (PFP) in adolescents, where a study by Rathleff et al 17 showed that 40.5% of adolescents still experienced knee pain after 5 years. We believe that this difference in the incidence of continued knee pain between adolescents with PFP and OSD may be due to the study design, as we had a shorter follow-up period and a more selective (hospital) population.…”

Section: Discussionmentioning

confidence: 74%

Long-term Prognosis and Impact of Osgood-Schlatter Disease 4 Years After Diagnosis: A Retrospective Study

Guldhammer

Rathleff

Jensen

et al. 2019

Orthopaedic Journal of Sports Medicine

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Background:Knee pain is common during adolescence, with Osgood-Schlatter disease (OSD) being the most frequent condition. Despite this, research regarding the long-term prognosis of OSD is limited.Purpose:To evaluate the prognosis 2 to 6 years after the diagnosis of OSD.Study Design:Cohort study; Level of evidence, 3.Methods:This retrospective cohort study included patients diagnosed with OSD at a single orthopaedic department between 2010 and 2016. Patients were contacted in 2018 and asked to complete a self-reported questionnaire regarding knee pain, knee function (Knee injury and Osteoarthritis Outcome Score [KOOS] Sports/Recreation subscale), Health-related quality of life (HRQoL) (youth version of EuroQol 5 dimensions 3 levels [EQ-5D-3L-Y]), and physical activity.Results:Out of 84 patients, 43 responded. Of these, 60.5% (n = 26) reported OSD-related knee pain at follow-up (median follow-up, 3.75 years). The median symptom duration was 90 months (interquartile range, 24-150 months) for those still experiencing knee pain, and 42.9% of these reported daily knee pain. Fifty-four percent with knee pain had reduced their sports participation compared with 35.3% of those without knee pain. KOOS Sports/Recreation subscale scores were significantly lower in those with knee pain compared with those without knee pain (53 [95% CI, 42-63] vs 85 [95% CI, 76-94], respectively). Participants with knee pain reported lower HRQoL (0.71 [95% CI, 0.57-0.84]) compared with those without knee pain (0.99 [95% CI, 0.97-1.00]).Conclusion:This study indicates that OSD may not always be self-limiting. The lower self-reported function and HRQoL in those with continued pain may be a consequence of impaired physical activity due to knee pain.

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“…Non-traumatic knee complaints can be long-lasting, with an impact on health-related quality of life and physical activity [9][10][11] . In light of this, the management strategy initiated by the health care practitioner becomes critical to improve long term prognosis.…”

Section: Introductionmentioning

confidence: 99%

Development and Validation of the Sorting Non-trauMatIc adoLescent knEe Pain (SMILE) Tool – a Development and Validation Study

Guldhammer

Holden

Sørensen

et al. 2020

Preprint

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Background: Despite the commonality of adolescent knee pain, there are no tools to support medical doctors to correctly diagnose knee pain. Aim: This study aimed to develop and evaluate a support tool for diagnosing the most common types of non-traumatic adolescent knee pain.Design and setting: Development and validation study in participants recruited from the general community. Method: A systematic search on Medline identified the literature on clinical tests and diagnoses of adolescent knee pain. The search was supplemented by textbooks and transformed into a diagnostic flowchart based on onset, symptoms, and pain localisation. This tool was revised based on feedback from general practitioners and experts in sports medicine. The tool was evaluated on two separate days with blinded assessors. Overall, 27 participants (aged 10-17 years) with non-traumatic knee pain were included. All participants were diagnosed by medical doctors or medical students, without and with the use of the tool. Diagnoses were compared to a golden standard (expert clinician). An interview to inform optimisations of the tool was performed with the assessors. Percentage agreement with the golden standard, and Kappa statistic for interrater reliability were calculated.Results: The final tool improved diagnostic agreement with the golden standard from 22.7% (95% CI 10.3-35.1) to 77.3% (95% CI 64.9-89.7). Inter-rater reliability increased from poor agreement k=-0.04 (95% CI, -0.12-0.04) moderate agreement k=0.56 (95% CI, 0.40-0.72).Conclusion: This simple diagnostic tool is quick to use and may assist doctors in diagnosing non-traumatic knee pain in adolescents.Trial registration: Not applicable.

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Five-year prognosis and impact of adolescent knee pain: a prospective population-based cohort study of 504 adolescents in Denmark

Cited by 57 publications

References 22 publications

Musculoskeletal pain distribution in 1,000 Danish schoolchildren aged 8–16 years

Musculoskeletal pain distribution in 1,000 Danish schoolchildren aged 8–16 years

Long-term Prognosis and Impact of Osgood-Schlatter Disease 4 Years After Diagnosis: A Retrospective Study

Development and Validation of the Sorting Non-trauMatIc adoLescent knEe Pain (SMILE) Tool – a Development and Validation Study

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