Prognostic factors for progression of clinical osteoarthritis of the knee: a systematic review of observational studies

Bastick, Alex N.; Runhaar, Jos; Belo, Janneke; Bierma-Zeinstra, Sita M A

doi:10.1186/s13075-015-0670-x

Cited by 137 publications

(115 citation statements)

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“…17 In a recent systematic review, strong evidence for the associations between BMI and clinical progression of knee OA was reported by the authors, 7 which is consistent with the findings presented here. The authors also found strong evidence for the association with comorbidity count, 7 and moderate evidence was found for the association between education level and symptomatic knee OA. 7 In this study a strong association for joint space tenderness, for which the evidence was limited in the systematic review, was found.…”

Section: Comparison With Existing Literaturesupporting

confidence: 82%

“…The authors also found strong evidence for the association with comorbidity count, 7 and moderate evidence was found for the association between education level and symptomatic knee OA. 7 In this study a strong association for joint space tenderness, for which the evidence was limited in the systematic review, was found. 7 The findings related to joint space tenderness are consistent with earlier findings described by Altman and colleagues, and underline the importance of physical examination.…”

Section: Comparison With Existing Literaturementioning

confidence: 70%

“…7 In this study a strong association for joint space tenderness, for which the evidence was limited in the systematic review, was found. 7 The findings related to joint space tenderness are consistent with earlier findings described by Altman and colleagues, and underline the importance of physical examination. 4,18 What is not included in the criteria described by Altman and colleagues is painful knee flexion.…”

Section: Comparison With Existing Literaturementioning

confidence: 97%

“…[4][5][6] Numerous studies have determined risk factors for incident and radiographic progression of knee OA, but previous reviews have shown that only few studies have used symptomatic knee OA progression as an outcome measure. 7,8 Discordance remains in the apparent correlation between stages of knee OA assessed by clinical and radiographic criteria and pain severity. This seems to imply that there are differences in risk factors for (radiographic) disease progression and pain progression in knee OA.…”

Section: Introductionmentioning

confidence: 99%

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Defining knee pain trajectories in early symptomatic knee osteoarthritis in primary care: 5-year results from a nationwide prospective cohort study (CHECK)

et al. 2015

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BackgroundGPs have high consultation rates for symptoms related to knee osteoarthritis (OA). Many risk factors for symptomatic knee OA progression remain unknown. AimTo define distinct knee pain trajectories in individuals with early symptomatic knee OA and determine the risk factors for these pain trajectories. Design and settingData were obtained from the multicentre prospective Cohort Hip and Cohort Knee study in the Netherlands. Participants with knee OA, according to the clinical criteria of the American College of Rheumatology, and a completed 5-year follow-up were included. MethodBaseline demographic, anamnestic, and physical examination characteristics were assessed. Outcome was annually assessed by the Numeric Rating Scale for pain. Pain trajectories were retrieved by latent class growth analysis. Multinomial logistic regression was used to calculate relative risk ratios. ResultsIn total, 705 participants were included. Six distinct pain trajectories were identified with favourable and unfavourable courses. Statistically significant differences were found in baseline characteristics, including body mass index (BMI), symptom severity, and pain coping strategies between the different trajectories. Higher BMI, lower level of education, greater comorbidity, higher activity limitation scores, and joint space tenderness were more often associated with trajectories characterised by more pain at first presentation and pain progression -compared with the reference group with a mild pain trajectory. No association was found for baseline radiographic features. ConclusionThese results can help differentiate those patients who require more specific monitoring in the management of early symptomatic knee OA from those for whom a 'wait-and-see' policy seems justifiable. Radiography provided no additional benefit over clinical diagnosis of early symptomatic knee OA in general practice.Keywords disease progression; knee osteoarthritis; knee pain; pain trajectories; primary health care.e32 British Journal of General Practice, January 2016• aged 45-65 years; and• never consulted a physician for these symptoms, or had done so <6 months prior to recruitment to the study.Participants were excluded from the CHECK study if they had:• other pathological conditions that could explain the existing complaints (for example, other rheumatic disease, previous hip or knee joint replacement, congenital dysplasia, osteochondritis dissecans, intraarticular fractures, septic arthritis, Perthes disease, ligament or meniscus injury, plica syndrome, Baker's cyst);• comorbidity that would not allow physical evaluation during 10 years' follow-up;• malignancy in the past 5 years; and• inability to understand Dutch.For the analyses of the current study participants were included if, at baseline, they:• reported knee pain; and• were considered to have knee OA according to the clinical criteria of the American College of Rheumatology. 4,11If a participant had two affected knees, the knee with the worse score based on pain, Kellgren-Lawrenc...

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Section: Comparison With Existing Literaturesupporting

confidence: 82%

Section: Comparison With Existing Literaturementioning

confidence: 70%

Section: Comparison With Existing Literaturementioning

confidence: 97%

Section: Introductionmentioning

confidence: 99%

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Defining knee pain trajectories in early symptomatic knee osteoarthritis in primary care: 5-year results from a nationwide prospective cohort study (CHECK)

et al. 2015

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“…High quality was defined as a quality score of C9 and low quality \9. The same approach has also been applied in studies on the prognostic factors of knee and hip arthritis [32,33]. All included articles were scored independently by SSAF and RMH.…”

Section: Methodological Qualitymentioning

confidence: 99%

De novo degenerative lumbar scoliosis: a systematic review of prognostic factors for curve progression

et al. 2016

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Purpose To identify prognostic factors for curve progression in de novo degenerative lumbar scoliosis (DNDLS) by performing a systematic review of the literature. Methods Studies were selected for inclusion following a systematic search in the bibliographic databases PubMed and EMBASE prior to September 2015 and hand searches of the reference lists of retrieved articles. Two authors independently assessed methodological quality. Data were extracted and presented according to a best evidence synthesis. Results The literature search generated a total of 2696 references. After removing duplicates and articles that did not meet inclusion criteria, 12 studies were included. Due to the lack of statistical analyses, pooling of data was not possible. Strong evidence indicates that increasing intervertebral disk degeneration, lateral vertebral translation C6 mm, and an intercrest line through L5 (rather than L4) are associated with DNDLS curve progression. Moderate evidence suggests that apical vertebral rotation Grade II or III is associated with curve progression. For the majority of other prognostic factors, we found limited, conflicting, or inconclusive evidence. Osteoporosis, a coronal Cobb angle \30°, lumbar lordosis, lateral osteophytes difference of C5 mm, and degenerative spondylolisthesis have not been shown to be risk factors. Clinical risk factors for progression were not identified. Conclusions This review shows strong evidence that increased intervertebral disk degeneration, an intercrest line through L5, and apical lateral vertebral translation C6 mm are associated with DNDLS curve progression. Moderate evidence was found for apical vertebral rotation (Grade II/III) as a risk factor for curve progression. These results, however, may not be directly applicable to the individual patient.

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Diagnosis and Treatment of Hip and Knee Osteoarthritis

Katz

Arant

Loeser

2021

JAMA

1,228

760

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ong characterized as a wear-and-tear disorder, osteoarthritis (OA) is now understood to have a complex pathophysiology affecting multiple joints and joint structures, as captured by the Osteoarthritis Research Society International definition of OA: "The disease manifests first as a molecular derangement (abnormal joint tissue metabolism) followed by anatomic, and/or physiologic derangements (characterized by cartilage degradation, bone remodeling, osteophyte formation, joint inflammation and loss of normal joint function), that can culminate in illness." 1 Worldwide, an estimated more than 240 million persons have symptomatic, activity-limiting OA, including an estimated more than 32 million in the US. 2,3 The knee and hip are 2 commonly affected joints and are the focus of this Review. Nearly 30% of individuals older than 45 years have radiographic evidence of knee OA, about half of whom have knee symptoms. 4,5 The prevalence of symptomatic, radiographic hip OA is around 10%. 6,7 The lifetime risk of symptomatic knee OA is greater in obese persons (body mass index Ն30) than in nonobese persons (19.7% vs 10.9%). 8 Prior joint trauma, such as anterior cruciate ligament rupture and ankle fracture, increases risk, accounting for 12% of knee OA cases. 9 The prevalence of symptomatic, radiographic knee OA was 11.4% in women and 6.8% in men in one large cohort study 4 and 18.7% in women and 13.5% in men in another large cohort study. 5 Compared with men with OA, women have more severe radiographic findings and symptoms. 10 Older age and female sex are risk factors for hip OA as well as knee OA. In addition, congenital and acquired anatomic abnormalities (eg, hip dysplasia) are risk factors for hip OA. Regarding race, African American and White persons have similar prevalence of hip OA (accounting for race, sex, and body mass index), while African American individuals, especially women, have higher prevalence of knee OA. 5,7 Osteoarthritis leads to substantial cost and mortality. Fortythree percent of the 54 million individuals in the US living with IMPORTANCE Osteoarthritis (OA) is the most common joint disease, affecting an estimated more than 240 million people worldwide, including an estimated more than 32 million in the US. Osteoarthritis is the most frequent reason for activity limitation in adults. This Review focuses on hip and knee OA.OBSERVATIONS Osteoarthritis can involve almost any joint but typically affects the hands, knees, hips, and feet. It is characterized by pathologic changes in cartilage, bone, synovium, ligament, muscle, and periarticular fat, leading to joint dysfunction, pain, stiffness, functional limitation, and loss of valued activities, such as walking for exercise and dancing. Risk factors include age (33% of individuals older than 75 years have symptomatic and radiographic knee OA), female sex, obesity, genetics, and major joint injury. Persons with OA have more comorbidities and are more sedentary than those without OA. The reduced physical activity leads to a 20% higher age-adj...

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Prognostic factors for progression of clinical osteoarthritis of the knee: a systematic review of observational studies

Cited by 137 publications

References 50 publications

Defining knee pain trajectories in early symptomatic knee osteoarthritis in primary care: 5-year results from a nationwide prospective cohort study (CHECK)

Defining knee pain trajectories in early symptomatic knee osteoarthritis in primary care: 5-year results from a nationwide prospective cohort study (CHECK)

De novo degenerative lumbar scoliosis: a systematic review of prognostic factors for curve progression

Diagnosis and Treatment of Hip and Knee Osteoarthritis

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