Trajectories and risk profiles of pain in persons with radiographic, symptomatic knee osteoarthritis: data from the osteoarthritis initiative
Trajectories and risk profiles of pain in persons with radiographic, symptomatic knee osteoarthritis: data from the osteoarthritis initiative
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DOI：
10.1016/j.joca.2014.03.009
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发表时间：
2014-05-01
影响因子：
7
通讯作者：
Losina, E.
中科院分区：
文献类型：
--
作者：
Collins, J. E.;Katz, J. N.;Losina, E.
背景：膝骨性关节炎(OA)患者疼痛严重程度的时间演变知之甚少。我们试图描述一组有放射学症状的膝关节骨性关节炎受试者6年来的疼痛轨迹。方法：我们使用了骨性关节炎倡议(OAI)的数据，这是一项多中心的纵向研究，研究对象有诊断为膝骨性关节炎的放射学证据。在基线和6年内每年对疼痛进行评估。我们的分析队列包括基线有症状的膝骨性关节炎的受试者，定义为基线Kellgren-Lawrence(KL)评分=2，西安大略省和麦克马斯特大学骨关节炎指数(WOMAC)疼痛评分>；0。我们使用基于群体的轨迹建模来确定6年随访期间疼痛进展的不同模式。调查的因素包括性别、种族、教育程度、合并症、年龄、体重指数(BMI)、路线、KL分级和抑郁。结果：我们使用了1753名患有有症状的膝骨性关节炎的OAI参与者的数据。平均基线WOMAC疼痛评分为26.5(0-100,100=最差)，标准差(SD)为19。基于组的轨迹建模确定了五条不同的疼痛轨迹；每条基线疼痛评分在15至62之间。没有一条轨迹显示出明显的恶化。在两个疼痛最大的轨迹中，五分之一的受试者在随访期间接受了全膝关节置换术(TKR)。KL评分较高、肥胖、抑郁、合并内科疾病、女性、非白人、文化程度低、年龄较小与疼痛程度较大的轨迹有关。结论：我们发现，在大多数受试者中，膝关节疼痛在6年内平均变化不大。这些观察表明膝骨性关节炎的特征是持续性的，而不是不可抗拒的恶化症状。(C)2014国际骨性关节炎研究会。爱思唯尔有限公司出版。保留所有权利。
Background: Little is known about the temporal evolution of pain severity in persons with knee osteo-arthritis (OA). We sought to describe the pain trajectory over 6 years in a cohort of subjects with radiographic, symptomatic knee OA.Methods: We used data from the Osteoarthritis Initiative (OAI), a multi-center, longitudinal study of subjects with diagnosed radiographic evidence of knee OA. Pain was Assessed at baseline and annually for 6 years. Our analysis cohort included subjects with symptomatic knee OA at baseline, defined as baseline Kellgren-Lawrence (KL) score >= 2 with Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) pain score >0. We used group-based trajectory modeling to identify distinct patterns of pain progression over a 6-year follow-up. Factors examined included sex, race, education, comorbidities, age, body mass index (BMI), alignment, KL grade, and depression.Results: We used data from 1753 OAI participants with symptomatic knee OA. Mean baseline WOMAC pain score was 26.5 (0-100, 100=worst) with standard deviation (SD) 19. Group-based trajectory modeling identified five distinct pain trajectories; baseline pain scores for each ranged from 15 to 62. None of the trajectories exhibited substantial worsening. One fifth of subjects in the two trajectories with the greatest pain underwent total knee replacement (TKR) over follow-up. Higher KL grade, obesity, depression, medical comorbidities, female sex, non-white race, lower education, and younger age were associated with trajectories characterized by greater pain.Conclusion: We found that knee pain changes little, on average, over 6 years in most subjects. These observations suggest knee OA is characterized by persistent rather than inexorably worsening symptoms. (C) 2014 Osteoarthritis Research Society International. Published by Elsevier Ltd. All rights reserved.