Three trajectories of activity limitations in early symptomatic knee osteoarthritis: a 5-year follow-up study
Three trajectories of activity limitations in early symptomatic knee osteoarthritis: a 5-year follow-up study
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DOI：
10.1136/annrheumdis-2012-202984
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发表时间：
2014-07-01
影响因子：
27.4
通讯作者：
Dekker, Joost
中科院分区：
文献类型：
--
作者：
Holla, Jasmijn F. M.;van der Leeden, Marike;Dekker, Joost
目的膝关节骨关节炎（OA）是导致活动受限的主要原因。膝关节OA人群可能由亚组组成。本研究的目的是确定同质亚组与不同的轨迹活动限制的早期症状性膝关节OA患者，并描述这些subgroup.Methods随访数据超过5年的697名参与者的早期症状性膝关节OA从队列髋关节和队列膝关节（OMG）的特点。活动限制每年用西安大略和麦克马斯特大学骨关节炎指数进行测量。潜在的类增长分析确定了具有不同的活动限制轨迹的同质亚组。多变量回归分析研究亚组之间的特征差异。亚组1（“良好结局”; n=330）的参与者随着时间的推移出现或显示轻微的活动限制。亚组2的参与者（“中度结局”; n=257）随着时间的推移发展或显示中度活动限制。亚组3（“不良结局”; n=110）的参与者随着时间的推移发展或显示出严重的活动限制。与“良好结局”亚组相比，“中度结局”和“不良结局”亚组的特征如下：年龄小，体重指数高，疼痛大，骨质压痛，膝关节屈曲减少，髋关节疼痛，骨赘，>= 3种合并症，活力降低或避免活动。结论基于5年活动受限的病程，我们确定了膝关节OA患者的同质亚组，中度或不良结局。这些亚组的特征与关于活动受限的预后因素的现有知识一致，这支持了该分类的有效性。
Objectives Knee osteoarthritis (OA) is a leading cause of activity limitations. The knee OA population is likely to consist of subgroups. The aim of the present study was to identify homogeneous subgroups with distinct trajectories of activity limitations in patients with early symptomatic knee OA and to describe characteristics of these subgroups.Methods Follow-up data over a period of 5 years of 697 participants with early symptomatic knee OA from the Cohort Hip and Cohort Knee (CHECK) were used. Activity limitations were measured yearly with the Western Ontario and McMaster Universities Osteoarthritis Index. Latent class growth analyses identified homogeneous subgroups with distinct trajectories of activity limitations. Multivariable regression analyses examined differences in characteristics between the subgroups.Results Three subgroups were identified. Participants in Subgroup 1 ('good outcome'; n=330) developed or displayed slight activity limitations over time. Participants in Subgroup 2 ('moderate outcome'; n=257) developed or displayed moderate activity limitations over time. Participants in subgroup 3 ('poor outcome'; n=110) developed or displayed severe activity limitations over time. Compared with the 'good outcome' subgroup, the 'moderate outcome' and 'poor outcome' subgroups were characterised by: younger age, higher body mass index, greater pain, bony tenderness, reduced knee flexion, hip pain, osteophytosis, >= 3 comorbidities, lower vitality or avoidance of activities.Conclusions Based on the 5-year course of activity limitations, we identified homogeneous subgroups of knee OA patients with good, moderate or poor outcome. Characteristics of these subgroups were consistent with existing knowledge on prognostic factors regarding activity limitations, which supports the validity of this classification.