Change in self-reported outcomes and objective physical function over 7 years in middle-aged subjects with or at high risk of knee osteoarthritis
Change in self-reported outcomes and objective physical function over 7 years in middle-aged subjects with or at high risk of knee osteoarthritis
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DOI：
10.1136/ard.2007.074088
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发表时间：
2008-04-01
影响因子：
27.4
通讯作者：
Lohmander, L. S.
中科院分区：
文献类型：
--
作者：
Roos, E. M.;Bremander, A. B.;Lohmander, L. S.
目的：在目前的工作中，我们描述了临床过程和自我报告的结果变化的预测因素，并客观地评估了高风险或患有膝关节骨关节炎（OA）的中年受试者随时间的身体功能。方法：我们检查了259名受试者（平均（SD）年龄52.6（10.4））和50名年龄和性别匹配的参考受试者，膝关节损伤和骨关节炎结局评分（KOOS），单腿单跳距离和30秒内屈膝次数。放射学OA定义为相当于Kellgren和Lawrence 2级或更差。结果：在第一次评估时，与参考组相比，腰椎切除术受试者报告的疼痛、功能和生活质量更差（p < 0.001）。他们每30 s的屈膝次数也更少（27 vs 31，p = 0.02）。在4-10年的观察时间内，所有测量的结局（p，0.001），子宫切除术患者的疼痛（-5，95% CI -10至0）和单腿跳跃（-11，95% CI 218至23）均比参考组更严重。女性或膝关节骨性关节炎患者的自我报告和客观评估结果均加重了病情恶化。年龄较大和较高的体重指数（BMI）影响客观评估的身体功能，但不自我报告outcomes.Conclusion：恶化随着时间的推移，在膝关节相关的疼痛和功能是更大的acupcectomised科目与参考科目相比。对于中年患者，尤其是女性和发生放射学膝关节骨性关节炎的患者，可能需要采取预防措施，因为这些患者恶化的风险更大。
Objective: In the present work, we describe the clinical course and predictors of change in self-reported outcomes and objectively assessed physical function over time in middle-aged subjects at high risk of, or with knee osteoarthritis (OA).Methods: We examined 259 subjects (mean (SD) age 52.6 (10.4)) at mean 18 and 25 years after previous meniscectomy and 50 population-based age-and sex-matched reference subjects with the Knee injury and Osteoarthritis Outcome Score (KOOS), one-leg hop for distance and number of knee-bendings in 30 s. Radiographic OA was defined as equivalent to Kellgren and Lawrence grade 2 or worse.Results: At first assessment, meniscectomised subjects reported worse pain, function and quality of life compared with the reference group (p < 0.001). They also performed fewer knee-bendings per 30 s (27 vs 31, p = 0.02). The meniscectomised patients worsened over the 4-10-year observation time in all measured outcomes (p, 0.001), and to a greater extent than the reference group in pain (-5, 95% CI -10 to 0) and one-leg hop (-11, 95% CI 218 to 23). Being a woman, or having radiographic knee OA, enhanced the worsening in self-reported and objectively assessed outcomes. Older age and a higher body mass index (BMI) influenced objectively assessed physical function, but not self-reported outcomes.Conclusion: Worsening over time in knee-related pain and function is greater in meniscectomised subjects compared with reference subjects. Rehabilitative efforts may be warranted in middle-aged meniscectomised patients, especially in women and those who have developed radiographic knee OA, who are at greater risk of worsening.