Prognostic factors of progression of osteoarthritis of the knee: A systematic review of observational studies
Prognostic factors of progression of osteoarthritis of the knee: A systematic review of observational studies
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DOI：
10.1002/art.22475
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发表时间：
2007-02-15
期刊：
影响因子：
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通讯作者：
Bierma-Zeinstra, S. M. A.
中科院分区：
文献类型：
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作者：
Belo, J. N.;Berger, M. Y.;Bierma-Zeinstra, S. M. A.
目标。目的：综述影响膝骨关节炎（OA）预后的因素。我们根据指定的搜索策略（疾病、地点和研究设计的关键字）搜索了Medline和Embase直到2003年12月。对满足预定标准的研究进行方法学质量评估。提取研究特征和关联，并根据最佳证据综合对结果进行总结。在1004项研究中，有37项符合纳入标准。评估方法学质量，只纳入高质量的研究（n = 36）。最好的证据合成产生了强有力的证据，血清透明质酸水平和广泛性OA是预测膝OA进展的。性别、膝关节疼痛、放射学严重程度、膝关节损伤、股四头肌力量和常规体育活动没有预测作用。在包括体重指数和年龄在内的几个因素中发现了相互矛盾的证据。有限的证据表明，与膝关节OA进展相关的几个因素，包括关节的对准（内翻/外翻）。有限的证据表明，与骨性关节炎进展无关的几个因素，包括半月板切除术，一些骨或软骨转换的标志物，以及局限性骨性关节炎的临床诊断。广泛性骨关节炎和透明质酸水平似乎与膝骨关节炎的放射学进展有关。膝关节疼痛、基线放射学严重程度、性别、股四头肌力量、膝关节损伤和常规体育活动似乎无关。对于其他因素，证据有限或相互矛盾。
objective. To provide an overview of prognostic factors of knee osteoarthritis (OA) progression.Methods. We searched Medline and Embase up to December 2003 according to a specified search strategy (keywords for disease, location, and study design). Studies that fulfilled predefined criteria were assessed for methodologic quality. Study characteristics and associations were extracted and the results were summarized according to a best evidence synthesis.Results. Of the 1,004 studies found, 37 met the inclusion criteria. Methodologic quality was assessed and only high-quality studies were included (n = 36). The best evidence synthesis yielded strong evidence that hyaluronic acid serum levels and generalized OA are predictive for progression of knee OA. Sex, knee pain, radiologic severity, knee injury, quadriceps strength, and regular sport activities were not predictive. Conflicting evidence for associations was found for several factors including body mass index and age. Limited evidence for an association with progression of knee OA was found for several factors, including the alignment (varus/valgus) of the joint. Limited evidence for no association with progression of OA was also found for several factors, including meniscectomy, several markers of bone or cartilage turnover, and the clinical diagnosis of localized OA.Conclusion. Generalized OA and level of hyaluronic acid seem to be associated with the radiologic progression of knee OA. Knee pain, radiologic severity at baseline, sex, quadriceps strength, knee injury, and regular sport activities seem not to be related. For other factors, the evidence was limited or conflicting.