The effect of patient characteristics on variability in pain and function over two years in early knee osteoarthritis.
The effect of patient characteristics on variability in pain and function over two years in early knee osteoarthritis.
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DOI：
10.1186/1477-7525-3-59
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发表时间：
2005-09-27
影响因子：
3.6
通讯作者：
Roos, Ewa M
中科院分区：
文献类型：
--
作者：
Paradowski, Przemyslaw T;Englund, Martin;Roos, Ewa M
背景：随着时间的推移，膝关节骨关节炎(OA)的高危人群的疼痛和功能有很大的不同。我们推测，这种变异可能不仅与膝骨性关节炎有关，还与患者的特征有关。本研究的目的是调查年龄、性别和体重指数(BMI)对膝关节骨质疏松症高危受试者两年内疼痛和功能变化的影响。方法：我们对143名受试者(女性占16%，平均年龄50岁[范围27-83])进行了两次评估，即单纯半月板切除术后14年和16年。受试者完成了一个特定疾病的问卷，膝关节损伤和骨关节炎结果评分(KOOS)和一个通用的测量，SF-36。BMI在25-29.9之间的个体被认为是超重的，而BMI在30或以上的个体被认为是肥胖。结果：46-56岁(中间三分位数)的受试者比年轻受试者更有可能在Koos日常生活活动(ADL)中改变(或=10分)(优势比[OR]4.5，95%可信区间[95%CI]1.5-13.0)。对基准值进行调整后，得到的结果基本相同。超重或肥胖是膝关节疼痛临床相关改变(OR 2.4，95%CI 1.0~5.8，OR 4.0，95%CI 1.2~13.6)和肥胖(OR 4.3，95%CI 1.2~15.4)的危险因素。当根据各自的基准值进行调整时，结果并不显著。在这个队列中，有症状与疼痛和功能变化的增加密切相关，而有或没有放射学变化不会影响两年内的变化。结论：在早期高度丰富和已建立的膝关节骨性关节炎的人群中，有症状的中年和超重或肥胖的受试者更有可能在两年内改变他们的膝关节功能和疼痛。膝关节疼痛和功能的自然病程可能与受试者的特征有关，如年龄和BMI。
BACKGROUND: Large variations in pain and function are seen over time in subjects at risk for and with radiographic knee osteoarthritis (OA). We hypothesized that this variation may be related not only to knee OA but also to patient characteristics. The objective of this study was to investigate the influence of age, gender, and body mass index (BMI) on clinically relevant change in pain and function over two years in subjects at high risk for or with knee OA.METHODS: We assessed 143 individuals (16% women, mean age 50 years [range 27-83]) twice; 14 and 16 years after isolated meniscectomy. Subjects completed one disease-specific questionnaire, the Knee injury and Osteoarthritis Outcome Score (KOOS) and one generic measure, the SF-36. Individuals with a BMI between 25 and 29.9 were considered overweight, while individuals with a BMI of 30 or more were considered obese.RESULTS: Subjects aged 46-56 (the middle tertile) were more likely to change (> or =10 points on a 0-100 scale) in the KOOS subscale Activities of Daily Living (ADL) than younger subjects (odds ratio [OR] 4.5, 95% confidence interval [95% CI] 1.5-13.0). Essentially the same result was obtained after adjusting for baseline values. Overweight or obesity was a risk factor for clinically relevant change for knee pain (OR 2.4, 95% CI 1.0-5.8, OR 4.0, 95% CI 1.2-13.6) and obesity for change in ADL (OR 4.3, 95% CI 1.2-15.4). The results did not remain significant when adjusted for the respective baseline value. Being symptomatic was strongly associated with increased variation in pain and function while presence or absence of radiographic changes did not influence change over two years in this cohort.CONCLUSION: In a population highly enriched in early-stage and established knee OA, symptomatic, middle-aged, and overweight or obese subjects were more likely to vary in their knee function and pain over two years. The natural course of knee pain and function may be associated with subject characteristics such as age and BMI.