Risk factors for anterior knee pain and the relation to future patellofemoral osteoarthritis

膝关节前痛的危险因素及其与未来髌股骨关节炎的关系

• 批准号: 10466866
• 负责人: Joshua Jon Stefanik
• 金额: $ 8.39万
• 依托单位: NORTHEASTERN UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2021
• 资助国家: 美国
• 起止时间: 2021-09-01 至 2024-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10466866
• 关键词: Address; Adolescence; Adult; Affect; Anterior; Anxiety; Body mass index; Child Rearing; Data; Degenerative polyarthritis; Development; Disease; Disease Management; Disease Progression; Event; Funding; Future; Gait; Goals; Hospital Costs; Image; Individual; Intervention; Joints; Knee Osteoarthritis; Knee bone; Knee joint; Knowledge; Lateral; Lead; Life; Location; Longevity; Lower Extremity; Malignant Neoplasms; Mechanics; Mediating; Mental Depression; Mentored Patient-Oriented Research Career Development Award; Morbidity - disease rate; Natural History; Occupational; Operative Surgical Procedures; Outcome; Pain; Persons; Physical Function; Physical activity; Population Intervention; Public Health; Quality of life; Randomized Controlled Trials; Reaction; Research; Research Design; Resources; Retrospective Studies; Risk; Risk Factors; Role; Subgroup; Symptoms; United States; United States National Institutes of Health; chronic painful condition; cohort; cost; design; disability; effective therapy; improved; innovation; joint loading; knee pain; knee replacement arthroplasty; modifiable risk; mortality; novel; pain catastrophizing; pain symptom; prevent; programs; radiological imaging; recruit; rehabilitation strategy; risk minimization; therapy design

PROJECT SUMMARY/ABSTRACT Osteoarthritis (OA) costs more than $81 billion per year in the United States, a burden similar to cancer. OA most commonly affects the knee joint and is associated with increased mortality. There are currently no effective therapies to prevent or treat this serious disease. Patellofemoral (PF) OA, which refers to OA in the PF joint, is a distinct subgroup of knee OA with substantial morbidity and is present in 39% of individuals with knee pain. Anterior knee pain (AKP) is one of the most common chronic pain conditions across the lifespan. AKP is persistent and affects a person’s function and quality of life. AKP and PFOA may represent a continuum of PF disease. However, longitudinal data is lacking on the relation of AKP to incident PFOA. By identifying risk factors for AKP, we could not only reduce the burden of this common condition, but potentially alter the natural history of knee pain and OA. The current proposal aims to understand risk factors for AKP and the relation of AKP to incident PFOA and functional limitations. Understanding risk factors for AKP in can improve clinicians’ abilities to address these symptoms and slow their progression. We will leverage data from the NIH-funded Multicenter Osteoarthritis (MOST) study to answer our proposed research questions. In the recent renewal of MOST, a cohort without established OA was recruited. This offers us a tremendous opportunity to study AKP and PFOA development, which is the first key step in identifying targets for rehabilitation strategies. MOST is the only large cohort in the world that has the necessary longitudinal data on knee pain location, functional limitations, potential modifiable risk factors that may influence PF joint loading, and PF joint imaging with OA features assessed, making our proposal feasible by leveraging this rich resource. Our specific aims are as follows: Aim 1: Determine the extent to which modifiable risk factors (e.g., lower extremity strength, gait mechanics, PF alignment, body mass index) are associated with prevalent and incident AKP over 2 years; Aim 2: Determine the relation of AKP to incident PFOA and functional limitations over 2 years. The proposed research is highly significant in that it will identify modifiable risk factors for AKP development and its downstream effects (e.g., PFOA, tibiofemoral OA, TKR). It is innovative in that, instead of taking the typical approach of managing disease after it occurs, the current proposal will allow us to develop strategies to intervene when we have the potential for the greatest impact on changing the natural history of PF disease, and subsequently minimizing the burden of OA.

项目概要/摘要 在美国，骨关节炎 (OA) 每年造成的费用超过 810 亿美元，这一负担与癌症类似。办公自动化 最常见的是影响膝关节，并与死亡率增加有关。目前还没有有效的 预防或治疗这种严重疾病的疗法。髌股关节 (PF) OA，是指 PF 关节的 OA， 膝 OA 的一个独特亚组，发病率很高，存在于 39% 的膝痛患者中。 膝前痛 (AKP) 是一生中最常见的慢性疼痛状况之一。 AKP 是 持续存在并影响人的功能和生活质量。 AKP 和 PFOA 可能代表 PF 的连续体 疾病。然而，缺乏 AKP 与 PFOA 事件关系的纵向数据。通过识别风险因素 对于 AKP，我们不仅可以减轻这种常见病症的负担，还可以改变自然史 膝盖疼痛和 OA。当前提案旨在了解 AKP 的风险因素以及 AKP 与 事件 PFOA 和功能限制。了解 AKP 的危险因素可以提高临床医生的能力 解决这些症状并减缓其进展。我们将利用 NIH 资助的多中心的数据 骨关节炎 (MOST) 研究回答了我们提出的研究问题。在最近更新的 MOST 中， 招募了未建立 OA 的队列。这为我们提供了研究 AKP 和 PFOA 的绝佳机会 发展，这是确定康复战略目标的第一个关键步骤。 MOST是唯一大的 世界上拥有关于膝盖疼痛位置、功能限制、潜力的必要纵向数据的队列 可能影响 PF 关节负荷的可改变风险因素，以及评估 OA 特征的 PF 关节成像， 利用这一丰富的资源使我们的建议变得可行。我们的具体目标如下： 目标 1：确定 可改变的风险因素（例如下肢力量、步态力学、PF 排列、身体 质量指数）与 2 年来的流行和发病 AKP 相关；目标 2：确定 AKP 的关系 2 年内发生 PFOA 事件和功能限制。拟议的研究非常重要，因为它将 确定 AKP 发育及其下游影响的可改变风险因素（例如 PFOA、胫股骨 OA、 TKR）。它的创新之处在于，它没有采取在疾病发生后进行管理的典型方法，而是 当前的提案将使我们能够制定战略，以便在我们有最大潜力时进行干预 改变 PF 疾病的自然史，从而最大限度地减少 OA 的负担。