Multicenter Osteoarthritis Study (MOST) Second Renewal: Iowa Clinical Center

项目总结 膝骨性关节炎是一种常见的慢性痛性疾病，也是导致活动的最常见原因。 老年人的残疾。MOST研究一直是关于这一过程的新知识的主要来源 疾病和影响其进程的因素。自2003年开始这项研究以来，人们越来越认识到， 当人们出现膝骨性关节炎的慢性症状时，他们通常会有晚期的结构发现 核磁共振显示有疾病。半月板撕裂、排列失调和软骨丢失等表现进一步推动结构性 情况恶化，几乎肯定限制了预防机会。我们认为，预防机会是 如果开始于那些还没有严重的持续性膝关节疼痛或晚期结构性疼痛的人，可能会更严重 疾病的发现。 膝关节骨性关节炎的功能影响发生在经历了多个肌肉骨骼的老年人 合并症，预防OA致残需要更广泛的视角，而不是专注于单一的 膝盖。例如，单膝疼痛的人患其他下肢肌肉骨骼疼痛的风险很高。 而且，即使膝关节被替换，他们最终也可能需要治疗其他关节发展中的疼痛 作为第一个受影响关节的结果。此外，除了功能丧失外，有办公自动化经验的人 屈曲、跌倒和限制它们与外部环境的接触。 我们建议有机会开发治疗和疾病预防策略，这些策略已经 通过使用新技术并将重点放在病情较轻或较早阶段的人身上 相比以往的研究，我们可以发现这样的机会。我们建议招募一个新的轻度疾病队列， 继续研究现有的MOST队列，以确定新的疾病风险因素并研究后果 疾病的威胁。我们的目标是找到新的策略，在早期阶段预防疾病，并限制 疾病一旦发生就会发生。

PROJECT SUMMARY Knee osteoarthritis (OA) is a common chronic painful disorder that is the most frequent cause of mobility disability in older people. The MOST study has been a major source of new knowledge about the course of this disease and factors that affect its course. Since the study began in 2003, it is increasingly recognized that by the time people develop chronic symptoms of knee OA, they usually have advanced structural findings of disease on MRI. Findings such as meniscal tears, malalignment and cartilage loss drive further structural deterioration and almost certainly limit prevention opportunities. We believe that prevention opportunities are likely to be greater if started in those who do not yet have severe continuous knee pain or advanced structural findings of disease. The functional impacts of knee OA occur in older people who experience multiple musculoskeletal comorbidities, and preventing disablement from OA requires a broader perspective than a focus on a single knee. For example, those with pain in one knee are at high risk of pain in other lower extremity musculoskeletal regions and, even if the knee is replaced, they may ultimately need treatment for pain in other joints developing as a consequence of the first joint affected. Also, in addition to functional loss, persons with OA experience buckling, falls and constraints in their involvement with the outside environment. We suggest there are opportunities to develop treatments and disease prevention strategies that have been unexplored and that by using new technologies and focusing on persons at a milder or earlier disease stage than previous studies, we can identify such opportunities. We propose to recruit a new mild disease cohort and continue to study the existing MOST cohort to identify new risk factors for disease and to study consequences of disease. Our goal is to find new strategies to prevent disease at an early stage and to limit the impact of disease once it has occurred.