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[Pain trajectories in early symptomatic knee osteoarthritis]
A N Bastick1, J Wesseling, J Damen
1*Dit onderzoek werd eerder gepubliceerd in British Journal of General Practice (2016;66:32-9) met als titel 'Defining knee pain trajectories in early symptomatic knee osteoarthritis in primary care: 5-year results from a nationwide prospective cohort study (CHECK)'. Afgedrukt met toestemming.
Nederlands Tijdschrift Voor Geneeskunde
|June 30, 2016
Summary
Six distinct knee osteoarthritis pain trajectories were identified. Higher BMI and activity limitations predict worse pain progression, guiding personalized patient monitoring strategies for better outcomes.
Area of Science:
- Orthopedics
- Rheumatology
- Epidemiology
Background:
- Knee osteoarthritis (KOA) is a leading cause of disability.
- Understanding pain progression in KOA is crucial for effective management.
- Identifying distinct patient subgroups with varying pain trajectories is needed.
Purpose of the Study:
- To identify distinct pain trajectories in patients with early symptomatic knee osteoarthritis.
- To determine baseline characteristics associated with different pain trajectories.
- To inform clinical monitoring and management strategies for KOA.
Main Methods:
- Retrospective cohort study using data from the 'Cohort Hip and Cohort Knee' (CHECK) study.
- Latent class growth analysis to define pain trajectories based on annual numeric rating scale.
- Multinomial logistic regression to identify associated baseline characteristics.
Main Results:
- Six distinct pain trajectories were identified, ranging from favorable to unfavorable courses.
- Significant differences in baseline characteristics (BMI, symptom severity, coping strategies) were observed across trajectories.
- Higher BMI, lower education, comorbidities, activity limitations, and joint tenderness predicted unfavorable pain trajectories.
Conclusions:
- Six distinct pain trajectories exist in early symptomatic knee osteoarthritis.
- Baseline characteristics can help identify patients at risk for unfavorable pain progression.
- Radiographic features at baseline do not predict pain trajectories; clinical factors are more informative for follow-up decisions.
