Early Knee Osteoarthritis Classification and Clinical Evolution: A Longitudinal Observational Pilot Study

Area of Science:

• Orthopedics
• Rheumatology
• Geriatric Medicine

Background:

• Knee osteoarthritis (KOA) significantly impacts aging populations, affecting quality of life and incurring economic burdens.
• Early diagnosis of KOA is crucial for timely intervention and management.
• Existing diagnostic criteria for early knee osteoarthritis (EKOA) require validation for practical application.

Purpose of the Study:

• To assess the practical utility of current diagnostic criteria for EKOA.
• To evaluate the clinical progression of at-risk healthy subjects (HS) and diagnosed EKOA patients.

Main Methods:

• A cross-sectional longitudinal pilot study involving 105 participants.
• Participants classified as EKOA or HS based on diagnostic criteria.
• Assessment of disability, pain, and self-reported variables.
• Two follow-ups to evaluate diagnostic and radiological progression, and clinical changes.

Main Results:

• Most participants maintained their initial classification (EKOA or HS) across follow-ups.
• A subset of participants experienced reclassification between EKOA and HS categories.
• Variability in self-reported measures, pain, and radiological findings contributed to classification shifts.

Conclusions:

• Current diagnostic criteria for EKOA, relying on self-reported data and clinical/radiological findings, may result in misdiagnosis.
• The observed fluctuations in patient classification indicate potential limitations in the reliability of existing EKOA diagnostic standards.
• Further refinement of diagnostic criteria is necessary for accurate and stable identification of early knee osteoarthritis.