Clinical Profile, Level of Affection and Therapeutic Management of Patients With Osteoarthritis in Primary Care: The Spanish Multicenter Study EVALÚA

Carou, Ana Castaño; Fernández, Salvador Pita; Díaz, Sonia Pértega; Santos, Francisco Javier de Toro

doi:10.1016/j.reumae.2015.03.007

Cited by 6 publications

(17 citation statements)

References 25 publications

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“…In this cohort, 56.8% of the patients with knee pain had radiological degenerative changes, and in concordance with previous studies (20,30), KL 3 was the most frequently identified group. Interestingly, 24% of the patients without radiographic degenerative changes presented ultrasonographic findings of OA.…”

Section: Discussionsupporting

confidence: 92%

Performance of Ultrasonography Compared to Conventional Radiography for the Diagnosis of Osteoarthritis in Patients With Knee Pain

et al. 2020

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To investigate the performance of ultrasonography (US) for the detection of knee osteoarthritis (OA) in patients suffering from knee pain, compared to conventional radiographs. Methods: Cross-sectional study performed at a university teaching hospital. Consecutive patients complaining of unilateral or bilateral mechanical knee pain who signed an informed consent were included. All patients underwent simultaneously an ultrasonographic and a radiographic evaluation of the knee. Exclusion criteria were age under 18 years, prior diagnosis of knee OA, diagnosis of inflammatory arthritis, history of knee surgery or trauma, severe knee deformities, and corticosteroid injection within the last 2 months. The diagnostic properties of US for the detection of knee OA were evaluated using radiological data as the reference method. Evaluated test properties were sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and the positive and negative likelihood ratio (LR+ and LR-). Results: Three-hundred twenty-two knees (281 patients) were included. Radiographic degenerative changes were present in 56.8% (183) of the evaluated knees. Regarding the diagnostic properties of the US, the presence of either osteophytes or the compromise of the femoral hyaline cartilage had the best sensitivity to detect OA (95%), with a NPV of 92% and a LR-of 0,07, while the combined identification of osteophytes and compromise of the femoral hyaline cartilage had the best specificity (94%), with 94% PPV and a LR+ of 13. Conclusion: US demonstrated an excellent sensitivity with an adequate specificity for the detection of radiographic knee OA.

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Section: Discussionsupporting

confidence: 92%

Performance of Ultrasonography Compared to Conventional Radiography for the Diagnosis of Osteoarthritis in Patients With Knee Pain

et al. 2020

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“…12,13 Surgically induced models, such as the destabilization of the medial meniscus (DMM) or anterior cruciate ligament transection (ACLT), generate knee joint instability responsible for progressive articular degeneration mimicking human posttraumatic OA. 14 Although in human knee OA both knees are involved in more than 75% of the cases, 15 bilateral mouse models of OA seem to have been rarely used. 16…”

Section: Introductionmentioning

confidence: 99%

Posttraumatic Osteoarthritis Damage in Mice: From Histological and Micro–Computed Tomodensitometric Changes to Gait Disturbance

et al. 2021

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Objectives Osteoarthritis is a painful joint disease responsible for walking impairment. Its quantitative assessment by gait analysis in mice may be a relevant and noninvasive strategy to assess the disease severity. In this study, we aimed to determine the severity of osteoarthritis at the tissular and gait levels in unilateral and bilateral posttraumatic murine osteoarthritis. Methods Twenty-four C57BL/6 male mice were randomly assigned to 3 groups ( n = 8/group): controls, unilateral surgery, and bilateral surgery. Posttraumatic osteoarthritis was induced unilaterally or bilaterally by destabilization of the medial meniscus. Gait analysis was performed weekly with the CatWalkTM XT system until the 16th week after surgery. After animal sacrifices, histological and micro–computed tomographic assessment was performed. Results Operated knees showed a significant increase in the histological score compared with controls ( P < 0.001). Calcified anterior medial meniscal bone volume was higher on the ipsilateral side after unilateral destabilization of the medial meniscus ( P < 0.001) and on both sides after bilateral intervention ( P < 0.01). One week after surgery, the mice mean speed decreased significantly in both operated groups ( P < 0.001 and P < 0.05). In the unilateral group, a significant increase in the contralateral hind print area appeared from week 4 to week 16. Conclusions While bilateral destabilization of the medial meniscus induced no detectable gait modification except 1 week after surgery, unilateral model was responsible for a gait disturbance on the contralateral side. Further studies are needed to better define the place of the CatWalkTM in the evaluation of mouse models of osteoarthritis.

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“…We conducted a sensitivity analysis to explore heterogeneity related to risk of bias. When studies scored as having a high risk of bias were removed (n = 5 studies) (46–48,67,69), the pooled prescribing estimate remained similar (43.8% [95% CI 36.8, 51.1], n = 46 studies, high quality of evidence I 2 = 5.1%) (11,12,25,26,28–46,49–56,58–61,58–64,65,66,68,70–73) compared to the original estimate with high heterogeneity (43.1% [95% CI 36.3, 50.1], n = 51 studies, I 2 = 99.9%, low quality of evidence). A post hoc sensitivity analysis was conducted to explore the primary analyses using an alternative statistical approach (see Supplementary Figure 1, available on the Arthritis Care & Research website at https://doi.org/10.1002/acr.25157), which resulted in less conservative estimates than our original model.…”

Section: Resultsmentioning

confidence: 98%

“…The pooled prevalence of NSAIDs varied widely across geographical locations. The pooled estimate of NSAIDs prescribing was highest in South Asia at 83.4% (95% CI 74.8, 89.4; n = 4 studies, I 2 = 3.0%, moderate quality of evidence) (37,47,49,57), followed by Latin America and Caribbean at 68.5% (95% CI 66.8, 70.1; n = 1 study, I 2 = 0%, high quality of evidence) (33), East Asia and Pacific at 46.8% (95% CI 35.0, 58.9; n = 10 studies, I 2 = 31.7%, high quality of evidence) (12,25,32,38,40,51,53,58–60), Europe and Central Asia at 40.2% (95% CI 31.8, 49.3; n = 23 studies, I 2 = 12.2%, moderate quality of evidence) (26,27,28,29,39,42,43,45,46,48,50,52,54–56,61–68), Middle East and North Africa at 34.1% (95% CI 33.9, 34.3; n = 1 study, I 2 = 0%, high quality of evidence) (44), and North America at 32.6% (95% CI 16.9, 53.6; n = 12 studies, I 2 = 11.0%, moderate quality of evidence) (11,30,31,34–36,41,69–73). The stratified analyses results are summarized in Table 3 and the forest plot shown in Supplementary Figure 3, available on the Arthritis Care & Research website at https://doi.org/10.1002/acr.25157.…”

Section: Resultsmentioning

confidence: 99%

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Prevalence of Nonsteroidal Antiinflammatory Drugs Prescribed for Osteoarthritis: A Systematic Review and Meta‐Analysis of Observational Studies

Yang

Mathieson

Kobayashi

et al. 2023

Arthritis Care & Research

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ObjectiveOur systematic review aimed to investigate the proportion of participants with osteoarthritis who were prescribed nonsteroidal antiinflammatory drugs (NSAIDs) by their health care provider.MethodsElectronic databases were searched for observational studies reporting NSAID prescribing to participants with diagnosed osteoarthritis of any region. Risk of bias was assessed using a tool designed for observational studies measuring prevalence. Random and fixed‐effects meta‐analysis was used. Meta‐regression investigated study‐level factors associated with prescribing. The overall evidence quality was assessed using Grading of Recommendations Assessment, Development, and Evaluation criteria.ResultsFifty‐one studies were included, published between 1989 and 2022, with 6,494,509 participants. The mean age of participants was 64.7 years (95% confidence interval [95% CI] 62.4, 67.0; n = 34 studies). Most studies were from Europe and Central Asia (n = 23 studies), and North America (n = 12 studies). Most studies were judged to be at low risk of bias (75%). Heterogeneity was eliminated when removing studies with a high risk of bias, to give a pooled estimate of NSAIDs prescribing to participants with osteoarthritis of 43.8% (95% CI 36.8, 51.1; moderate quality of evidence). Meta‐regression determined that prescribing was associated with year (decreased prescribing over time; P = 0.05) and geographic region (P = 0.03; higher in Europe and Central Asia and in South Asia than in North America) but not with clinical setting.ConclusionData from over 6.4 million participants with osteoarthritis between 1989 and 2022 indicate that NSAID prescribing has decreased over time and that prescribing differs between geographic locations. image

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Clinical Profile, Level of Affection and Therapeutic Management of Patients With Osteoarthritis in Primary Care: The Spanish Multicenter Study EVALÚA

Cited by 6 publications

References 25 publications

Performance of Ultrasonography Compared to Conventional Radiography for the Diagnosis of Osteoarthritis in Patients With Knee Pain

Performance of Ultrasonography Compared to Conventional Radiography for the Diagnosis of Osteoarthritis in Patients With Knee Pain

Posttraumatic Osteoarthritis Damage in Mice: From Histological and Micro–Computed Tomodensitometric Changes to Gait Disturbance

Prevalence of Nonsteroidal Antiinflammatory Drugs Prescribed for Osteoarthritis: A Systematic Review and Meta‐Analysis of Observational Studies

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