Prognostic factors of progression of osteoarthritis of the knee: A systematic review of observational studies

Abstract

Objective. To provide an overview of prognostic factors of knee osteoarthritis (OA) progression. Methods. We searched Medline and Embase up to December 2003 according to a specified search strategy (keywords for disease, location, and study design). Studies that fulfilled predefined criteria were assessed for methodologic quality. Study characteristics and associations were extracted and the results were summarized according to a best evidence synthesis. Results. Of the 1,004 studies found, 37 met the inclusion criteria. Methodologic quality was assessed and only highquality studies were included (n ‫؍‬ 36). The best evidence synthesis yielded strong evidence that hyaluronic acid serum levels and generalized OA are predictive for progression of knee OA. Sex, knee pain, radiologic severity, knee injury, quadriceps strength, and regular sport activities were not predictive. Conflicting evidence for associations was found for several factors including body mass index and age. Limited evidence for an association with progression of knee OA was found for several factors, including the alignment (varus/valgus) of the joint. Limited evidence for no association with progression of OA was also found for several factors, including meniscectomy, several markers of bone or cartilage turnover, and the clinical diagnosis of localized OA. Conclusion. Generalized OA and level of hyaluronic acid seem to be associated with the radiologic progression of knee OA. Knee pain, radiologic severity at baseline, sex, quadriceps strength, knee injury, and regular sport activities seem not to be related. For other factors, the evidence was limited or conflicting.

Prognostic factors for the two‐year course of activity limitations in early osteoarthritis of the hip and/or knee

“…Associations between activity limitations in knee and/or hip OA and ethnicity (11,34,35), multiplesite joint pain (36,37), morning stiffness (38), comorbidity count (5,39), BMI (8), impaired hip flexion (33), bodily pain (8), general health perception (6), and the pain coping strategy transformation (40) have been identified previously in established OA. Furthermore, the results of the present study confirm earlier observations that radiographic status is not closely associated with physical function in patients with knee or hip OA (41)(42)(43). Apparently, in both early and established OA the same underlying processes of an increase in activity limitations are playing a role.…”

Patient characteristics that predict progression of knee osteoarthritis: A systematic review of prognostic studies

“…wiley.com/journal/10.1002/(ISSN)2151-4658); this was adapted for EMBase, CINAHL, AMED, and Web of Science. Reference lists of identified reviews were mined for further studies (5)(6)(7). Neither study type nor language was limited (10,13).…”

“…Previous systematic reviews have sought to identify predictors of knee OA progression using radiographic change (5,6) or functional decline and change in pain (7) as outcome measures. Usual clinical practice is to gather information from both radiographs and patient-reported symptoms.…”

Efficacy of Chondroitin Sulfate for Painful Knee Osteoarthritis: A One-Year, Randomized, Double-Blind, Multicenter Clinical Study in Japan

“…[4][5][6][7][28][29][30][31] Recently, various biomarkers have been developed to detect the articular alterations in OA, and accumulating evidence suggests that there are associations with changes in ECM protein components in the cartilage and synovium as disease progresses in knee OA. 45,46) Finding the level of COMP in serum allows defining the degree of cartilage damage in OA 47,48) and observing effectiveness of the treatment. [49][50][51][52] In the serum of the normal population the COMP level is 5 µg/mL.…”