Six‐year course and prognosis of nontraumatic knee symptoms in adults in general practice: A prospective cohort study

Abstract

Objective. To examine the 6-year course of nontraumatic knee symptoms in adults in general practice, to identify prognostic factors for unfavorable outcome, and to develop a clinical prediction rule. Methods. Adults (ages >35 years) with incident nontraumatic knee symptoms (n ‫؍‬ 549) were followed for 6 years. Multivariable logistic regression analysis was used to identify prognostic factors associated with an unfavorable outcome, the area under the receiver operating curve (AUC) was calculated to determine discriminative ability, and a clinical prediction rule was developed. Unfavorable outcome is defined as persistent knee symptoms at 6-year followup or having undergone knee replacement surgery during followup.

Characteristics of patients with knee and ankle symptoms accessing physiotherapy: self-referral vs general practitioner’s referral

“…Also, the present study found that the patient characteristics associated with self-referral are comparable with the prognostic factors for better recovery rates in both knee and ankle symptoms reported by others (e.g. younger age, shorter duration of symptoms, higher level of education) [20,21]. This may indicate that these patients are more likely to have a positive outcome, with or without treatment from a physiotherapist.…”

Promoting exercise for OA in ambivalent older adults

“…The results are in agreement with another report showing that Wnt10b is upregulated in bleomycininduced mouse models of skin fibrosis. 4 The results reported here are also largely in agreement with our previous observations that fascial hypertrophy seen in Tsk1 mice, starting during late embryogenesis, is associated with striking upregulation of several Wnts including Wnt2 and Wnt11, though with only mo destly increased Wnt10b expres sion. 7 Thus, the specific Wnts involved in Tsk1 fascial hypertrophy are probably Wnt2 and Wnt11.…”

“…3 Thus, our data strongly implicate WIF1, rather than DKK1, in potentially permit ting unrestrained Wnt activity in the skin of patients with SSc. On the other hand, consistent with the current report, Wei et al 4 have also shown the Wnt10b protein is upregulated in the skin of an SSc mouse model. Differences between mRNA and protein levels could explain the differ ences in these studies, but the ambiguities associ ated with immuno histochemical studies should provide some pause for thought regarding the specific Wnt(s) and Wnt inhibitors regulated in SSc skin.…”

Prognostic factors associated with changes in knee pain outcomes, identified from initial primary care consultation data. A systematic literature review

“…The majority (six) were based in the Netherlands [ 25–28 , 31 ] and the remaining two based in the UK [ 30 , 32 ]. Collection of outcome measures ranged from 54 months [ 26–28 ] to 3 months [ 24 – 26 , 29 ]. Follow-up frequency ranged from five follow up time points in three studies [ 24 , 26 , 28 ], two in two studies [ 27 , 31 ] and one in the remaining three studies [ 25 , 30 , 32 ].…”

“…One study reported on co-morbidities [ 24 ]. Knee symptoms and signs were investigated in all eight studies; frequently reported were knee pain level [ 24–31 ], Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) pain, stiffness and function questionnaire [ 24–27 ], duration of knee symptoms [ 25 , 26 , 29 , 31 ] presence of locking [ 25 , 27 , 28 , 30 ] and symptoms of giving way [ 25 , 27 , 28 , 30 ]. Physical examination factors were reported in five studies [ 25 – 26 , 28 , 30 ] and frequently included palpable warmth [ 24 – 26 ], presence of a joint effusion [ 26 , 28 , 29 ], and collateral ligament testing [ 25 , 26 , 28 ].…”