Physical Therapy Department, School of Science and Technology, Universidade Estadual Paulista "Julio de Mesquita Filho" (UNESP), Presidente Prudente, SP, Brazil; La Trobe Sports and Exercise Medicine Research Centre (LASEM), School of Allied Health, La Trobe University, Bundoora, Victoria, Australia.
Physical Therapy Department, School of Science and Technology, Universidade Estadual Paulista "Julio de Mesquita Filho" (UNESP), Presidente Prudente, SP, Brazil.
Braz J Phys Ther. 2019 Nov-Dec;23(6):491-496. doi: 10.1016/j.bjpt.2018.11.001. Epub 2018 Nov 16.
Crepitus is a common clinical feature of knee osteoarthritis. However, the importance of crepitus in the overall clinical presentation of individuals with knee osteoarthritis is unknown.
OBJECTIVE(S): (A) To compare function, pain and quality of life between individuals with knee osteoarthritis with and without crepitus; (B) to compare whether individuals with knee osteoarthritis in both knees, but crepitus in just one, differ in terms of function pain, and knee strength.
Setting: Observational study.
(A) A total of 584 participants with crepitus who had the same Kellgren-Lawrence grade on both knees were matched for gender, body mass index and Kellgren-Lawrence grade to participants without crepitus on both knees. (B) 361 participants with crepitus in only one knee and with the same Kellgren-Lawrence grade classification on both knees were included.
MAIN OUTCOME MEASURE(S): A - Self-reported function, pain, quality of life, 20-m walk test and chair-stand test. B -Knee extensor and flexor strength, self-reported function and pain.
A - Individuals with crepitus had lower self-reported function, quality of life and higher pain compared to those without crepitus (3-11%; small effect=0.17-0.41, respectively). No difference was found in objective function between groups. B - Self-reported function was lower in the limb with crepitus compared to the limb without crepitus (15%; trivial effect=0.09). No difference was found in pain and knee strength between-groups.
CONCLUSION(S): Individuals with knee osteoarthritis and knee crepitus have slightly lower self-reported physical function and knee-related quality of life (small or trivial effect). However, the presence of knee crepitus is not associated with objective function or knee strength.
膝关节骨关节炎的一个常见临床特征是弹响。然而，膝关节骨关节炎患者弹响在整体临床表现中的重要性尚不清楚。
（A）比较有和无膝关节弹响的膝关节骨关节炎患者的功能、疼痛和生活质量；（B）比较双膝均有膝关节骨关节炎但仅单膝有弹响和双膝均有弹响的患者在功能、疼痛和膝关节力量方面是否存在差异。
观察性研究。
（A）共纳入 584 例双膝均有弹响且 Kellgren-Lawrence 分级相同的患者，按性别、体重指数和 Kellgren-Lawrence 分级与双膝均无弹响的患者进行匹配。（B）纳入 361 例单膝有弹响且双膝 Kellgren-Lawrence 分级相同的患者。
（A）自我报告的功能、疼痛、生活质量、20 米步行试验和坐站试验。（B）膝关节伸肌和屈肌力量、自我报告的功能和疼痛。
（A）与无弹响者相比，有弹响者的自我报告功能、生活质量较低，疼痛较高（3%-11%；小效应=0.17-0.41），两组间的客观功能无差异。（B）有弹响侧的自我报告功能较无弹响侧低（15%；小效应=0.09），两组间疼痛和膝关节力量无差异。
膝关节骨关节炎合并膝关节弹响的患者自我报告的身体功能和膝关节相关生活质量略低（小或小效应）。然而，膝关节弹响的存在与客观功能或膝关节力量无关。
