Faculty of Medicine and Health, Discipline of Physiotherapy, The University of Sydney, Sydney, Australia.
Australia Institute of Health Service Management, University of Tasmania, Sydney, Australia.
Arthritis Res Ther. 2021 Jun 4;23(1):160. doi: 10.1186/s13075-021-02540-9.
The aim of this study was to identify modifiable clinical factors associated with radiographic osteoarthritis progression over 1 to 2 years in people with painful medial knee osteoarthritis.
A longitudinal study was conducted within a randomised controlled trial, the "Long-term Evaluation of Glucosamine Sulfate" (LEGS study). Recruitment occurred in 2007-2009, with 1- and 2-year follow-up assessments by blinded assessors. Community-dwelling people with chronic knee pain (≥4/10) and medial tibiofemoral narrowing (but retaining >2mm medial joint space width) on radiographs were recruited. From 605 participants, follow-up data were available for 498 (82%, mean [sd] age 60 [8] years). Risk factors evaluated at baseline were pain, physical function, use of non-steroidal anti-inflammatory drugs (NSAIDs), statin use, not meeting physical activity guidelines, presence of Heberden's nodes, history of knee surgery/trauma, and manual occupation. Multivariable logistic regression analysis was conducted adjusting for age, sex, obesity, high blood pressure, allocation to glucosamine and chondroitin treatment, and baseline structural disease severity (Kellgren and Lawrence grade, joint space width, and varus alignment). Radiographic osteoarthritis progression was defined as joint space narrowing ≥0.5mm over 1 to 2 years (latest follow-up used where available).
Radiographic osteoarthritis progression occurred in 58 participants (12%). Clinical factors independently associated with radiographic progression were the use of NSAIDs, adjusted odds ratios (OR) and 95% confidence intervals (CI) 2.05 (95% CI 1.1 to 3.8), and not meeting physical activity guidelines, OR 2.07 (95% CI 0.9 to 4.7).
Among people with mild radiographic knee osteoarthritis, people who use NSAIDs and/or do not meet physical activity guidelines have a greater risk of radiographic osteoarthritis progression.
ClinicalTrials.gov , NCT00513422 . This original study trial was registered a priori, on August 8, 2007. The current study hypothesis arose before inspection of the data.
本研究旨在确定与内侧膝关节骨关节炎疼痛患者的放射学骨关节炎进展相关的可改变的临床因素，随访时间为 1 至 2 年。
这是一项在随机对照试验（“硫酸氨基葡萄糖长期评估”（LEGS 研究））中进行的纵向研究。招募于 2007-2009 年进行，通过盲法评估员进行 1 年和 2 年的随访评估。招募了患有慢性膝关节疼痛（≥4/10）和内侧胫骨股关节狭窄（但保留>2mm 的内侧关节间隙宽度）的社区居住人群。在 605 名参与者中，498 名（82%，平均[标准差]年龄 60[8]岁）有随访数据。在基线时评估的危险因素为疼痛、身体功能、使用非甾体抗炎药（NSAIDs）、他汀类药物使用、未达到体力活动指南、存在 Heberden 节点、膝关节手术/创伤史和体力劳动。使用多变量逻辑回归分析调整年龄、性别、肥胖、高血压、氨基葡萄糖和软骨素治疗的分配以及基线结构疾病严重程度（Kellgren 和 Lawrence 分级、关节间隙宽度和内翻排列）。放射学骨关节炎进展定义为 1 至 2 年内关节间隙狭窄≥0.5mm（最新随访数据用于可用数据）。
58 名参与者（12%）发生放射学骨关节炎进展。与放射学进展独立相关的临床因素是使用 NSAIDs，调整后的比值比（OR）和 95%置信区间（CI）为 2.05（95%CI 1.1 至 3.8），未达到体力活动指南，OR 为 2.07（95%CI 0.9 至 4.7）。
在轻度放射学膝关节骨关节炎患者中，使用 NSAIDs 和/或未达到体力活动指南的患者发生放射学骨关节炎进展的风险更高。
ClinicalTrials.gov，NCT00513422。本原始研究试验在 2007 年 8 月 8 日预先进行了注册。当前研究的假设是在检查数据之前出现的。
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