Yoo Hyun Jin, Jeong Ho Won, Park Sung Bae, Shim Seung Jae, Nam Hee Seung, Lee Yong Seuk
Department of Orthopaedic Surgery, Seoul National University College of Medicine, Seoul National University Bundang Hospital, Seoul 13620, Republic of Korea.
Department of Orthopedic Surgery, Konyang University College of Medicine, Daejeon 35365, Republic of Korea.
J Clin Med. 2023 Feb 2;12(3):1204. doi: 10.3390/jcm12031204.
Factors affecting the progression rate and fate of osteoarthritis need to be analyzed when considering patient-specific situation. This study aimed to identify the rate of remarkable progression and fate of primary knee osteoarthritis based on patient-specific situations. Between May 2003 and May 2019, 83,280 patients with knee pain were recruited for this study from the clinical data warehouse. Finally, 2492 knees with pain that were followed up for more than one year were analyzed. For analyzing affecting factors, patient-specific information was categorized and classified as demographic, radiologic, social, comorbidity disorders, and surgical intervention data. The degree of contribution of factors to the progression rate and the fate of osteoarthritis was analyzed. Bone mineral density (BMD), Kellgren-Lawrence (K-L) grade, and physical occupational demands were major contributors to the progression rate of osteoarthritis. Hypertension, initial K-L grade, and physical occupational demands were major contributors to the outcome of osteoarthritis. The progression rate and fate of osteoarthritis were mostly affected by the initial K-L grade and physical occupational demands. Patients who underwent surgical intervention for less than five years had the highest proportion of initial K-L grade 2 (49.0%) and occupations with high physical demand (41.3%). In identifying several contributing factors, the initial K-L grade and physical occupational demands were the most important factors. BMD and hypertension were also major contributors to the progression and fate of osteoarthritis, and the degree of contribution was lower compared to the two major factors.
在考虑患者具体情况时，需要分析影响骨关节炎进展速度和转归的因素。本研究旨在根据患者具体情况确定原发性膝关节骨关节炎的显著进展速度和转归。2003年5月至2019年5月期间，从临床数据仓库招募了83280例膝关节疼痛患者参与本研究。最后，对2492例随访超过一年的疼痛膝关节进行了分析。为了分析影响因素，将患者的具体信息进行分类，分为人口统计学、放射学、社会、合并症和手术干预数据。分析了各因素对骨关节炎进展速度和转归的贡献程度。骨密度（BMD）、凯尔格伦-劳伦斯（K-L）分级和体力劳动需求是骨关节炎进展速度的主要影响因素。高血压、初始K-L分级和体力劳动需求是骨关节炎转归的主要影响因素。骨关节炎的进展速度和转归主要受初始K-L分级和体力劳动需求的影响。手术干预时间少于五年的患者中，初始K-L 2级的比例最高（49.0%），体力劳动需求高的职业比例最高（41.3%）。在确定几个影响因素时，初始K-L分级和体力劳动需求是最重要的因素。骨密度和高血压也是骨关节炎进展和转归的主要影响因素，但其贡献程度低于这两个主要因素。
