King L K, Mahmoudian A, Waugh E J, Stanaitis I, Gomes M, Hung V, MacKay C, Liew J W, Wang Q, Turkiewicz A, Haugen I K, Appleton C T, Lohmander S, Englund M, Runhaar J, Neogi T, Hawker G A
St. Michael's Hospital, Unity Health Toronto, Toronto, Canada.
Department of Medicine, University of Toronto, Toronto, Canada.
Osteoarthr Cartil Open. 2023 Dec 16;6(1):100428. doi: 10.1016/j.ocarto.2023.100428. eCollection 2024 Mar.
As part of the first phase of the OARSI Early-stage Symptomatic Knee Osteoarthritis (EsSKOA) initiative, we explored the first symptoms and experiences recalled by individuals with knee osteoarthritis (OA).
This qualitative study, informed by qualitative description, was a secondary analysis of focus groups (n = 17 groups) and one-on-one interviews (n = 3) conducted in 91 individuals living with knee OA as part of an international study to better understand the OA pain experience. In each focus group or interview, participants were asked to describe their first symptoms of knee OA. We inductively coded these transcripts and conducted thematic analysis.
Mean age of participants was 70 years (range 47-92) and 68 % were female. We developed four overarching themes: , , and . Participants described the gradual and intermittent way in which symptoms of knee OA developed over many years; many could not identify a specific starting point. Participants described diverse initial knee symptoms, including activity-exacerbated joint pain, stiffness and crepitus. Most participants dismissed early symptoms or rationalized their presence, employing various strategies to enable continued participation in recreational and daily activities. Few sought medical attention until physical functioning was demonstrably impacted.
The earliest symptoms of knee OA are frequently insidious in onset, episodic and present long before individuals present to health professionals. These results highlight challenges to identifying people with knee OA early and support the development of specific classification criteria for EsSKOA to capture individuals at an early stage.
作为骨关节炎研究学会（OARSI）早期症状性膝关节骨关节炎（EsSKOA）倡议第一阶段的一部分，我们探究了膝关节骨关节炎（OA）患者回忆起的最初症状和经历。
这项基于质性描述的定性研究，是对作为一项国际研究一部分的91名膝关节OA患者进行的焦点小组访谈（n = 17组）和一对一访谈（n = 3）的二次分析，以更好地了解OA疼痛体验。在每个焦点小组或访谈中，参与者被要求描述他们膝关节OA的最初症状。我们对这些文字记录进行归纳编码并进行主题分析。
参与者的平均年龄为70岁（范围47 - 92岁），68%为女性。我们确定了四个总体主题： ， ，以及 。参与者描述了膝关节OA症状在多年间逐渐且间歇性出现的方式；许多人无法确定一个具体的起始点。参与者描述了多样的膝关节初始症状，包括活动加剧的关节疼痛、僵硬和摩擦音。大多数参与者忽视早期症状或为其存在找理由，采用各种策略以继续参与娱乐和日常活动。很少有人在身体功能明显受到影响之前寻求医疗帮助。
膝关节OA的最早症状在发病时通常很隐匿，呈发作性，且在患者就医之前就已出现很长时间。这些结果凸显了早期识别膝关节OA患者的挑战，并支持为EsSKOA制定特定的分类标准，以便在早期阶段发现患者。
