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Association between several clinical and radiological determinants with long-term clinical progression and good prognosis of lower limb osteoarthritis.

Yusuf E, Bijsterbosch J, Slagboom PE, Kroon HM, Rosendaal FR, Huizinga TW, Kloppenburg M - PLoS ONE (2011)

Bottom Line: Worsening in WOMAC pain (0.1 (0.1 to 0.8)) and function score (0.1 (0.1 to 0.7)), were negatively associated with good prognosis.Worsening in WOMAC pain and function score in 1- year were associated with lower risk to have good prognosis.These findings help to inform patients with regard to their OA prognosis.

View Article: PubMed Central - PubMed

Affiliation: Department of Rheumatology, Leiden University Medical Center, Leiden, The Netherlands. angga.yusuf@gmail.com

ABSTRACT

Objective: To investigate the factors associated with clinical progression and good prognosis in patients with lower limb osteoarthritis (OA).

Methods: Cohort study of 145 patients with OA in either knee, hip or both. Progression was defined as 1) new joint prosthesis or 2) increase in WOMAC pain or function score during 6-years follow-up above pre-defined thresholds. Patients without progression with decrease in WOMAC pain or function score lower than pre-defined thresholds were categorized as good prognosis. Relative risks (RRs) for progression and good prognosis with 95% confidence interval (95% CI) were calculated by comparing the highest tertile or category to the lowest tertile, for baseline determinants (age, sex, BMI, WOMAC pain and function scores, pain on physical examination, total range of motion (tROM), osteophytes and joint space narrowing (JSN) scores), and for worsening in WOMAC pain and function score in 1-year. Adjustments were performed for age, sex, and BMI.

Results: Follow-up was completed by 117 patients (81%, median age 60 years, 84% female); 62 (53%) and 31 patients (26%) showed progression and good prognosis, respectively. These following determinants were associated with progression: pain on physical examination (RR 1.2 (1.0 to 1.5)); tROM (1.4 (1.1 to 1.6); worsening in WOMAC pain (1.9 (1.2 to 2.3)); worsening in WOMAC function (2.4 (1.7 to 2.6)); osteophytes 1.5 (1.0 to 1.8); and JSN scores (2.3 (1.5 to 2.7)). Worsening in WOMAC pain (0.1 (0.1 to 0.8)) and function score (0.1 (0.1 to 0.7)), were negatively associated with good prognosis.

Conclusion: Worsening of self-reported pain and function in one year, limited tROM and higher osteophytes and JSN scores were associated with clinical progression. Worsening in WOMAC pain and function score in 1- year were associated with lower risk to have good prognosis. These findings help to inform patients with regard to their OA prognosis.

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Related in: MedlinePlus

Cumulative probability plot of Western Ontario and McMaster Universities (WOMAC) scores change of patients without prosthesis during follow-up (n = 81) for WOMAC pain scores change (above) and WOMAC function scores change (below).The horizontal line above is the line set at minimal perceptible clinical improvement (MPCI) score which is used as the cut-off to define progression and the horizontal line below is the line set to define good prognosis.
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pone-0025426-g001: Cumulative probability plot of Western Ontario and McMaster Universities (WOMAC) scores change of patients without prosthesis during follow-up (n = 81) for WOMAC pain scores change (above) and WOMAC function scores change (below).The horizontal line above is the line set at minimal perceptible clinical improvement (MPCI) score which is used as the cut-off to define progression and the horizontal line below is the line set to define good prognosis.

Mentions: Cumulative probability plots show the variation in natural course of self-reported pain and function in the sub-group of patients without prosthesis (n = 81) (Figures 1a and 1b). Fifteen and 22 patients showed progression of WOMAC pain and WOMAC function based on changes above the MCPI, respectively. In total, 26 patients (19.7%) showed clinical deterioration. Together with the 36 patients receiving joint replacement during follow-up, 62 of 117 patients (53.0%) showed clinical progression. Thirty-one patients showed good prognosis, based on change in WOMAC pain or WOMAC function score change lower than −9.7 (n = 23) or −9.3 (n = 22), respectively.


Association between several clinical and radiological determinants with long-term clinical progression and good prognosis of lower limb osteoarthritis.

Yusuf E, Bijsterbosch J, Slagboom PE, Kroon HM, Rosendaal FR, Huizinga TW, Kloppenburg M - PLoS ONE (2011)

Cumulative probability plot of Western Ontario and McMaster Universities (WOMAC) scores change of patients without prosthesis during follow-up (n = 81) for WOMAC pain scores change (above) and WOMAC function scores change (below).The horizontal line above is the line set at minimal perceptible clinical improvement (MPCI) score which is used as the cut-off to define progression and the horizontal line below is the line set to define good prognosis.
© Copyright Policy
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC3198737&req=5

pone-0025426-g001: Cumulative probability plot of Western Ontario and McMaster Universities (WOMAC) scores change of patients without prosthesis during follow-up (n = 81) for WOMAC pain scores change (above) and WOMAC function scores change (below).The horizontal line above is the line set at minimal perceptible clinical improvement (MPCI) score which is used as the cut-off to define progression and the horizontal line below is the line set to define good prognosis.
Mentions: Cumulative probability plots show the variation in natural course of self-reported pain and function in the sub-group of patients without prosthesis (n = 81) (Figures 1a and 1b). Fifteen and 22 patients showed progression of WOMAC pain and WOMAC function based on changes above the MCPI, respectively. In total, 26 patients (19.7%) showed clinical deterioration. Together with the 36 patients receiving joint replacement during follow-up, 62 of 117 patients (53.0%) showed clinical progression. Thirty-one patients showed good prognosis, based on change in WOMAC pain or WOMAC function score change lower than −9.7 (n = 23) or −9.3 (n = 22), respectively.

Bottom Line: Worsening in WOMAC pain (0.1 (0.1 to 0.8)) and function score (0.1 (0.1 to 0.7)), were negatively associated with good prognosis.Worsening in WOMAC pain and function score in 1- year were associated with lower risk to have good prognosis.These findings help to inform patients with regard to their OA prognosis.

View Article: PubMed Central - PubMed

Affiliation: Department of Rheumatology, Leiden University Medical Center, Leiden, The Netherlands. angga.yusuf@gmail.com

ABSTRACT

Objective: To investigate the factors associated with clinical progression and good prognosis in patients with lower limb osteoarthritis (OA).

Methods: Cohort study of 145 patients with OA in either knee, hip or both. Progression was defined as 1) new joint prosthesis or 2) increase in WOMAC pain or function score during 6-years follow-up above pre-defined thresholds. Patients without progression with decrease in WOMAC pain or function score lower than pre-defined thresholds were categorized as good prognosis. Relative risks (RRs) for progression and good prognosis with 95% confidence interval (95% CI) were calculated by comparing the highest tertile or category to the lowest tertile, for baseline determinants (age, sex, BMI, WOMAC pain and function scores, pain on physical examination, total range of motion (tROM), osteophytes and joint space narrowing (JSN) scores), and for worsening in WOMAC pain and function score in 1-year. Adjustments were performed for age, sex, and BMI.

Results: Follow-up was completed by 117 patients (81%, median age 60 years, 84% female); 62 (53%) and 31 patients (26%) showed progression and good prognosis, respectively. These following determinants were associated with progression: pain on physical examination (RR 1.2 (1.0 to 1.5)); tROM (1.4 (1.1 to 1.6); worsening in WOMAC pain (1.9 (1.2 to 2.3)); worsening in WOMAC function (2.4 (1.7 to 2.6)); osteophytes 1.5 (1.0 to 1.8); and JSN scores (2.3 (1.5 to 2.7)). Worsening in WOMAC pain (0.1 (0.1 to 0.8)) and function score (0.1 (0.1 to 0.7)), were negatively associated with good prognosis.

Conclusion: Worsening of self-reported pain and function in one year, limited tROM and higher osteophytes and JSN scores were associated with clinical progression. Worsening in WOMAC pain and function score in 1- year were associated with lower risk to have good prognosis. These findings help to inform patients with regard to their OA prognosis.

Show MeSH
Related in: MedlinePlus