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Prodromal symptoms in knee osteoarthritis: a nested case-control study using data from the Osteoarthritis Initiative.

Case R, Thomas E, Clarke E, Peat G - Osteoarthr. Cartil. (2015)

Bottom Line: The prodromal phase for subscale scores ranged from 29 months (KOOS Other Symptoms) to 37 months (WOMAC Pain).Pain and difficulty on activities associated with higher dynamic knee loading were associated with longer prodromal phases (e.g., pain on twisting/pivoting (39 months, 95% confidence interval: 13, 64) vs pain on standing (25 months: 7, 42)).Our analysis found that incident ROA is preceded by prodromal symptoms lasting at least 2-3 years.

View Article: PubMed Central - PubMed

Affiliation: Arthritis Research UK Primary Care Centre, Research Institute for Primary Care & Health Sciences, Keele University, Keele, Staffordshire, United Kingdom. Electronic address: r.l.case@keele.ac.uk.

No MeSH data available.


Related in: MedlinePlus

Probability of cases (solid line, diamond marker) and controls (dashed line, triangle marker) responding moderate, severe or extreme to at least 1 item in the WOMAC pain subscale at each time prior to t0 (incidence for the cases)estimated from multi-level model. The length of the prodrome is estimated as the time point where these lines cross. Data from the OAI, United States of America, 2004–2010.
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fig1: Probability of cases (solid line, diamond marker) and controls (dashed line, triangle marker) responding moderate, severe or extreme to at least 1 item in the WOMAC pain subscale at each time prior to t0 (incidence for the cases)estimated from multi-level model. The length of the prodrome is estimated as the time point where these lines cross. Data from the OAI, United States of America, 2004–2010.

Mentions: From multi-level models, the estimated length of prodrome – taken as the point at which the probability of scoring at least 1 item in the subscale as moderate/severe/extreme were equal for cases and controls – ranged from almost 29 months for the KOOS Other Symptoms (Table II) to 37 months for the WOMAC Pain (Fig. 1). For dichotomised individual items, the estimated length of prodrome – defined as the point when the estimated probability of that symptom being moderate/severe/extreme was equal for cases and controls – ranged from 24 months (difficulty with light domestic chores) to 47 months (difficulty taking off socks/stockings). Fig. 2 illustrates 4 examples of items with contrasting changes in the probabilities of the cases having the symptom. The 95% confidence intervals for the estimated length of prodrome crossed zero for an additional five individual items not displayed in Table II (difficulty descending stairs, difficulty standing, difficulty walking, difficulty with heavy domestic chores and pain on straightening the knee fully). At each level, only random intercept models were fitted, as when random slope models were fitted, the variance around the slope was consistently not significantly different from zero. There was little difference to the overall shape of the growth model when using fractional polynomials to consider time as a non-linear effect and so the simpler model whereby time was linear was fitted.


Prodromal symptoms in knee osteoarthritis: a nested case-control study using data from the Osteoarthritis Initiative.

Case R, Thomas E, Clarke E, Peat G - Osteoarthr. Cartil. (2015)

Probability of cases (solid line, diamond marker) and controls (dashed line, triangle marker) responding moderate, severe or extreme to at least 1 item in the WOMAC pain subscale at each time prior to t0 (incidence for the cases)estimated from multi-level model. The length of the prodrome is estimated as the time point where these lines cross. Data from the OAI, United States of America, 2004–2010.
© Copyright Policy - CC BY-NC-ND
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4491193&req=5

fig1: Probability of cases (solid line, diamond marker) and controls (dashed line, triangle marker) responding moderate, severe or extreme to at least 1 item in the WOMAC pain subscale at each time prior to t0 (incidence for the cases)estimated from multi-level model. The length of the prodrome is estimated as the time point where these lines cross. Data from the OAI, United States of America, 2004–2010.
Mentions: From multi-level models, the estimated length of prodrome – taken as the point at which the probability of scoring at least 1 item in the subscale as moderate/severe/extreme were equal for cases and controls – ranged from almost 29 months for the KOOS Other Symptoms (Table II) to 37 months for the WOMAC Pain (Fig. 1). For dichotomised individual items, the estimated length of prodrome – defined as the point when the estimated probability of that symptom being moderate/severe/extreme was equal for cases and controls – ranged from 24 months (difficulty with light domestic chores) to 47 months (difficulty taking off socks/stockings). Fig. 2 illustrates 4 examples of items with contrasting changes in the probabilities of the cases having the symptom. The 95% confidence intervals for the estimated length of prodrome crossed zero for an additional five individual items not displayed in Table II (difficulty descending stairs, difficulty standing, difficulty walking, difficulty with heavy domestic chores and pain on straightening the knee fully). At each level, only random intercept models were fitted, as when random slope models were fitted, the variance around the slope was consistently not significantly different from zero. There was little difference to the overall shape of the growth model when using fractional polynomials to consider time as a non-linear effect and so the simpler model whereby time was linear was fitted.

Bottom Line: The prodromal phase for subscale scores ranged from 29 months (KOOS Other Symptoms) to 37 months (WOMAC Pain).Pain and difficulty on activities associated with higher dynamic knee loading were associated with longer prodromal phases (e.g., pain on twisting/pivoting (39 months, 95% confidence interval: 13, 64) vs pain on standing (25 months: 7, 42)).Our analysis found that incident ROA is preceded by prodromal symptoms lasting at least 2-3 years.

View Article: PubMed Central - PubMed

Affiliation: Arthritis Research UK Primary Care Centre, Research Institute for Primary Care & Health Sciences, Keele University, Keele, Staffordshire, United Kingdom. Electronic address: r.l.case@keele.ac.uk.

No MeSH data available.


Related in: MedlinePlus