Risk factors for pain and functional impairment in people with knee and hip osteoarthritis: a systematic review and meta-analysis

Sandhar, Sandeep, Smith, Toby, Howe, Franklyn A., Toor, Kavanbir and Sofat, Nidhi (2020) Risk factors for pain and functional impairment in people with knee and hip osteoarthritis: a systematic review and meta-analysis. BMJ Open. ISSN 2044-6055 (In Press)

[img]
Preview
PDF (Accepted_Manuscript) - Submitted Version
Available under License ["licenses_description_unspecified" not defined].

Download (718kB) | Preview

Abstract

Objective: To identify risk factors for pain and functional deterioration in people with knee and hip osteoarthritis (OA) to form the basis of a future ‘stratification tool’ for OA development or progression. Design: Systematic review and meta-analysis Methods: An electronic search of the literature databases: MEDLINE, EMBASE, CINAHL, MEDLINE and Web of Science (1990-February 2020) was conducted. Studies which identified risk factors for pain and functional deterioration to knee and hip OA were included. Where data and study heterogeneity permitted, meta-analyses presenting mean difference (MD) and odd ratios (OR) with corresponding 95% confidence intervals (CI) were undertaken. Where this was not possible, a narrative analysis was undertaken. The Downs & Black tool assessed methodological quality of selected studies before data extraction. Pooled analysis outcomes were assessed and reported using the GRADE approach. Results: 82 studies (41,810 participants) were included. On meta-analysis: there was moderate quality evidence that knee OA pain was associated with factors including: Kellgren and Lawrence≥ 2 (MD: 2.04, 95% CI:1.48,2.81; p<0.01), increasing age (MD: 1.46, 95% CI:0.26,2.66; p=0.02) and whole-organ MRI scoring method Knee effusion score ≥1 (OR: 1.35, 95% CI: 0.99,1.83; p=0.05). On narrative analysis: knee OA pain was associated with factors including WORMS meniscal damage≥1 (OR: 1.83). Predictors of joint pain in hip OA were large acetabular bone marrow lesions (OR: 5.23), chronic widespread pain (OR: 5.02) and large hip BMLs (OR: 4.43). Conclusions: Our study identified risk factors for clinical pain in OA by imaging measures that can assist in predicting and stratifying people with knee/hip OA. A ‘stratification tool’ combining verified risk factors that we have identified, would allow selective stratification based on pain and structural outcomes in OA.

Item Type: Article
Uncontrolled Keywords: osteoarthritis,hip,knee,pain,function,predictors
Faculty \ School: Faculty of Medicine and Health Sciences > School of Health Sciences
Depositing User: LivePure Connector
Date Deposited: 24 Jun 2020 00:02
Last Modified: 22 Jul 2020 02:45
URI: https://ueaeprints.uea.ac.uk/id/eprint/75754
DOI:

Actions (login required)

View Item View Item