Clinical Edge

Summaries of Must-Read Clinical Literature, Guidelines, and FDA Actions

Pain and Functional Trajectories for Knee OA Found

Osteoarthritis Cartilage; 2018 April; Lee, Harvey, et al

Researchers found 4 distinct trajectories for pain and function over up to 12-weeks of exercise interventions in a recent study that aimed to identify these trajectories from exercise interventions in knee osteoarthritis (OA), and to determine their association with baseline factors. These findings will help disentangle the heterogeneity of treatment response and may advance patient-centered care in knee OA. Researchers analyzed a prospective cohort of 171 participants (mean age 61 years; BMI 32 kg/m2; 71% female; 57% white) with symptomatic knee OA from a randomized trial comparing 12-week Tai Chi and physical therapy. They analyzed weekly Western Ontario and McMaster Osteoarthritis Index (WOMAC) pain (0–500) and function (0–1700) scores using group-based trajectory models. They found:

  • 4 pain trajectories were identified: Lower-Early Improvement (43%), Moderate-Early Improvement (32%), Higher-Delayed Improvement (15%), and Higher-No Improvement (10%).
  • There were similar trajectories for function, except that the lower function trajectories diverged into gradual (12%) or delayed-improvement (15%).
  • Compared with the Lower-Early Improvement pain trajectory, moderate and higher trajectories were associated with poorer physical and psychosocial health.
  • A similar pattern of associations was found among the function trajectories.

Citation:

Lee AC, Harvey WF, Han X, et al. Pain and functional trajectories in symptomatic knee osteoarthritis over up to 12 weeks of exercise exposure. Osteoarthritis Cartilage. 2018;26(4):501-512. doi:10.1016/j.joca.2018.01.016.

This Week's Must Reads

Patient Global Assessment Discordance in RA vs OA, Rheumatol Int; ePub 2018 Oct 6; Castrejon, et al

Chronic Lung Disease, RA, and Impact on Survival , Clin Rheumatol; ePub 2018 Oct 2; England, et al

RA and Systemic Sclerosis Share Similar Impairments, Disabil Rehab; 2018 Oct; Poole, New, et al

Synovial Hypertrophy With/Without Doppler Activity , Arthritis Res Ther; ePub 2018 Oct 3; Tersley, et al

Cortical Interruptions in Finger Joints in RA, J Bone Miner Res; 2018 Sep; Peters, et al

Must Reads in Osteoarthritis

>50% of Arthritis Sufferers Not Being Treated, J Clin Rheumatol; ePub 2018 Sep 18; Theis, et al

Varus Thrust Linked with Worsening Knee Pain, Arthritis Care Res; ePub 2018 Sep 22; Wink, et al

Does Exercise Contribute to Radiographic Worsening?, Arthritis Care Res; ePub 2018 Sep 20; Jayabalan, et al

Significance of Patient-Reported Symptoms of Knee OA, Osteoarthritis Cartilage; ePub 2018 Sep 20; Berlinberg, et al

Incident Hand OA Linked with Reduced Telomere Length, Osteoarthritis Cartilage; ePub 2018 Aug 30; McAlindon, et al