Healthy knee aging vs. osteoarthritis in three large diverse cohorts: What is the clinical relevance of structural changes seen on radiographs?

三个不同队列中的健康膝关节老化与骨关节炎：X光片上看到的结构变化的临床相关性是什么？

• 批准号: 10096225
• 负责人: JEFFREY W DURYEA
• 金额: $ 215.53万
• 依托单位: UNIVERSITY OF ARIZONA
• 依托单位国家: 美国
• 财政年份: 2021
• 资助国家: 美国
• 起止时间: 2021-09-27 至 2024-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10096225
• 关键词: Address; Adult; Affect; African American; Age; Age-Years; Aging; Assessment tool; Bone Spur; Characteristics; Clinical; County; Data; Data Pooling; Degenerative polyarthritis; Deterioration; Development; Disease; Evaluation of Risk Factors; Future; High Prevalence; Individual; Intervention; Joints; Knee; Knee Injuries; Knee Osteoarthritis; Knowledge; Lateral; Longitudinal observational study; Measurement; Measures; Medial; Medical; Morbidity - disease rate; Musculoskeletal; Natural History; Obesity; Organ; Outcome; Pain; Participant; Patient Outcomes Assessments; Patients; Premature Mortality; Prevention strategy; Probability; Progressive Disease; Public Health; Race; Recording of previous events; Reproducibility; Risk; Risk Assessment; Risk Factors; Severities; Sex Differences; Structure; Subgroup; Visit; Weight-Bearing state; Western Ontario and McMaster Universities Arthritis Index; Width; Woman; Work; age related; base; caucasian American; clinically relevant; cohort; demographics; high risk; knee pain; knee replacement arthroplasty; men; population based; prevent; racial difference; sex

Knee osteoarthritis (KOA) is a major public health problem that has high prevalence and is associated with increased morbidity and premature mortality. It has been identified as the biggest unmet medical need among musculoskeletal conditions. It is typically described as a slowly progressive disease, though some individuals have rapid structural progression. There are currently no treatments available to prevent the disease or halt its progression, due in part to challenges in identifying knees at highest risk for structural progression. The standard for assessing structural progression following development of KOA is loss of joint space width (JSW), however there is limited information regarding normal age-related changes vs. disease-related changes in JSW, potential differences by sex and race, or consequences for pain and function. The distinction between normal age-related decline in organ function and JSW loss characteristic of progressive KOA is not known and represents an important knowledge gap. The current proposal is a critical first step in evaluating the clinical relevance of change in JSW in terms of pain and function, as well as evaluation of risk factors. It uses pooled data from three of the largest and most diverse longitudinal observational studies of KOA: the Johnston County Osteoarthritis Project (JoCoOA), a population-based cohort; and the Multicenter Osteoarthritis Study (MOST) and the Osteoarthritis Initiative (OAI), two cohorts of individuals with or at risk of developing symptomatic KOA. Over multiple visits, these three cohorts, together comprising ~10,500 participants, collected comparable data on demographics, risk factors, patient-reported outcomes, and identical weightbearing fixed flexion knee radiographs scored for OA severity. The specific aims are to 1.) Describe the natural history of healthy knee aging in disease-free knees; 2.) Identify subgroups of knees based on longitudinal changes in knee structure, pain and function across the spectrum from healthy knee aging to rapid OA progression; and 3.) Evaluate the clinical relevance of JSW changes for an individual knee based on concurrent risk of increased pain and functional limitations, and for future knee replacement. These aims will be addressed separately for men and women, and separately for whites and African Americans.

膝骨关节炎（KOA）是一个主要的公共卫生问题，发病率很高，并且与以下疾病相关： 发病率和过早死亡率增加。它被认为是最大的未满足的医疗需求 肌肉骨骼状况。它通常被描述为一种缓慢进展的疾病，尽管有些人 具有快速的结构进展。目前没有任何治疗方法可以预防这种疾病或阻止其发展 进展，部分原因是在确定结构进展风险最高的膝盖方面存在挑战。这 评估 KOA 发展后结构进展的标准是关节间隙宽度 (JSW) 的损失， 然而，关于正常年龄相关变化与疾病相关变化的信息有限。 JSW，性别和种族的潜在差异，或对疼痛和功能的影响。之间的区别 与年龄相关的正常器官功能衰退和进行性 KOA 的 JSW 损失特征尚不清楚， 代表了一个重要的知识差距。 目前的提议是评估 JSW 变化在疼痛方面的临床相关性的关键第一步 和功能，以及风险因素的评估。它使用来自三个最大和最 KOA 的多种纵向观察研究：约翰斯顿县骨关节炎项目 (JoCoOA) 基于人群的队列；多中心骨关节炎研究 (MOST) 和骨关节炎倡议 (OAI)，两组患有或有患症状 KOA 风险的个体。经过多次访问，这些 三个队列总共由约 10,500 名参与者组成，收集了有关人口统计、风险的可比数据 因素、患者报告的结果以及相同的负重固定屈膝 X 光片对 OA 进行评分 严重程度。 具体目标是 1.) 描述无病膝关节健康老化的自然史； 2.) 根据膝关节结构、疼痛和功能的纵向变化来识别膝关节亚组 从健康的膝关节老化到骨关节炎的快速进展； 3.) 评估 JSW 的临床相关性 根据疼痛增加和功能限制的并发风险对单个膝盖进行更改，以及 未来的膝关节置换术。这些目标将分别针对男性和女性以及针对 白人和非裔美国人。