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.

膝盖骨关节炎（KOA）是一个主要的公共卫生问题，患病率很高，与 发病率增加和过早死亡。它被确定为最大的未满足医疗需求 肌肉骨骼条件。尽管有些人 具有快速的结构发展。目前尚无治疗方法来防止疾病或停止疾病 进展，部分是由于确定结构发展风险最高的膝盖的挑战。这 KOA发展后评估结构进程的标准是关节空间宽度（JSW）的损失， 但是，关于正常年龄相关变化与疾病相关的变化的信息有限 JSW，性别和种族的潜在差异，或对疼痛和功能的后果。之间的区别 正常的器官功能下降和JSW损失特征的正常下降是尚不清楚的，并且 代表一个重要的知识差距。 当前的提案是评估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。它使用来自最大和最大的三个的汇总数据 KOA的各种纵向观察研究：约翰斯顿县骨关节炎项目（JOCOOA），一个 基于人群的队列；以及多中心骨关节炎研究（大多数）和骨关节炎倡议 （OAI），有两个人群有症状KOA的人群。在多次访问中，这些 三个队列共同组成约10,500名参与者，收集了可比的人口统计数据，风险 因素，患者报告的结果以及与OA评分的相同重量的固定屈曲膝关节射线照相仪 严重程度。 具体目的是1.）描述无疾病膝盖健康膝盖衰老的自然史； 2.） 根据膝盖结构的纵向变化，疼痛和功能，识别膝盖亚组 从健康的膝盖衰老到快速OA进展的频谱； 3.）评估JSW的临床相关性 基于增加疼痛和功能局限性的同时风险以及对单个膝盖的变化，以及 未来的膝盖更换。这些目标将分别针对男人和女人，并分别针对 白人和非裔美国人。