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| 2. |
- Gossec, L., et al.
(författare)
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The role of pain and functional impairment in the decision to recommend total joint replacement in hip and knee osteoarthritis: an international cross-sectional study of 1909 patients. Report of the OARSI-OMERACT Task Force on total joint replacement
- 2011
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Ingår i: Osteoarthritis and Cartilage. - : Elsevier BV. - 1063-4584. ; 19:2, s. 147-154
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Tidskriftsartikel (refereegranskat)abstract
- Objective: To assess the pain and functional disability levels corresponding to an indication for total joint replacement (TJR) in hip and knee osteoarthritis (OA). Methods: Design: International cross-sectional study in 10 countries. Patients: Consecutive outpatients with definite hip or knee OA attending an orthopaedic outpatient clinic. Gold standard measure for recommendation for TJR: Surgeon's decision that TJR is justified. Outcome measures: Pain (ICOAP: intermittent and constant osteoarthritis pain, 0-100) and functional impairment (HOOS-PS/KOOS-PS: Hip/Knee injury and Osteoarthritis Outcome Score Physical function Short-form, 0-100). Analyses: Comparison of patients with vs without surgeons' indication for TJR. Receiver Operating Characteristic (ROC) curve analyses and logistic regression were applied to determine cut points of pain and disability defining recommendation for TJR. Results: In all, 1909 patients were included (1130 knee/779 hip OA). Mean age was 66.4 [standard deviation (SD) 10.9] years, 58.1% were women; 628/1130 (55.6%) knee OA and 574/779 (73.7%) hip OA patients were recommended for TJR. Although patients recommended for TJR (yes vs no) had worse symptom levels [pain, 55.5 (95% confidence interval 54.2, 56.8) vs. 44.9 (43.2, 46.6), and functional impairment, 59.8 (58.7, 60.9) vs. 50.9 (49.3, 52.4), respectively, both P < 0.0001]. there was substantial overlap in symptom levels between groups, even when adjusting for radiographic joint status. Thus, it was not possible to determine cut points for pain and function defining 'requirement for TJR'. Conclusion: Although symptom levels were higher in patients recommended for TJR, pain and functional disability alone did not discriminate between those who were and were not considered to need TJR by the orthopaedic surgeon. (C) 2010 Osteoarthritis Research Society International. Published by Elsevier Ltd. All rights reserved.
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| 3. |
- Huynh, C., et al.
(författare)
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Factors associated with the orthopaedic surgeon's decision to recommend total joint replacement in hip and knee osteoarthritis : an international cross-sectional study of 1905 patients
- 2018
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Ingår i: Osteoarthritis and Cartilage. - : Elsevier BV. - 1063-4584. ; 26:10, s. 1311-1318
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Tidskriftsartikel (refereegranskat)abstract
- Objective: To determine factors associated with orthopaedic surgeons’ decision to recommend total joint replacement (TJR) in people with knee and hip osteoarthritis (OA). Design: Cross-sectional study in eleven countries. For consecutive outpatients with definite hip or knee OA consulting an orthopaedic surgeon, the surgeon's indication of TJR was collected, as well as patients’ characteristics including comorbidities and social situation, OA symptom duration, pain, stiffness and function (Western Ontario and McMaster Universities Osteoarthritis Index [WOMAC]), joint-specific quality of life, Osteoarthritis Research Society International (OARSI) joint space narrowing (JSN) radiographic grade (0–4), and surgeons’ characteristics. Univariable and multivariable logistic regressions were performed to identify factors associated with the indication of TJR, adjusted by country. Results: In total, 1905 patients were included: mean age was 66.5 (standard deviation [SD], 10.8) years, 1082 (58.0%) were women, mean OA symptom duration was 5.0 (SD 7.0) years. TJR was recommended in 561/1127 (49.8%) knee OA and 542/778 (69.7%) hip OA patients. In multivariable analysis on 516 patients with complete data, the variables associated with TJR indication were radiographic grade (Odds Ratio, OR for one grade increase, for knee and hip OA, respectively: 2.90, 95% confidence interval [1.69–4.97] and 3.30 [2.17–5.03]) and WOMAC total score (OR for 10 points increase: 1.65 [1.32–2.06] and 1.38 [1.15–1.66], respectively). After excluding radiographic grade from the analyses, on 1265 patients, greater WOMAC total score was the main predictor for knee and hip OA; older age was also significant for knee OA. Conclusion: Radiographic severity and patient-reported pain and function play a major role in surgeons’ recommendation for TJR.
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| 4. |
- King, L. K., et al.
(författare)
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“You don't put it down to arthritis” : A qualitative study of the first symptoms recalled by individuals with knee osteoarthritis
- 2024
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Ingår i: Osteoarthritis and Cartilage Open. - 2665-9131. ; 6:1
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Tidskriftsartikel (refereegranskat)abstract
- Objective: As part of the first phase of the OARSI Early-stage Symptomatic Knee Osteoarthritis (EsSKOA) initiative, we explored the first symptoms and experiences recalled by individuals with knee osteoarthritis (OA). Design: This qualitative study, informed by qualitative description, was a secondary analysis of focus groups (n = 17 groups) and one-on-one interviews (n = 3) conducted in 91 individuals living with knee OA as part of an international study to better understand the OA pain experience. In each focus group or interview, participants were asked to describe their first symptoms of knee OA. We inductively coded these transcripts and conducted thematic analysis. Results: Mean age of participants was 70 years (range 47–92) and 68 % were female. We developed four overarching themes: Insidious and Episodic Onset, Diverse Early Symptoms, Must be Something Else, and Adjustments. Participants described the gradual and intermittent way in which symptoms of knee OA developed over many years; many could not identify a specific starting point. Participants described diverse initial knee symptoms, including activity-exacerbated joint pain, stiffness and crepitus. Most participants dismissed early symptoms or rationalized their presence, employing various strategies to enable continued participation in recreational and daily activities. Few sought medical attention until physical functioning was demonstrably impacted. Conclusions: The earliest symptoms of knee OA are frequently insidious in onset, episodic and present long before individuals present to health professionals. These results highlight challenges to identifying people with knee OA early and support the development of specific classification criteria for EsSKOA to capture individuals at an early stage.
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| 5. |
- Liew, Jean W, et al.
(författare)
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A scoping review of how early-stage knee osteoarthritis has been defined
- 2023
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Ingår i: Osteoarthritis and Cartilage. - 1063-4584. ; 31:9, s. 1234-1241
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Forskningsöversikt (refereegranskat)abstract
- BACKGROUND: Early-stage knee osteoarthritis (KOA) classification criteria will enable consistent identification and trial recruitment of individuals with knee osteoarthritis (OA) at an earlier stage of the disease when interventions may be more effective. Toward this goal, we identified how early-stage KOA has been defined in the literature.METHODS: We performed a scoping literature review in PubMed, EMBASE, Cochrane, and Web of Science, including human studies where early-stage KOA was included as a study population or outcome. Extracted data included demographics, symptoms/history, examination, laboratory, imaging, performance-based measures, gross inspection/histopathologic domains, and the components of composite early-stage KOA definitions.RESULTS: Of 6142 articles identified, 211 were included in data synthesis. An early-stage KOA definition was used for study inclusion in 194 studies, to define study outcomes in 11 studies, and in the context of new criteria development or validation in six studies. The element most often used to define early-stage KOA was Kellgren-Lawrence (KL) grade (151 studies, 72%), followed by symptoms (118 studies, 56%), and demographic characteristics (73 studies, 35%); 14 studies (6%) used previously developed early-stage KOA composite criteria. Among studies defining early-stage KOA radiographically, 52 studies defined early-stage KOA by KL grade alone; of these 52, 44 (85%) studies included individuals with KL grade 2 or higher in their definitions.CONCLUSION: Early-stage KOA is variably defined in the published literature. Most studies included KL grades of 2 or higher within their definitions, which reflects established or later-stage OA. These findings underscore the need to develop and validate classification criteria for early-stage KOA.
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| 7. |
- Maillefert, J. F., et al.
(författare)
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Multi-language translation and cross-cultural adaptation of the OARSI/OMERACT measure of intermittent and constant osteoarthritis pain (ICOAP)
- 2009
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Ingår i: Osteoarthritis and Cartilage. - : Elsevier BV. - 1063-4584. ; 17:10, s. 1293-1296
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Tidskriftsartikel (refereegranskat)abstract
- Aim: To conduct a multi-language translation and cross-cultural adaptation of the Intermittent and Constant OsteoArthritis Pain (ICOAP) questionnaire for hip and knee osteoarthritis (OA). Methods: The questionnaires were translated and cross-culturally adapted in parallel, using a common protocol, into the following languages: Czech, Dutch, French (France), German, Italian, Norwegian, Spanish (Castillan), North and Central American Spanish, Swedish. The process was conducted following five steps: (1) - independent translation into the target language by two or three persons; (2) - consensus meeting to obtain a single preliminary translated version; (3) - backward translation by an independent bilingual native English speaker, blinded to the English original version; (4) - final version produced by a multidisciplinary consensus committee; (5) - pre-testing of the final version with 10-20 target-language-native hip and knee OA patients. Results: The process could be followed and completed in all countries. Only slight differences were identified in the structure of the sentences between the original and the translated versions. A large majority of the patients felt that the questionnaire was easy to understand and complete. Only a few minor criticisms were expressed. Moreover, a majority of patients found the concepts of constant pain and pain that comes and goes to be of a great pertinence and were very happy with the distinction. Conclusion: The ICOAP questionnaire is now available for multi-center international studies. (c) 2009 Osteoarthritis Research Society International. Published by Elsevier Ltd. All rights reserved.
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| 8. |
- McAlindon, T E, et al.
(författare)
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OARSI guidelines for the non-surgical management of knee osteoarthritis.
- 2014
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Ingår i: Osteoarthritis and Cartilage. - : Elsevier BV. - 1063-4584. ; 22:3, s. 363-388
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Tidskriftsartikel (refereegranskat)abstract
- To develop concise, up-to-date, patient-focused, evidence-based, expert consensus guidelines for the management of knee osteoarthritis (OA), intended to inform patients, physicians, and allied healthcare professionals worldwide.
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| 9. |
- Sadiq, Sakar, et al.
(författare)
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Mechanism of Haibat Sultan Mountain Landslide in Koya, North Iraq
- 2016
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Ingår i: Engineering. - : Scientific Research Publishing, Inc.. - 1947-3931 .- 1947-394X. ; 8:8, s. 535-544
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Tidskriftsartikel (refereegranskat)abstract
- Haibat Sultan Mountain is a long range with elevation of about 860 m (a.s.l.); the PilaSpi Formation forms its carapace in Koya vicinity, with relief difference of about 300 m from Koisanjaq plain. The PilaSpi Formation consists of well thickly to massively bedded dolostone and dolomitic limestone with thickness of about 120 m in Koya vicinity. The main trend is NW - SE being a limb of Bustana anticline representing part of the southwestern limb, with dip amount that ranges from (15 - 30). On 11th of November 2015 a landslide had occurred after a heavy rainfall along Koya - Dukan main road. The type of the slide was plane sliding due to daylight slope, which was formed afterthe road cut. The length of the slide area: along the road is 90 m with height of 40 m forming almost a parallelogram shape; the thickness of the slid beds is about 2.5 m. The estimated volume of the slid mass is 9000 m3. The main cause of the landslide is the presence of daylight slope, high slope angle; more than the dip angle, presence of old crack surfaces which are filled by reddish brown clayey residual soil. After the he heavy rain fall, which lasted for 20 hours, the infiltrated rain water in the bedding planes in the well bedded, cracked, and jointed beds has increased the pore pressure and decreased the internal friction angle; therefore, the sliding has occurred. The root of the slid mass is below the base of the paved road; therefore, that part which is above the paved road has slid. The remaining part is highly cracked and partly accumulated in the base of the slid mass. Fortunately, the height of the slid mass is only 40 m and the relief difference between the crown area and the toe area is about 50 m; otherwise the slid mass would be larger than the present slid mass. From the field inspection, it is very clear that the involved area is very unstable and in critical equilibrium. The presence of daylight bedding above the crown area, clayey soil in the fractures and open joints and steep slope all are very favorable conditions for triggering the unstable slope, consequently developing of another landslide with larger mass.
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