Symptoms predict total knee arthroplasty more than osteoarthritis severity: A multivariable analysis of more than 7500 knees.

IF 3.3 2区医学 Q1 ORTHOPEDICS

Knee Surgery, Sports Traumatology, Arthroscopy Pub Date : 2025-02-20 DOI:10.1002/ksa.12623

Luca Bianco Prevot, Alessandro Bensa, Giuseppe Peretti, Giuseppe Filardo

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引用次数: 0

Abstract

Purpose: Multiple clinical factors may concur to determine the clinical trajectory leading towards total knee arthroplasty (TKA) in patients affected by knee osteoarthritis (OA). The aim of this study was to identify the main factors influencing progression to TKA in a large population of knee OA patients.

Methods: A total of 7552 knees were selected from the Osteoarthritis Initiative (OAI) multicentre database. The data collected included demographic data, Kellgren-Lawrence (KL) grade, the presence of knee swelling, the frequency of swelling, visual analogue scale (VAS) for pain, Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), Knee Injury and Osteoarthritis Outcome Score (KOOS) and the number of knees requiring TKA. The baseline data were collected as reported by the OAI database, and patients were followed up at 12, 24, 36, 48, 60, 72, 84 and 96 months, documenting whether they underwent TKA during this period.

Results: A multivariable analysis was performed to identify factors independently influencing progression to TKA. At 96 months, 7.1% of knees underwent TKA. The progression to TKA correlated with age (p < 0.001), KL grade (p < 0.001), swelling frequency (p < 0.001), knee swelling (p < 0.001), VAS (p = 0.003) and KOOS (p < 0.001). Knees with KL Grades 3 and 4 had the same risk of undergoing this procedure, while the need for TKA was able to be predicted based on WOMAC pain (p = 0.035, hazard ratio [HR] = 0.864), VAS (p = 0.008, HR = 1.131) and KOOS (p = 0.02, HR = 0.966).

Conclusions: This study revealed that several factors influenced progression to TKA, including age, KL grade, knee swelling, VAS pain and KOOS. However, there was no statistically significant difference between KL 3 and KL 4 in predicting the disease trajectory, and patients' clinical symptoms, as quantified by WOMAC pain subscale, VAS and KOOS, had a greater influence on progression to TKA than knee KL OA severity.

Level of evidence: Level IIb.

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来源期刊

Knee Surgery, Sports Traumatology, Arthroscopy 医学-外科

CiteScore

8.10

自引率

18.40%

发文量

418

审稿时长

2 months

期刊介绍： Few other areas of orthopedic surgery and traumatology have undergone such a dramatic evolution in the last 10 years as knee surgery, arthroscopy and sports traumatology. Ranked among the top 33% of journals in both Orthopedics and Sports Sciences, the goal of this European journal is to publish papers about innovative knee surgery, sports trauma surgery and arthroscopy. Each issue features a series of peer-reviewed articles that deal with diagnosis and management and with basic research. Each issue also contains at least one review article about an important clinical problem. Case presentations or short notes about technical innovations are also accepted for publication. The articles cover all aspects of knee surgery and all types of sports trauma; in addition, epidemiology, diagnosis, treatment and prevention, and all types of arthroscopy (not only the knee but also the shoulder, elbow, wrist, hip, ankle, etc.) are addressed. Articles on new diagnostic techniques such as MRI and ultrasound and high-quality articles about the biomechanics of joints, muscles and tendons are included. Although this is largely a clinical journal, it is also open to basic research with clinical relevance. Because the journal is supported by a distinguished European Editorial Board, assisted by an international Advisory Board, you can be assured that the journal maintains the highest standards. Official Clinical Journal of the European Society of Sports Traumatology, Knee Surgery and Arthroscopy (ESSKA).