F P Luyten1, S Bierma-Zeinstra2, F Dell'Accio3, V B Kraus4, K Nakata5, I Sekiya6, N K Arden7, L S Lohmander8. 1. Department of Development and Regeneration, Skeletal Biology and Engineering Research Center, KU Leuven, Herestraat 49 Box 813, B-3000 Leuven, Belgium. Electronic address: frank.luyten@uzleuven.be. 2. Department of General Practice, University Medical Center Rotterdam, Erasmus MC, Rotterdam, the Netherlands; Department of Orthopedics, University Medical Center Rotterdam, Erasmus MC, Rotterdam, the Netherlands. 3. William Harvey Research Institute, Barts and the London School of Medicine and Dentistry, Queen Mary University of London, London, UK. 4. Division of Rheumatology, Duke Molecular Physiology Institute, Duke University School of Medicine, Durham, NC. 5. Medicine for Sports and Performing Arts, Department of Health and Sport Sciences, Osaka University Graduate School of Medicine, Osaka, Japan. 6. Center for Stem Cell and Regenerative Medicine, Tokyo Medical and Dental University, Tokyo, Japan. 7. Arthritis Research UK Centre for Sport, Exercise and Osteoarthritis, University of Oxford, Oxford, England. 8. Department of Clinical Sciences, Faculty of Medicine, Lund University, Lund, Sweden.
Abstract
OBJECTIVE: To propose draft classification criteria for early stage osteoarthritis (OA) of the knee for use in a primary care setting. METHODS: A group of basic scientists, physician-scientists, rheumatologists, orthopedic surgeons, and physiotherapists in a workshop setting discussed potential classification criteria for early osteoarthritis of the knee. The workshop was divided into sessions around relevant topics with short state of the art presentations followed by breakout sessions, consensus discussions, and consolidation into a consensus document. RESULTS: Three classes of criteria were agreed: (1) Pain, symptoms/signs, self-reported function, and quality of life using tools such as KOOS: scoring ≤85% in at least 2 out of these 4 categories; (2) Clinical examination: at least 1 present out of joint line tenderness or crepitus; (3) Knee radiographs: Kellgren & Lawrence (KL) grade of 0 or 1. MRI is at present not recommended as an aid to identify or define early OA in routine clinical practice or primary care, in light of the absence of validated consensus criteria and the high population prevalence of structural joint changes detected by this method. Biomarkers may have future utility in early OA classification, but no individual or set of biomarkers is yet robust enough. CONCLUSION: Based on our consensus proposal, draft classification criteria for early OA of the knee for use in clinical studies should include patient reported outcomes such as pain and function, together with clinical signs and KL grade 0-1 on radiographs.
OBJECTIVE: To propose draft classification criteria for early stage osteoarthritis (OA) of the knee for use in a primary care setting. METHODS: A group of basic scientists, physician-scientists, rheumatologists, orthopedic surgeons, and physiotherapists in a workshop setting discussed potential classification criteria for early osteoarthritis of the knee. The workshop was divided into sessions around relevant topics with short state of the art presentations followed by breakout sessions, consensus discussions, and consolidation into a consensus document. RESULTS: Three classes of criteria were agreed: (1) Pain, symptoms/signs, self-reported function, and quality of life using tools such as KOOS: scoring ≤85% in at least 2 out of these 4 categories; (2) Clinical examination: at least 1 present out of joint line tenderness or crepitus; (3) Knee radiographs: Kellgren & Lawrence (KL) grade of 0 or 1. MRI is at present not recommended as an aid to identify or define early OA in routine clinical practice or primary care, in light of the absence of validated consensus criteria and the high population prevalence of structural joint changes detected by this method. Biomarkers may have future utility in early OA classification, but no individual or set of biomarkers is yet robust enough. CONCLUSION: Based on our consensus proposal, draft classification criteria for early OA of the knee for use in clinical studies should include patient reported outcomes such as pain and function, together with clinical signs and KL grade 0-1 on radiographs.
Authors: Armaghan Mahmoudian; L Stefan Lohmander; Ali Mobasheri; Martin Englund; Frank P Luyten Journal: Nat Rev Rheumatol Date: 2021-08-31 Impact factor: 20.543
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