Knie-artrose

Fietsen verstandig?

Feit

Bij hardlopen wordt de knie belast met 6x uw lichaamsgewicht bij elke stap

Máxima Medisch Centrum

Value-Based Health Care

ESSKA Accredited Teacher

Orthopedie Groot Eindhoven

Goede uitleg is essentieel voor juiste keuze behandeling

Meniscus-scheur

Voorste kruisbandreconstructie

Achterste kruisbandletsel

Zorg op maat

YouTube kanaal dr RPA Janssen

Internationaal wetenschappelijk onderzoek

Kruisbandoperaties knie

RPA Janssen MD PhD

Kruisbandoperaties

Waardegedreven zorg

Last van knie-artrose?

Spreekuur / Policlinique / Outpatient clinic

Nederlandse Vereniging voor Arthroscopie

Máxima Medisch Centrum

Kruisbandoperaties bij kinderen

Veel pijn bij ernstige knie-artrose?

Samen met uw arts gekozen voor een knie-operatie?

Eenzijdige knie-artrose knie en actief leven?

Máxima Medisch Centrum Eindhoven-Veldhoven

Kwaliteit van leven

Samen kiezen voor de beste behandeling

Sporten met plezier

Oplossingen voor de lange termijn

Associate Professor Knee Reconstruction

Fact

Kneecap pain is a regular occurrence in fitness knee rehabilitation

Knee osteoarthritis

Cycling wise?

Fact

When running, the knee is loaded with 6x your body weight with each step

Diagnosis of early stage knee osteoarthritis based on early clinical course: data from the CHECK cohort

Wang, Q., Runhaar, J., Kloppenburg, M., Boers, M., Bijlsma, J. W. J., Bierma-Zeinstra, S. M. A., & Janssen, R. P. A. (Credo study group)
Arthritis Research & Therapy, 2021;23(1):217. https://doi.org/10.1186/s13075-021-02598-5

Abstract

Background: Early diagnosis of knee osteoarthritis (OA) is important in managing this disease, but such an early diagnostic tool is still lacking in clinical practice. The purpose of this study was to develop diagnostic models for early stage knee OA based on the first 2-year clinical course after the patient’s initial presentation in primary care and to identify whether these course factors had additive discriminative value over baseline factors.

Methods: We extracted eligible patients’ clinical and radiographic data from the CHECK cohort and formed the first 2-year course factors according to the factors’ changes over the 2 years. Clinical expert consensus-based diagnosis, which was made via evaluating patients’ 5- to 10-year follow-up data, was used as the outcome factor. Four models were developed: model 1, included clinical course factors only; model 2, included clinical and radiographic course factors; model 3, clinical baseline factors + clinical course factors; and model 4, clinical and radiographic baseline factors + clinical and radiographic course factors. All the models were built by a generalized estimating equation with a backward selection method. Area under the receiver operating characteristic curve (AUC) and its 95% confidence interval (CI) were calculated for assessing model discrimination. Delong’s method compared AUCs.

Results: Seven hundred sixty-one patients with 1185 symptomatic knees were included in this study. Thirty-seven percent knees were diagnosed as OA at follow-up. Model 1 contained 6 clinical course factors; model 2: 6 clinical and 3 radiographic course factors; model 3: 6 baseline clinical factors combined with 5 clinical course factors; and model 4: 4 clinical and 1 radiographic baseline factors combined with 5 clinical and 3 radiographic course factors. Model discriminations are as follows: model 1, AUC 0.70 (95% CI 0.67-0.74); model 2, 0.74 (95% CI 0.71-0.77); model 3, 0.77 (95% CI 0.74-0.80); and model 4, 0.80 (95% CI 0.77-0.82). AUCs of model 3 and model 4 were slightly but significantly higher than corresponding baseline-factor models (model 3 0.77 vs 0.75, p = 0.031; model 4 0.80 vs 0.76, p = 0.003).

Conclusions: Four diagnostic models were developed with “fair” to “good” discriminations. First 2-year course factors had additive discriminative value over baseline factors.

Keywords: CHECK cohort; Early clinical course; Early diagnosis; Knee osteoarthritis.