CHECK (Cohort Hip & Cohort Knee) is a cohort of 1002 subjects with pain and/or stiffness of one or both knee(s) and/or hip(s), age between 45 and 65 years, that had never or <6 months ago visited a general physician for these complaints for the first time. Subjects were included in ten medical centers throughout The Netherlands and are being followed-up for 10 years (current follow-up 8 to 10 years). The general objective of CHECK is to study the course of complaints in early-stage knee and/or hip osteoarthritis (OA), mechanisms that cause joint damage at this stage, and diagnostic and prognostic markers for the (course of) joint damage.
During follow-up, subjects are characterized on three main areas: clinically through yearly questionnaires and physical assessments, radiographically through X-ray images of knees and hips, and biochemically through collection of blood and urine samples. All X-ray images are being scored according to the Kellgren & Lawrence and Altman classification systems, as well as using the more innovative Knee Images Digital Analysis (KIDA) for the knee and Holy analysis for the hip providing continuous measures of individual OA features. Baseline blood and urine samples from all subjects were used for assessing a wide spectrum of biochemical markers of joint matrix metabolism (in cartilage, bone, and synovial tissue), adipokines (leptin, adiponectin, and resistin), and markers of inflammation (erythrocyte sedimentation rate and high-sensitivity C-reactive protein). In addition, a variety of other assessments have been performed in specific cohort subsets (e.g. synovial tissue histology, statistical shape modelling of the hip, skin biopsies, and MRI of the knee).
In each of these areas, data are now being investigated and combined by multiple CHECK research groups to elucidate important aspects of the pathogenesis of OA, with a particular emphasis on its very early stage. For example, what is the impact of comorbidity on physical and mental health in OA? Can different longitudinal radiographic phenotypes of knee OA and different pain trajectories be recognized? And, what biochemical processes underlie radiographic knee and hip OA features and joint pain?
The efforts being put into CHECK have already led to interesting and innovative conclusions. The current presentation will give an overview of what CHECK has taught us about early-stage knee and hip OA and what CHECK may have to offer in the nearby future.
CHECK is funded by the Dutch Arthritis Association on the lead of a steering committee comprising 16 members with expertise in different fields of OA. Involved are: Academic Hospital Maastricht; Erasmus Medical Center Rotterdam; Jan van Breemen Institute/VU Medical Center Amsterdam; Kennemer Gasthuis Haarlem; Martini Hospital Groningen/Allied Health Care Center for Rheumatology and Rehabilitation Groningen; Medical Spectrum Twente Enschede/Twenteborg Hospital Almelo; St Maartenskliniek Nijmegen; Leiden University Medical Center; University Medical Center Utrecht and Wilhelmina Hospital Assen.
Disclosure of Interest None Declared
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