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Predicting poor functional outcome in community-dwelling older adults with knee pain: prognostic value of generic indicators
  1. Christian David Mallen (c.d.mallen{at}cphc.keele.ac.uk)
  1. Primary Care Musculoskeletal Research Centre, Keele University, United Kingdom
    1. George Peat (g.m.peat{at}cphc.keele.ac.uk)
    1. Primary Care Musculoskeletal Research Centre, Keele University, United Kingdom
      1. Elaine Thomas (e.thomas{at}cphc.keele.ac.uk)
      1. Primary Care Musculoskeletal Research Centre, Keele University, United Kingdom
        1. Rosie Lacey (r.lacey{at}cphc.keele.ac.uk)
        1. Primary Care Musculoskeletal Research Centre, Keele University, United Kingdom
          1. Peter R Croft (p.r.croft{at}cphc.keele.ac.uk)
          1. Primary Care Musculoskeletal Research Centre, Keele University, United Kingdom

            Abstract

            Background In longitudinal studies across a range of regional musculoskeletal pain syndromes, certain prognostic factors consistently emerge. They are “generic” in the sense that they appear to apply regardless of the particular anatomical site or underlying cause of the pain.

            Objective This study has investigated the value of generic indicators of poor functional outcome for knee pain and osteoarthritis in the community.

            Methods We conducted a population based cohort study of adults aged 50 years and over with knee pain as part of the Clinical Assessment Study (Knee)(CAS(K)). At baseline, participants completed a postal questionnaire and attended a research clinic where they completed a further questionnaire and underwent structured physical examination and X-rays. 18 month follow-up was via self-complete questionnaire. Risk ratios were calculated using Cox regression with a fixed time period assigned to each participant.

            Results 60% of participants experienced a poor outcome at 18 months. 12 univariate associations were associated with poor outcome, with four variables remaining in the multivariate model (older age, being overweight or obese, having possible or probable anxiety, and more severe pain).Using a simple unweighted additive risk score (1 point each for age 60 years or over, BMI 25 kg/m2, possible or probable anxiety, Chronic Pain Grade II-IV), 90% of participants with all four generic indicators were correctly classified.

            Conclusions This study has demonstrated that generic prognostic indicators can be used to determine the prognosis of older people with knee pain in the community.

            • Epidemiology
            • Knee pain
            • Osteoarthritis
            • Prognosis

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