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The natural course of knee osteoarthritis in middle-aged individuals with knee pain - A 12 year follow-up using clinical and radiographic criteria
  1. Carina A Thorstensson (carina.thorstensson{at}spenshult.se)
  1. Research and Development Centre, Spenshult Hospital for Rheumatic Diseases, Sweden
    1. Maria L.E. Andersson (maria.andersson{at}spenshult.se)
    1. Research and Development Centre, Spenshult Hospital for Rheumatic Diseases, Sweden
      1. Hanna Jönsson (hanna.jonsson{at}spenshult.se)
      1. Research and Development Centre, Spenshult Hospital for Rheumatic Diseases, Sweden
        1. Tore Saxne (tore.saxne{at}med.lu.se)
        1. Clinical Sciences Lund, Lund University, Sweden
          1. Ingemar F Petersson (ingemar.petersson{at}med.lu.se)
          1. Clinical Sciences Lund, Lund University, Sweden

            Abstract

            Objective: To explore the natural course of knee osteoarthritis (OA) in a middle-aged population with chronic knee pain.

            Methods: A population-based sample of 143 individuals (mean age 45 (range 35-54), 44% women) with knee pain (> 3 months) at inclusion was studied. Weight-bearing postero-anterior tibiofemoral (TF) radiographs were obtained at baseline and 12 years later, and classified according to Kellgren/Lawrence (K/L). Patellofemoral (PF) OA was determined at 5 and 12 year follow-up using a skyline view and a cut-off of < 5 mm joint space width. The ACR clinical criteria were used at baseline.

            Results: Seventy-six (53%) had no TF OA (K/L 0) at baseline, whereof 49 had clinical OA. Overall, 65/76 (86%) developed incident TF OA over 12 years (K/L ≥1); 44/49 (90%) of the individuals with clinical OA and 21/27 (78%) without clinical OA. Progression was found in 65/67 (97%) with TF OA at baseline. Of the 84 with no PF OA at the 5 year examination, 26 (31%) developed PF OA over 7 years.

            Conclusion: A majority of the individuals with chronic knee pain developed knee OA over 12 years. We conclude that knee pain is often the first sign of knee OA.

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