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典型文献
Eight-year trajectories of malalignment progression in symptomatic knee osteoarthritis
文献摘要:
Background::Although various therapies have been developed to treat malalignment in osteoarthritic knees, the pattern of malalignment progression is still unclear. This study aimed to identify homogeneous subgroups with distinct trajectories of malalignment progression in subjects with symptomatic knee osteoarthritis (KOA) and to determine corresponding risk factors.Methods::Eight-year follow-up (from 2004 to 2012) data on 1252 participants with symptomatic KOA from the Osteoarthritis Initiative were included. Varus/valgus angle progression was characterized by group-based trajectory models. Time-varying covariates were introduced into the model to investigate how they affected trajectories. Multinomial logistic regression for trajectory group membership was applied to ascertain risk factors.Results::Five subgroups were identified. Participants in the varus worsening trajectory ( n = 166) or valgus worsening trajectory ( n = 118) proceeded to worsen malalignment over time. The neutral trajectory ( n = 378), varus stable trajectory ( n = 328), and valgus stable trajectory ( n = 262) maintained close to the initial varus/valgus angle over 8 years. Higher baseline Kellgren and Lawrence grade (odds ratio [OR] = 4.35, P < 0.001 for varus; OR= 3.85, P < 0.001 for valgus) and "severe" baseline malalignment (OR = 13.57, P < 0.001 for varus; OR = 23.04, P < 0.001 for valgus) were risk factors for worsening trajectories. The cutoff point of the baseline varus/valgus angle to discriminate between stable or worsening trajectory was -4.5° for varus and 3.6° for valgus. Conclusions::This study identified the malalignment progression pattern — minor malalignment (-4.5° to +3.6°) tends to remain stable, while major baseline malalignment is likely to progress. This provides a reference for therapy to prevent malalignment from deteriorating and emphasizes the necessity of determining the trigger factors for malalignment onset.
文献关键词:
Malalignment;Knee osteoarthritis;Group-based trajectory modeling
作者姓名:
Li Mingyang;Nie Yong;Zeng Yi;Wu Yuangang;Wu Limin;Liu Yuan;Shen Bin
作者机构:
Department of Orthopedics, Orthopedic Research Institute, West China Hospital, Sichuan University, Chengdu, Sichuan 610041, China
引用格式:
[1]Li Mingyang;Nie Yong;Zeng Yi;Wu Yuangang;Wu Limin;Liu Yuan;Shen Bin-.Eight-year trajectories of malalignment progression in symptomatic knee osteoarthritis)[J].中华医学杂志(英文版),2022(21):2570-2576
A类:
malalignment,osteoarthritic,Varus,Malalignment
B类:
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AB值:
0.438359
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