Abstract:
:Because the pathophysiology of knee osteoarthritis is poorly understood, optimal evidence-based clinical management is uncertain. Sibling comparison studies can help inform a clinical model to guide preventive care. We compared the 8-year clinical outcomes in 2 sisters with a family history of osteoarthritis, normal BMI, and absence of knee pain at baseline. Both patients had Kellgren-Lawrence grade 1 in the affected knee at the time of twisting knee injuries leading to osteoarthritis diagnoses at age 50 (patient 1) and 51 (patient 2). Patient 1 developed a chronic right knee effusion, and progressed to Kellgren-Lawrence grade 3 bilaterally by the time she had a right total knee replacement at age 58. Patient 2 had subchondral fractures of the right knee with transient effusion, which healed after 1 year of partial weight-bearing with crutches and subsequent daily use of knee sleeves. Patient 2 had Kellgren-Lawrence grade 0 bilaterally upon surveillance imaging at age 58. The terms "osteoarthritis and knee and diagnostic imaging and subchondral bone and pathophysiology" were searched in the PubMed database to identify original research articles to inform a clinical model consistent with the patients' outcomes. A fluid model of osteoarthritis was the best explanatory model for the discordant clinical trajectories of the age-matched siblings. Patient recommendations are presented based on these findings.
journal_name
Clin Rheumatoljournal_title
Clinical rheumatologyauthors
Gourlay ML,Gourlay LLdoi
10.1007/s10067-020-05181-6subject
Has Abstractpub_date
2020-10-01 00:00:00pages
3105-3113issue
10eissn
0770-3198issn
1434-9949pii
10.1007/s10067-020-05181-6journal_volume
39pub_type
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journal_title:Clinical rheumatology
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journal_title:Clinical rheumatology
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journal_title:Clinical rheumatology
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journal_title:Clinical rheumatology
pub_type: 杂志文章,已发布勘误
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journal_title:Clinical rheumatology
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journal_title:Clinical rheumatology
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journal_title:Clinical rheumatology
pub_type: 杂志文章
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journal_title:Clinical rheumatology
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journal_title:Clinical rheumatology
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journal_title:Clinical rheumatology
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journal_title:Clinical rheumatology
pub_type: 杂志文章
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journal_title:Clinical rheumatology
pub_type: 杂志文章
doi:10.1007/BF02208035
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journal_title:Clinical rheumatology
pub_type: 杂志文章,评审
doi:10.1007/s10067-014-2721-0
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pub_type: 杂志文章,已发布勘误
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journal_title:Clinical rheumatology
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journal_title:Clinical rheumatology
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