MedicalResearch.com Interview with:
Grace H. Lo MD MSc
Department of Medicine, Baylor College of Medicine
Medical Care Line and Research Care Line, Houston VA HSR&D Center for Innovations in Quality, Effectiveness and Safety
Michael E. DeBakey Medical Center, Houston, TX
MedicalResearch.com: What is the background for this study? What are the main findings?
Response: Osteoarthritis is the most common form of arthritis. Many people who have signs of osteoarthritis on x-rays do not necessarily complain of pain. Presently, there are no known strategies for preventing the development of pain in this group of people.
This study suggests that if these people have noisy knees (otherwise known as “crepitus”), they are at higher risk for developing pain within the next year compared to the people who do not have noisy knees. Future studies that target people who have x-ray signs of osteoarthritis, who do not complain of pain, but do report noisy knees, hold the promise of identifying interventions that can prevent knee pain.
MedicalResearch.com: What should readers take away from your report?
Response: Not all noises coming from a knee are a bad sign. However, in those people who have evidence of osteoarthritis on an x-ray who do not have frequent knee pain, noises coming from a knee can help to predict who is at higher risk for developing frequent knee pain over the following year. So, if you have noisy knees, it might be helpful to ask your primary care provider for a regular x-ray to see if you have evidence of osteoarthritis. And if you do, then, it might be helpful to follow some common sense precautions to decrease the risk of developing frequent knee symptoms. Although there are no formalized clinical trials that identify weight loss in this population will reduce the risk for developing frequent knee pain, it makes sense that this would potentially be helpful. Additionally, we know that injury to knees increases the risk for progression of knee osteoarthritis, so it also probably makes sense to avoid activities that put knees at high risk for injury (i.e. extreme sports like skydiving or high contact sports like football or soccer).
MedicalResearch.com: What recommendations do you have for future research as a result of this study?
Response: It would be helpful to look at the MRIs of the people who had ROA, no pain, and always had crepitus to understand where the pathology is in their knees. This might be helpful to identify interventions that would be most likely to decrease the risk for developing knee pain in this group of people. We would certainly want to include an evaluation of the patellofemoral compartment in this study.
MedicalResearch.com: Is there anything else you would like to add?
Response: I am an Assistant Professor of Medicine in the Section of Immunology, Allergy and Rheumatology at Baylor College of Medicine and Physician and IQuEST (Center for Innovations in Quality, Effectiveness and Safety) Investigator at the Michael E. DeBakey VA Medical Center, Houston, TX. The research in this publication is supported by the National Institute of Arthritis and Musculoskeletal and Skin Diseases of the National Institutes of Health through awards AR062127 and AR060718. The Osteoarthritis Initiative is a public-private partnership comprised of five contracts funded by the National Institutes of Health (N01-AR-2-2258; N01-AR-2-2259; N01-AR-2-2260; N01-AR-2-2261; N01-AR-2-2262) and Private funding partners include Merck Research Laboratories; Novartis Pharmaceuticals Corporation, GlaxoSmithKline; and Pfizer, Inc. Private sector funding for the Osteoarthritis Initiative is managed by the Foundation for the National Institutes of Health. This work was supported in part by the Center for Innovations in Quality, Effectiveness and Safety (#CIN 13-413), Michael E. DeBakey VA Medical Center, Houston, Texas. The views expressed in this article are those of the author(s) and do not necessarily represent the views of the National Institutes of Health or the Department of Veterans Affairs.
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Lo, G. H., Strayhorn, M. T., Driban, J. B., Lyn Price, L., Eaton, C. B. and McAlindon, T. E. (2017), Subjective Crepitus as a Risk Factor for Incident Symptomatic Knee Osteoarthritis: Data from the Osteoarthritis Initiative. Arthritis Care & Research. Accepted Author Manuscript. doi:10.1002/acr.23246
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