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      The Prevalence of Symptomatic Knee Osteoarthritis in Relation to Age, Sex, Area, Region, and Body Mass Index in China: A Systematic Review and Meta-Analysis

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          Abstract

          Purpose: This study aimed to investigate the overall prevalence of symptomatic knee osteoarthritis (OA) in China by conducting a meta-analysis.

          Methods: Six databases were searched for articles published from the date of inception to October 1, 2017, based on the Population, Intervention, Comparator, Outcomes (PICO) framework. The review was in line with preferred reporting items for systematic reviews and meta-analyses (PRISMA) guidelines. The χ 2-based Q statistic and I 2 metrics were used for exploring the sources of heterogeneity. Random models were utilized to obtain prevalence estimates due to the heterogeneity that was observed. Comprehensive Meta-Analysis version 2.0 was used for assessing publication bias by inspecting funnel plots and Egger's tests.

          Results: Twenty-one eligible studies (74,908 participants in total) were identified. The overall pooled prevalence of symptomatic knee OA in China was 14.6%. The prevalence of symptomatic knee OA presented a rapid growth trend between the periods of 1990–2008 and 2008–2013 (9.1 vs. 20.1%, p = 0.005). However, after 2013, the prevalence dropped to 14.9% ( p = 0.01). The prevalence rates of symptomatic knee OA increased with age and presented an almost linear growth after 40 years of age. Compared with males (10.9%), females (19.1%) exhibited a higher prevalence of symptomatic knee OA ( p = 0.015). The symptomatic knee OA prevalence was significantly higher in rural than it was in urban areas (16.9 vs. 11.1%, p = 0.037).

          Conclusion: For symptomatic knee OA intervention, more attention should be paid to females, people in rural areas, and people aged over 40 years.

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          Knee pain and osteoarthritis in older adults: a review of community burden and current use of primary health care.

          G. Peat, R. McCarney, P. Croft (2001)
          Osteoarthritis is the single most common cause of disability in older adults, and most patients with the condition will be managed in the community and primary care. To discuss case definition of knee osteoarthritis for primary care and to summarise the burden of the condition in the community and related use of primary health care in the United Kingdom. Narrative review. A literature search identified studies of incidence and prevalence of knee pain, disability, and radiographic osteoarthritis in the general population, and data related to primary care consultations. Findings from UK studies were summarised with reference to European and international studies. During a one year period 25% of people over 55 years have a persistent episode of knee pain, of whom about one in six in the UK and the Netherlands consult their general practitioner about it in the same time period. The prevalence of painful disabling knee osteoarthritis in people over 55 years is 10%, of whom one quarter are severely disabled. Knee osteoarthritis sufficiently severe to consider joint replacement represents a minority of all knee pain and disability suffered by older people. Healthcare provision in primary care needs to focus on this broader group to impact on community levels of pain and disability.
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            EULAR evidence based recommendations for the management of hip osteoarthritis: report of a task force of the EULAR Standing Committee for International Clinical Studies Including Therapeutics (ESCISIT).

            W. Zhang, Stefan Lohmander (2005)
            To develop evidence based recommendations for the management of hip osteoarthritis (OA). The multidisciplinary guideline development group comprised 18 rheumatologists, 4 orthopaedic surgeons, and 1 epidemiologist, representing 14 European countries. Each participant contributed up to 10 propositions describing key clinical aspects of hip OA management. Ten final recommendations were agreed using a Delphi consensus approach. Medline, Embase, CINAHL, Cochrane Library, and HTA reports were searched systematically to obtain research evidence for each proposition. Where possible, outcome data for efficacy, adverse effects, and cost effectiveness were abstracted. Effect size, rate ratio, number needed to treat, and incremental cost effectiveness ratio were calculated. The quality of evidence was categorised according to the evidence hierarchy. The strength of recommendation was assessed using the traditional A-D grading scale and a visual analogue scale. Ten key treatment propositions were generated through three Delphi rounds. They included 21 interventions, such as paracetamol, NSAIDs, symptomatic slow acting disease modifying drugs, opioids, intra-articular steroids, non-pharmacological treatment, total hip replacement, osteotomy, and two general propositions. 461 studies were identified from the literature search for the proposed interventions of efficacy, side effects, and cost effectiveness. Research evidence supported 15 interventions in the treatment of hip OA. Evidence specific for the hip was strikingly lacking. Strength of recommendation varied according to category of research evidence and expert opinion. Ten key recommendations for the treatment of hip OA were developed based on research evidence and expert consensus. The effectiveness and cost effectiveness of these recommendations were evaluated and the strength of recommendation was scored.
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              Knee extensor muscle weakness is a risk factor for development of knee osteoarthritis. A systematic review and meta-analysis.

              B Oiestad, C B Juhl, I Eitzen … (2015)
              The objective of this study was to perform a systematic review and meta-analysis on the association between knee extensor muscle weakness and the risk of developing knee osteoarthritis. A systematic review and meta-analysis was conducted with literature searches in Medline, SPORTDiscus, EMBASE, CINAHL, and AMED. Eligible studies had to include participants with no radiographic or symptomatic knee osteoarthritis at baseline; have a follow-up time of a minimum of 2 years, and include a measure of knee extensor muscle strength. Hierarchies for extracting data on knee osteoarthritis and knee extensor muscle strength were defined prior to data extraction. Meta-analysis was applied on the basis of the odds ratios (ORs) of developing symptomatic knee osteoarthritis or radiographic knee osteoarthritis in subjects with knee extensor muscle weakness. ORs for knee osteoarthritis and 95% confidence intervals (CI) were estimated and combined using a random effects model. Twelve studies were eligible for inclusion in the meta-analysis after the initial searches. Five cohort studies with a follow-up time between 2.5 and 14 years, and a total number of 5707 participants (3553 males and 2154 females), were finally included. The meta-analysis showed an overall increased risk of developing symptomatic knee osteoarthritis in participants with knee extensor muscle weakness (OR 1.65 95% CI 1.23, 2.21; I(2) = 50.5%). This systematic review and meta-analysis showed that knee extensor muscle weakness was associated with an increased risk of developing knee osteoarthritis in both men and women.
              Article 0 comments Cited 152 times – based on 0 reviews     Review now
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                Author and article information

                Contributors
                Journal
                Journal ID (nlm-ta): Front Med (Lausanne)
                Journal ID (iso-abbrev): Front Med (Lausanne)
                Journal ID (publisher-id): Front. Med.
                Title: Frontiers in Medicine
                Publisher: Frontiers Media S.A.
                ISSN (Electronic): 2296-858X
                Publication date (Electronic): 16 July 2020
                Publication date Collection: 2020
                Volume: 7
                Electronic Location Identifier: 304
                Affiliations
                [1] 1Department of Pathology, Renji Hospital, School of Medicine, Shanghai Jiao Tong University , Shanghai, China
                [2] 2Department of Clinical Laboratory, Eye & ENT Hospital, Shanghai Medical College, Fudan University , Shanghai, China
                [3] 3School of Public Health, Shandong First Medical University , Tai'an, China
                [4] 4Department of Orthopaedics, Jinan City People's Hospital , Shandong, China
                Author notes

                Edited by: Peter Mandl, Medical University of Vienna, Austria

                Reviewed by: Garifallia Sakellariou, University of Pavia, Italy; Shanthi Sabarimurugan, University of Western Australia, Australia

                *Correspondence: Shengjie Li lishengjie6363020@ 123456163.com

                This article was submitted to Rheumatology, a section of the journal Frontiers in Medicine

                †These authors have contributed equally to this work

                Article
                DOI: 10.3389/fmed.2020.00304
                PMC ID: 7378378
                PubMed ID: 32766258
                SO-VID: 4dfed6be-175e-4980-b709-806795396345
                Copyright © Copyright © 2020 Li, Li, Chen and Xie.
                License:

                This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

                History
                Date received : 12 February 2020
                Date accepted : 27 May 2020
                Page count
                Figures: 5, Tables: 1, Equations: 0, References: 57, Pages: 12, Words: 6530
                Categories
                Subject: Medicine
                Subject: Systematic Review

                Keywords: osteoarthritis,prevalence,age,sex,area,region
                Data availability:
                Keywords: osteoarthritis, prevalence, age, sex, area, region

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