Identification of pre-clinical osteoarthritis: the first step for early treatment
01 / 2006 - onbekend
Osteoarthritis (OA) is a chronic progressive disease leading to severe disability and pain. Current OA treatment is mainly symptom driven. Studies on the effectiveness of possible disease modifiers in OA have produced variable results; these interventions, however, were investigated in patients with clinically established OA with manifest radiological degenerative changes implying irreversible joint damage. Treatment with (possible) disease-modifying interventions might be more successful in pre-clinical OA, and should be studied in that particular disease stage. However, it is not yet possible to define populations at extremely high risk, or populations already showing early signs of OA, that would allow to study the effect of preventive or early interventions. Moreover, it is not yet known what early signs of OA can best be used as intermediate outcomes to a clinically manifest OA several years later. Therefore, the proposed project has two major aims: 1) to identify early predictive signs of clinically manifest OA of the knee in a predefined high-risk group, and 2) to identify extremely high-risk groups to develop knee OA, by establishing what additional factors determine a clinically manifest OA in a pre-defined high-risk group. For this aim, we will study the large high-risk group for knee OA of overweight middle-aged women. In a prospective cohort of 400 overweight women aged 45-55 years who have not yet consulted for knee complaints, possible determinants of OA, possible early signs of development of OA, and the development of clinically manifest knee OA will be measured. The cohort will be followed for at least three years and will be measured with one and a half year intervals.