目的

        ：主诉骨擦音是指在关节或关节周围听到摩擦音，破裂音或者爆裂声。我们目的是通过一项多中心纵向美国队列研究骨关节炎联盟(OAI)评价骨擦音和症状性膝骨关节炎(SOA)发生之间的关系。

方法：

        纳入尚无SOA的患者。在0，12，24，36月分别使用膝关节损伤和骨关节炎结局评分(KOOS)的调查问卷评价骨擦音频率。从0月评价膝关节痛频率及放射学直到48个月。放射学OA(ROA)为胫股Kellgren &Lawrence (KL) 评分≥2。SOA定义为同时具有持续的症状和ROA。以从未主诉骨擦音的作为对照组，校正年龄、性别和BMI后对骨擦音的预测因素和SOA发生结局重复进行测量分析。

结果

        ：3495例入组者(男性42%)平均年龄61.1(9.2)岁，平均BMI 28.2(4.7)kg/m2。骨擦音发生的越频繁(从不，很少，偶尔，经常，总是)，SOA发生的相对风险越高;校正的相对风险为(参考)1.5，1.8，2.2，3.0(P<0.0001)。该观察中具有ROA但没有临床表现的患者占了26%，但占了发生SOA的75%以上。

结论

        ：在这些没有SOA的病例中，主观感觉骨擦音纵向预测SOA的发生，其中大多数病例为存在胫股ROA而没有持续的膝关节痛。一个重要的局限性是在OAI中没有系统性的评价膑股OA。主诉骨擦感可用于风险人群、预测模型的确定及将来的研究。

        END

        附原文：

OBJECTIVE

        :Subjective crepitus is the complaint of hearing grating, cracking or popping sounds in and/or around a joint. We aimed to evaluate whether there is an association between crepitus and incident symptomatic knee osteoarthritis (SOA) in the Osteoarthritis Initiative (OAI), a multicenter longitudinal U.S. cohort.

METHODS

        :Knees without baseline SOA were included. Crepitus frequency was assessed using a question from the Knee Injury and Osteoarthritis Outcome Score (KOOS) at baseline, 12-, 24-, and 36-month visits. Frequent knee pain and radiographs were assessed at baseline and annual visits up to 48-months. Radiographic OA (ROA) was tibiofemoral Kellgren and Lawrence (KL) grade ≥ 2. SOA was a knee with both frequent symptoms and ROA. We performed a repeated measures analysis with a predictor of crepitus and outcome of incident SOA, adjusting for age, sex, and BMI where never complaining of crepitus was the referent group.

RESULTS

        :3495 participants (42.2% male) with mean age of 61.1 (9.2) years, mean BMI of 28.2 (4.7) kg/m2. Odds of incident SOA was higher with greater frequency of creitus (never, rarely, sometimes, often, always); adjusted odds ratios were (referent), 1.5, 1.8, 2.2, 3.0 (p for trend < 0.0001). The group at OAI baseline with ROA but without symptoms contributed 26% of the observations, but over 75% of the incident SOA cases.

CONCLUSION

        :Among those without SOA, subjective knee crepitus predicts incident SOA longitudinally, with most cases occurring in those with pre-existing tibiofemoral ROA but without frequent knee pain. An important limitation is that patellofemoral OA was not systematically evaluated within the OAI. Subjective crepitus offers utility for identification of at-risk individuals, predictive modeling, and future research.

        引自：Lo GH, Strayhorn MT, Driban JB, et al. Subjective Crepitus as a Risk Factor for Incident Symptomatic Knee Osteoarthritis: Data from the Osteoarthritis Initiative. Arthritis Care Res (Hoboken). 2017 May 4. [Epub ahead of print]