目的

        ：主訴骨擦音是指在關節或關節周圍聽到摩擦音，破裂音或者爆裂聲。我們目的是通過一項多中心縱向美國隊列研究骨關節炎聯盟(OAI)評價骨擦音和症狀性膝骨關節炎(SOA)發生之間的關係。

方法：

        納入尚無SOA的患者。在0，12，24，36月分別使用膝關節損傷和骨關節炎結局評分(KOOS)的調查問卷評價骨擦音頻率。從0月評價膝關節痛頻率及放射學直到48個月。放射學OA(ROA)為脛股Kellgren &Lawrence (KL) 評分≥2。SOA定義為同時具有持續的症狀和ROA。以從未主訴骨擦音的作為對照組，校正年齡、性別和BMI後對骨擦音的預測因素和SOA發生結局重複進行測量分析。

結果

        ：3495例入組者(男性42%)平均年齡61.1(9.2)歲，平均BMI 28.2(4.7)kg/m2。骨擦音發生的越頻繁(從不，很少，偶爾，經常，總是)，SOA發生的相對風險越高;校正的相對風險為(參考)1.5，1.8，2.2，3.0(P<0.0001)。該觀察中具有ROA但沒有臨床表現的患者占了26%，但占了發生SOA的75%以上。

結論

        ：在這些沒有SOA的病例中，主觀感覺骨擦音縱向預測SOA的發生，其中大多數病例為存在脛股ROA而沒有持續的膝關節痛。一個重要的局限性是在OAI中沒有係統性的評價臏股OA。主訴骨擦感可用於風險人群、預測模型的確定及將來的研究。

        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]