Knee osteoarthritis improvement predictors

Meaningful improvement is common among patients who have or are at risk for osteoarthritis (OA) of the knee 30 months after initial assessment. Improvements occur more frequently in persons who do not have evidence of radiographic OA and in those who have fast walking speeds.

To determine what factors might influence or predict a patient’s level of activity after receiving a diagnosis of OA, White and associates examined data from 1801 participants in the longitudinal Multicenter Osteoarthritis Study (MOST). They used the Western Ontario McMaster Universities Osteoarthritis Index (WOMAC) to identify minimal clinically important (to the patient) improvement (MCII).

MOST patients who attained MCII had several shared characteristics that set them apart from those with functional limitations: a lower body mass index, less radiographic OA and knee pain, fewer depressive symptoms, less medication use, faster walking speed, and stronger knees. The strongest predictors of functionality were radiographic OA and walking speed: persons with no radiographic OA were 40% to 50% more likely to achieve MCII, and those who walked 1.0 m/s faster were twice as likely to remain functional.

The authors noted that physicians might consider predictors of functionality in trying to determine who may benefit from therapeutic intervention.