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Risk factors for knee osteoarthritis after traumatic knee injury : A systematic review and meta-analysis of randomised controlled trials and cohort studies for the OPTIKNEE Consensus

Whittaker, Jackie L. ; Losciale, Justin M. ; Juhl, Carsten B. ; Thorlund, Jonas Bloch ; Lundberg, Matilde ; Truong, Linda K. ; Miciak, Maxi ; Van Meer, Belle Lore ; Culvenor, Adam G. and Crossley, Kay M. , et al. (2022) In British journal of sports medicine 56(24). p.1406-1421
Abstract

Objective: To identify and quantify potential risk factors for osteoarthritis (OA) following traumatic knee injury. Design: Systematic review and meta-analyses that estimated the odds of OA for individual risk factors assessed in more than four studies using random-effects models. Remaining risk factors underwent semiquantitative synthesis. The modified GRADE (Grading of Recommendations Assessment, Development and Evaluation) approach for prognostic factors guided the assessment. Data sources: MEDLINE, EMBASE, CENTRAL, SPORTDiscus, CINAHL searched from inception to 2009-2021. Eligibility: Randomised controlled trials and cohort studies assessing risk factors for symptomatic or structural OA in persons with a traumatic knee injury, mean... (More)

Objective: To identify and quantify potential risk factors for osteoarthritis (OA) following traumatic knee injury. Design: Systematic review and meta-analyses that estimated the odds of OA for individual risk factors assessed in more than four studies using random-effects models. Remaining risk factors underwent semiquantitative synthesis. The modified GRADE (Grading of Recommendations Assessment, Development and Evaluation) approach for prognostic factors guided the assessment. Data sources: MEDLINE, EMBASE, CENTRAL, SPORTDiscus, CINAHL searched from inception to 2009-2021. Eligibility: Randomised controlled trials and cohort studies assessing risk factors for symptomatic or structural OA in persons with a traumatic knee injury, mean injury age ≤30 years and minimum 2-year follow-up. Results: Across 66 included studies, 81 unique potential risk factors were identified. High risk of bias due to attrition or confounding was present in 64% and 49% of studies, respectively. Ten risk factors for structural OA underwent meta-analysis (sex, rehabilitation for anterior cruciate ligament (ACL) tear, ACL reconstruction (ACLR), ACLR age, ACLR body mass index, ACLR graft source, ACLR graft augmentation, ACLR+cartilage injury, ACLR+partial meniscectomy, ACLR+total medial meniscectomy). Very-low certainty evidence suggests increased odds of structural OA related to ACLR+cartilage injury (OR=2.31; 95% CI 1.35 to 3.94), ACLR+partial meniscectomy (OR=1.87; 1.45 to 2.42) and ACLR+total medial meniscectomy (OR=3.14; 2.20 to 4.48). Semiquantitative syntheses identified moderate-certainty evidence that cruciate ligament, collateral ligament, meniscal, chondral, patellar/tibiofemoral dislocation, fracture and multistructure injuries increase the odds of symptomatic OA. Conclusion: Moderate-certainty evidence suggests that various single and multistructure knee injuries (beyond ACL tears) increase the odds of symptomatic OA. Risk factor heterogeneity, high risk of bias, and inconsistency in risk factors and OA definition make identifying treatment targets for preventing post-traumatic knee OA challenging.

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publishing date
type
Contribution to journal
publication status
published
subject
keywords
anterior cruciate ligament, meniscus, osteoarthritis, risk factor
in
British journal of sports medicine
volume
56
issue
24
pages
1406 - 1421
publisher
BMJ Publishing Group
external identifiers
  • scopus:85137897371
  • pmid:36455966
ISSN
0306-3674
DOI
10.1136/bjsports-2022-105496
language
English
LU publication?
yes
id
176d7fa1-d7ea-4f92-8205-f0bd3a931ce9
date added to LUP
2022-12-05 09:01:05
date last changed
2024-04-18 18:21:11
@article{176d7fa1-d7ea-4f92-8205-f0bd3a931ce9,
  abstract     = {{<p>Objective: To identify and quantify potential risk factors for osteoarthritis (OA) following traumatic knee injury. Design: Systematic review and meta-analyses that estimated the odds of OA for individual risk factors assessed in more than four studies using random-effects models. Remaining risk factors underwent semiquantitative synthesis. The modified GRADE (Grading of Recommendations Assessment, Development and Evaluation) approach for prognostic factors guided the assessment. Data sources: MEDLINE, EMBASE, CENTRAL, SPORTDiscus, CINAHL searched from inception to 2009-2021. Eligibility: Randomised controlled trials and cohort studies assessing risk factors for symptomatic or structural OA in persons with a traumatic knee injury, mean injury age ≤30 years and minimum 2-year follow-up. Results: Across 66 included studies, 81 unique potential risk factors were identified. High risk of bias due to attrition or confounding was present in 64% and 49% of studies, respectively. Ten risk factors for structural OA underwent meta-analysis (sex, rehabilitation for anterior cruciate ligament (ACL) tear, ACL reconstruction (ACLR), ACLR age, ACLR body mass index, ACLR graft source, ACLR graft augmentation, ACLR+cartilage injury, ACLR+partial meniscectomy, ACLR+total medial meniscectomy). Very-low certainty evidence suggests increased odds of structural OA related to ACLR+cartilage injury (OR=2.31; 95% CI 1.35 to 3.94), ACLR+partial meniscectomy (OR=1.87; 1.45 to 2.42) and ACLR+total medial meniscectomy (OR=3.14; 2.20 to 4.48). Semiquantitative syntheses identified moderate-certainty evidence that cruciate ligament, collateral ligament, meniscal, chondral, patellar/tibiofemoral dislocation, fracture and multistructure injuries increase the odds of symptomatic OA. Conclusion: Moderate-certainty evidence suggests that various single and multistructure knee injuries (beyond ACL tears) increase the odds of symptomatic OA. Risk factor heterogeneity, high risk of bias, and inconsistency in risk factors and OA definition make identifying treatment targets for preventing post-traumatic knee OA challenging.</p>}},
  author       = {{Whittaker, Jackie L. and Losciale, Justin M. and Juhl, Carsten B. and Thorlund, Jonas Bloch and Lundberg, Matilde and Truong, Linda K. and Miciak, Maxi and Van Meer, Belle Lore and Culvenor, Adam G. and Crossley, Kay M. and Roos, Ewa M. and Lohmander, Stefan and Van Middelkoop, Marienke}},
  issn         = {{0306-3674}},
  keywords     = {{anterior cruciate ligament; meniscus; osteoarthritis; risk factor}},
  language     = {{eng}},
  number       = {{24}},
  pages        = {{1406--1421}},
  publisher    = {{BMJ Publishing Group}},
  series       = {{British journal of sports medicine}},
  title        = {{Risk factors for knee osteoarthritis after traumatic knee injury : A systematic review and meta-analysis of randomised controlled trials and cohort studies for the OPTIKNEE Consensus}},
  url          = {{http://dx.doi.org/10.1136/bjsports-2022-105496}},
  doi          = {{10.1136/bjsports-2022-105496}},
  volume       = {{56}},
  year         = {{2022}},
}