Symptomatic Progression of Knee and Hip Osteoarthritis in Primary Care

Chapter 2 contains a systematic review of all available evidence for prognostic factors for the clinical progression of knee OA. This is one of the first systematic reviews of its kind.
Chapter 3 reviews the evidence for prognostic factors for radiographic progression of knee OA. This is an update of a systematic review, previously published in 2007. However, the literature search of the original review had been performed up to December 2003 and many articles studying radiographic progression of knee OA have been published in the decade thereafter.
Chapter 4 presents patient- and disease characteristics associated with pain progression in individuals with early symptomatic knee OA during a 5-year follow-up period. Latent Class Growth Analyses were used to create pain trajectories obtained from multiple knee pain assessments over time. Data for this chapter were obtained from the CHECK study.
Chapter 5 describes patient- and disease characteristics associated with pain progression in individuals with early symptomatic hip OA during a 5-year follow-up period. Latent Class Growth Analyses were used to create pain trajectories obtained from multiple hip pain assessments over time. Data for this chapter were also obtained from the CHECK study.
Chapter 6 presents risk factors for rapid symptomatic progression of knee and hip OA, leading to undergoing total joint replacement surgery of the knee and/or hip within six years after first presentation of symptoms to a physician. Data for this chapter were obtained from the CHECK study.
Chapter 7 tests the hypothesis using Structural Equation Modeling that pain coping behavior plays a role in the causal pathway, i.e. acts as a mediating factor between pain severity and role limitations in patients with lower limb OA over a 5-year follow-up period. Substantial benefit could be achieved by focusing on pain coping behavior in the management of symptomatic knee or hip OA. Data for this chapter were obtained from the CHECK study.
Chapter 8 discusses the results, recommendations for future research and implications for clinical practice of this thesis.