Is there a causal link between knee loading and knee osteoarthritis progression? A systematic review and meta-analysis of cohort studies and randomised trials

Marius Henriksen, Mark W Creaby, Hans Lund, Carsten Juhl, Robin Christensen

Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

Resumé

OBJECTIVE: We performed a systematic review, meta-analysis and assessed the evidence supporting a causal link between knee joint loading during walking and structural knee osteoarthritis (OA) progression.

DESIGN: Systematic review, meta-analysis and application of Bradford Hill's considerations on causation.

DATA SOURCES: We searched MEDLINE, Scopus, AMED, CINAHL and SportsDiscus for prospective cohort studies and randomised controlled trials (RCTs) from 1950 through October 2013.

STUDY ELIGIBILITY CRITERIA: We selected cohort studies and RCTs in which estimates of knee joint loading during walking were used to predict structural knee OA progression assessed by X-ray or MRI.

DATA ANALYSES: Meta-analysis was performed to estimate the combined OR for structural disease progression with higher baseline loading. The likelihood of a causal link between knee joint loading and OA progression was assessed from cohort studies using the Bradford Hill guidelines to derive a 0-4 causation score based on four criteria and examined for confirmation in RCTs.

RESULTS: Of the 1078 potentially eligible articles, 5 prospective cohort studies were included. The studies included a total of 452 patients relating joint loading to disease progression over 12-72 months. There were very serious limitations associated with the methodological quality of the included studies. The combined OR for disease progression was 1.90 (95% CI 0.85 to 4.25; I(2)=77%) for each one-unit increment in baseline knee loading. The combined causation score was 0, indicating no causal association between knee loading and knee OA progression. No RCTs were found to confirm or refute the findings from the cohort studies.

CONCLUSIONS: There is very limited and low-quality evidence to support for a causal link between knee joint loading during walking and structural progression of knee OA.

TRIAL REGISTRATION NUMBER: CRD42012003253.

OriginalsprogEngelsk
Artikelnummere005368
TidsskriftBMJ Open
Vol/bind4
Udgave nummer7
ISSN2044-6055
DOI
StatusUdgivet - 15. jul. 2014

Fingeraftryk

Knee Osteoarthritis
Meta-Analysis
Knee
Knee Joint
Cohort Studies
Randomized Controlled Trials
Causality
Prospective Studies
MEDLINE
Joints
X-Rays
Guidelines

Citer dette

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abstract = "OBJECTIVE: We performed a systematic review, meta-analysis and assessed the evidence supporting a causal link between knee joint loading during walking and structural knee osteoarthritis (OA) progression.DESIGN: Systematic review, meta-analysis and application of Bradford Hill's considerations on causation.DATA SOURCES: We searched MEDLINE, Scopus, AMED, CINAHL and SportsDiscus for prospective cohort studies and randomised controlled trials (RCTs) from 1950 through October 2013.STUDY ELIGIBILITY CRITERIA: We selected cohort studies and RCTs in which estimates of knee joint loading during walking were used to predict structural knee OA progression assessed by X-ray or MRI.DATA ANALYSES: Meta-analysis was performed to estimate the combined OR for structural disease progression with higher baseline loading. The likelihood of a causal link between knee joint loading and OA progression was assessed from cohort studies using the Bradford Hill guidelines to derive a 0-4 causation score based on four criteria and examined for confirmation in RCTs.RESULTS: Of the 1078 potentially eligible articles, 5 prospective cohort studies were included. The studies included a total of 452 patients relating joint loading to disease progression over 12-72 months. There were very serious limitations associated with the methodological quality of the included studies. The combined OR for disease progression was 1.90 (95{\%} CI 0.85 to 4.25; I(2)=77{\%}) for each one-unit increment in baseline knee loading. The combined causation score was 0, indicating no causal association between knee loading and knee OA progression. No RCTs were found to confirm or refute the findings from the cohort studies.CONCLUSIONS: There is very limited and low-quality evidence to support for a causal link between knee joint loading during walking and structural progression of knee OA.TRIAL REGISTRATION NUMBER: CRD42012003253.",
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Is there a causal link between knee loading and knee osteoarthritis progression? A systematic review and meta-analysis of cohort studies and randomised trials. / Henriksen, Marius; Creaby, Mark W; Lund, Hans ; Juhl, Carsten; Christensen, Robin.

I: BMJ Open, Bind 4, Nr. 7, e005368, 15.07.2014.

Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

TY - JOUR

T1 - Is there a causal link between knee loading and knee osteoarthritis progression?

T2 - A systematic review and meta-analysis of cohort studies and randomised trials

AU - Henriksen, Marius

AU - Creaby, Mark W

AU - Lund, Hans

AU - Juhl, Carsten

AU - Christensen, Robin

N1 - Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

PY - 2014/7/15

Y1 - 2014/7/15

N2 - OBJECTIVE: We performed a systematic review, meta-analysis and assessed the evidence supporting a causal link between knee joint loading during walking and structural knee osteoarthritis (OA) progression.DESIGN: Systematic review, meta-analysis and application of Bradford Hill's considerations on causation.DATA SOURCES: We searched MEDLINE, Scopus, AMED, CINAHL and SportsDiscus for prospective cohort studies and randomised controlled trials (RCTs) from 1950 through October 2013.STUDY ELIGIBILITY CRITERIA: We selected cohort studies and RCTs in which estimates of knee joint loading during walking were used to predict structural knee OA progression assessed by X-ray or MRI.DATA ANALYSES: Meta-analysis was performed to estimate the combined OR for structural disease progression with higher baseline loading. The likelihood of a causal link between knee joint loading and OA progression was assessed from cohort studies using the Bradford Hill guidelines to derive a 0-4 causation score based on four criteria and examined for confirmation in RCTs.RESULTS: Of the 1078 potentially eligible articles, 5 prospective cohort studies were included. The studies included a total of 452 patients relating joint loading to disease progression over 12-72 months. There were very serious limitations associated with the methodological quality of the included studies. The combined OR for disease progression was 1.90 (95% CI 0.85 to 4.25; I(2)=77%) for each one-unit increment in baseline knee loading. The combined causation score was 0, indicating no causal association between knee loading and knee OA progression. No RCTs were found to confirm or refute the findings from the cohort studies.CONCLUSIONS: There is very limited and low-quality evidence to support for a causal link between knee joint loading during walking and structural progression of knee OA.TRIAL REGISTRATION NUMBER: CRD42012003253.

AB - OBJECTIVE: We performed a systematic review, meta-analysis and assessed the evidence supporting a causal link between knee joint loading during walking and structural knee osteoarthritis (OA) progression.DESIGN: Systematic review, meta-analysis and application of Bradford Hill's considerations on causation.DATA SOURCES: We searched MEDLINE, Scopus, AMED, CINAHL and SportsDiscus for prospective cohort studies and randomised controlled trials (RCTs) from 1950 through October 2013.STUDY ELIGIBILITY CRITERIA: We selected cohort studies and RCTs in which estimates of knee joint loading during walking were used to predict structural knee OA progression assessed by X-ray or MRI.DATA ANALYSES: Meta-analysis was performed to estimate the combined OR for structural disease progression with higher baseline loading. The likelihood of a causal link between knee joint loading and OA progression was assessed from cohort studies using the Bradford Hill guidelines to derive a 0-4 causation score based on four criteria and examined for confirmation in RCTs.RESULTS: Of the 1078 potentially eligible articles, 5 prospective cohort studies were included. The studies included a total of 452 patients relating joint loading to disease progression over 12-72 months. There were very serious limitations associated with the methodological quality of the included studies. The combined OR for disease progression was 1.90 (95% CI 0.85 to 4.25; I(2)=77%) for each one-unit increment in baseline knee loading. The combined causation score was 0, indicating no causal association between knee loading and knee OA progression. No RCTs were found to confirm or refute the findings from the cohort studies.CONCLUSIONS: There is very limited and low-quality evidence to support for a causal link between knee joint loading during walking and structural progression of knee OA.TRIAL REGISTRATION NUMBER: CRD42012003253.

U2 - 10.1136/bmjopen-2014-005368

DO - 10.1136/bmjopen-2014-005368

M3 - Journal article

C2 - 25031196

VL - 4

JO - B M J Open

JF - B M J Open

SN - 2044-6055

IS - 7

M1 - e005368

ER -