Five-year prognosis and impact of adolescent knee pain: A prospective population-based cohort study of 504 adolescents in Denmark

Michael Skovdal Rathleff*, Sinead Holden, Christian Lund Straszek, Jens Lykkegaard Olesen, Martin Bach Jensen, Ewa M. Roos

*Corresponding author for this work

Research output: Contribution to journalJournal articleResearchpeer-review

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Abstract

Objectives: Investigate the prognosis of adolescent knee pain, and evaluate its impact on health, care-seeking and career choices 5 years later. Design: Pre-registered, prospective cohort study. Setting: Population-based cohort initiated in school setting. Participants: From a cohort of 2200 adolescents aged 15-19 years in 2011, 504 reported knee pain on at least a monthly basis, and were followed prospectively in this cohort study, together with 252 controls who did not have knee pain in 2011. Main outcome measures: Outcomes included the Pain and Symptoms subscales from the Knee injury and Osteoarthritis Outcome Score (KOOS), pain intensity measured with a Numeric Rating Scale, pain frequency, knee-related and health-related quality of life, sports participation, physical activity level, KOOS subscales: Function and Sport/recreation, quality of sleep, healthcare consultations, treatments received for their knee pain, the use of painkillers and impact on choice of job or career. Results: At follow-up, 358 (71.0%) from the knee pain group and 182 (72.2%) from the control group responded. Of note, 40.5% (95% CI: 35.4% to 45.6%) from the knee pain group reported knee pain 5 years later which was frequent and intense compared with 13.2% (95% CI: 8.2 to 18.1) of the control group. Those from the knee pain group still suffering from knee pain reported poorer physical health (13 points worse on KOOS Function and 30 points worse on KOOS Sport/recreation), stopped or reduced their sports participation because of knee pain (60%), reported worse sleep quality and worse knee-related and general quality of life. In terms of health behaviours, those still with knee pain reported more healthcare consultations. One-third used pain killers regularly, and 15% (95% CI: 12% to 20%) reported that knee pain influenced their choice of job or career. Conclusion: Four out of every 10 adolescents with knee pain still experienced frequent and intense knee pain 5 years later, severe enough to impact health, health behaviours and career choices.

Original languageEnglish
Article numbere024113
JournalBMJ Open
Volume9
Issue number5
Number of pages9
ISSN2044-6055
DOIs
Publication statusPublished - 28. May 2019

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Denmark
Knee
Cohort Studies
Population
Knee Injuries
Knee Osteoarthritis
Recreation
Health Behavior
Referral and Consultation
Quality of Life
Delivery of Health Care
Control Groups
Quality of Health Care
Health

Keywords

  • care-seeking
  • growing pains;
  • health behaviours
  • musculoskeletal
  • youth

Cite this

Rathleff, Michael Skovdal ; Holden, Sinead ; Straszek, Christian Lund ; Olesen, Jens Lykkegaard ; Jensen, Martin Bach ; Roos, Ewa M. / Five-year prognosis and impact of adolescent knee pain : A prospective population-based cohort study of 504 adolescents in Denmark. In: BMJ Open. 2019 ; Vol. 9, No. 5.
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title = "Five-year prognosis and impact of adolescent knee pain: A prospective population-based cohort study of 504 adolescents in Denmark",
abstract = "Objectives: Investigate the prognosis of adolescent knee pain, and evaluate its impact on health, care-seeking and career choices 5 years later. Design: Pre-registered, prospective cohort study. Setting: Population-based cohort initiated in school setting. Participants: From a cohort of 2200 adolescents aged 15-19 years in 2011, 504 reported knee pain on at least a monthly basis, and were followed prospectively in this cohort study, together with 252 controls who did not have knee pain in 2011. Main outcome measures: Outcomes included the Pain and Symptoms subscales from the Knee injury and Osteoarthritis Outcome Score (KOOS), pain intensity measured with a Numeric Rating Scale, pain frequency, knee-related and health-related quality of life, sports participation, physical activity level, KOOS subscales: Function and Sport/recreation, quality of sleep, healthcare consultations, treatments received for their knee pain, the use of painkillers and impact on choice of job or career. Results: At follow-up, 358 (71.0{\%}) from the knee pain group and 182 (72.2{\%}) from the control group responded. Of note, 40.5{\%} (95{\%} CI: 35.4{\%} to 45.6{\%}) from the knee pain group reported knee pain 5 years later which was frequent and intense compared with 13.2{\%} (95{\%} CI: 8.2 to 18.1) of the control group. Those from the knee pain group still suffering from knee pain reported poorer physical health (13 points worse on KOOS Function and 30 points worse on KOOS Sport/recreation), stopped or reduced their sports participation because of knee pain (60{\%}), reported worse sleep quality and worse knee-related and general quality of life. In terms of health behaviours, those still with knee pain reported more healthcare consultations. One-third used pain killers regularly, and 15{\%} (95{\%} CI: 12{\%} to 20{\%}) reported that knee pain influenced their choice of job or career. Conclusion: Four out of every 10 adolescents with knee pain still experienced frequent and intense knee pain 5 years later, severe enough to impact health, health behaviours and career choices.",
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author = "Rathleff, {Michael Skovdal} and Sinead Holden and Straszek, {Christian Lund} and Olesen, {Jens Lykkegaard} and Jensen, {Martin Bach} and Roos, {Ewa M.}",
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Five-year prognosis and impact of adolescent knee pain : A prospective population-based cohort study of 504 adolescents in Denmark. / Rathleff, Michael Skovdal; Holden, Sinead; Straszek, Christian Lund; Olesen, Jens Lykkegaard; Jensen, Martin Bach; Roos, Ewa M.

In: BMJ Open, Vol. 9, No. 5, e024113, 28.05.2019.

Research output: Contribution to journalJournal articleResearchpeer-review

TY - JOUR

T1 - Five-year prognosis and impact of adolescent knee pain

T2 - A prospective population-based cohort study of 504 adolescents in Denmark

AU - Rathleff, Michael Skovdal

AU - Holden, Sinead

AU - Straszek, Christian Lund

AU - Olesen, Jens Lykkegaard

AU - Jensen, Martin Bach

AU - Roos, Ewa M.

PY - 2019/5/28

Y1 - 2019/5/28

N2 - Objectives: Investigate the prognosis of adolescent knee pain, and evaluate its impact on health, care-seeking and career choices 5 years later. Design: Pre-registered, prospective cohort study. Setting: Population-based cohort initiated in school setting. Participants: From a cohort of 2200 adolescents aged 15-19 years in 2011, 504 reported knee pain on at least a monthly basis, and were followed prospectively in this cohort study, together with 252 controls who did not have knee pain in 2011. Main outcome measures: Outcomes included the Pain and Symptoms subscales from the Knee injury and Osteoarthritis Outcome Score (KOOS), pain intensity measured with a Numeric Rating Scale, pain frequency, knee-related and health-related quality of life, sports participation, physical activity level, KOOS subscales: Function and Sport/recreation, quality of sleep, healthcare consultations, treatments received for their knee pain, the use of painkillers and impact on choice of job or career. Results: At follow-up, 358 (71.0%) from the knee pain group and 182 (72.2%) from the control group responded. Of note, 40.5% (95% CI: 35.4% to 45.6%) from the knee pain group reported knee pain 5 years later which was frequent and intense compared with 13.2% (95% CI: 8.2 to 18.1) of the control group. Those from the knee pain group still suffering from knee pain reported poorer physical health (13 points worse on KOOS Function and 30 points worse on KOOS Sport/recreation), stopped or reduced their sports participation because of knee pain (60%), reported worse sleep quality and worse knee-related and general quality of life. In terms of health behaviours, those still with knee pain reported more healthcare consultations. One-third used pain killers regularly, and 15% (95% CI: 12% to 20%) reported that knee pain influenced their choice of job or career. Conclusion: Four out of every 10 adolescents with knee pain still experienced frequent and intense knee pain 5 years later, severe enough to impact health, health behaviours and career choices.

AB - Objectives: Investigate the prognosis of adolescent knee pain, and evaluate its impact on health, care-seeking and career choices 5 years later. Design: Pre-registered, prospective cohort study. Setting: Population-based cohort initiated in school setting. Participants: From a cohort of 2200 adolescents aged 15-19 years in 2011, 504 reported knee pain on at least a monthly basis, and were followed prospectively in this cohort study, together with 252 controls who did not have knee pain in 2011. Main outcome measures: Outcomes included the Pain and Symptoms subscales from the Knee injury and Osteoarthritis Outcome Score (KOOS), pain intensity measured with a Numeric Rating Scale, pain frequency, knee-related and health-related quality of life, sports participation, physical activity level, KOOS subscales: Function and Sport/recreation, quality of sleep, healthcare consultations, treatments received for their knee pain, the use of painkillers and impact on choice of job or career. Results: At follow-up, 358 (71.0%) from the knee pain group and 182 (72.2%) from the control group responded. Of note, 40.5% (95% CI: 35.4% to 45.6%) from the knee pain group reported knee pain 5 years later which was frequent and intense compared with 13.2% (95% CI: 8.2 to 18.1) of the control group. Those from the knee pain group still suffering from knee pain reported poorer physical health (13 points worse on KOOS Function and 30 points worse on KOOS Sport/recreation), stopped or reduced their sports participation because of knee pain (60%), reported worse sleep quality and worse knee-related and general quality of life. In terms of health behaviours, those still with knee pain reported more healthcare consultations. One-third used pain killers regularly, and 15% (95% CI: 12% to 20%) reported that knee pain influenced their choice of job or career. Conclusion: Four out of every 10 adolescents with knee pain still experienced frequent and intense knee pain 5 years later, severe enough to impact health, health behaviours and career choices.

KW - care-seeking

KW - growing pains;

KW - health behaviours

KW - musculoskeletal

KW - youth

U2 - 10.1136/bmjopen-2018-024113

DO - 10.1136/bmjopen-2018-024113

M3 - Journal article

C2 - 31142518

AN - SCOPUS:85066619820

VL - 9

JO - B M J Open

JF - B M J Open

SN - 2044-6055

IS - 5

M1 - e024113

ER -