Evidence for key individual characteristics associated with outcomes following combined first-line interventions for knee osteoarthritis: A systematic review

Jacqui M. Couldrick, Andrew P. Woodward, M. C.Denika Silva, Joseph T. Lynch, Diana M. Perriman, Christian J. Barton, Jennie M. Scarvell

Research output: Contribution to journalArticlepeer-review

2 Citations (Scopus)
29 Downloads (Pure)

Abstract

Objective To identify individual characteristics associated with outcomes following combined first-line interventions for knee osteoarthritis. Methods MEDLINE, CINAHL, Scopus, Web of Science Core Collection and the Cochrane library were searched. Studies were included if they reported an association between baseline factors and change in pain or function following combined exercise therapy, osteoarthritis education, or weight management interventions for knee osteoarthritis. Risk of bias was assessed using Quality in Prognostic Factor Studies. Data was visualised and a narrative synthesis was conducted for key factors (age, sex, BMI, comorbidity, depression, and imaging severity). Results 32 studies were included. Being female compared to male was associated with 2–3 times the odds of a positive response. Older age was associated with reduced odds of a positive response. The effect size (less than 10% reduction) is unlikely to be clinically relevant. It was difficult to conclude whether BMI, comorbidity, depression and imaging severity were associated with pain and function outcomes following a combined first-line intervention for knee osteoarthritis. Low to very low certainty evidence was found for sex, BMI, depression, comorbidity and imaging severity and moderate certainty evidence for age. Varying study methods contributed to some difficulty in drawing clear conclusions. Conclusions This systematic review found no clear evidence to suggest factors such as age, sex, BMI, OA severity and presence of depression or comorbidities are associated with the response to first-line interventions for knee OA. Current evidence indicates that some groups of people may respond equally to first-line interventions, such as those with or without comorbidities. First-line interventions consisting of exercise therapy, education, and weight loss for people with knee OA should be recommended irrespective of sex, age, obesity, comorbidity, depression and imaging findings.

Original languageEnglish
Article numbere0284249
Pages (from-to)1-31
Number of pages31
JournalPLoS One
Volume18
Issue number4 April
DOIs
Publication statusPublished - Apr 2023

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