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<record><TEI><teiHeader><fileDesc><titleStmt><title xml:lang="en">OARSI/OMERACT Initiative to Define States of Severity and Indication for Joint Replacement in Hip and Knee Osteoarthritis. An OMERACT 10 Special Interest Group</title><author><name sortKey="Gossec, Laure" sort="Gossec, Laure" uniqKey="Gossec L" first="Laure" last="Gossec">Laure Gossec</name></author><author><name sortKey="Paternotte, Simon" sort="Paternotte, Simon" uniqKey="Paternotte S" first="Simon" last="Paternotte">Simon Paternotte</name></author><author><name sortKey="Bingham, Clifton O" sort="Bingham, Clifton O" uniqKey="Bingham C" first="Clifton O." last="Bingham">Clifton O. Bingham</name></author><author><name sortKey="Clegg, Daniel O" sort="Clegg, Daniel O" uniqKey="Clegg D" first="Daniel O." last="Clegg">Daniel O. Clegg</name></author><author><name sortKey="Coste, Philippe" sort="Coste, Philippe" uniqKey="Coste P" first="Philippe" last="Coste">Philippe Coste</name></author><author><name sortKey="Conaghan, Philip G" sort="Conaghan, Philip G" uniqKey="Conaghan P" first="Philip G." last="Conaghan">Philip G. Conaghan</name></author><author><name sortKey="Davis, Aileen M" sort="Davis, Aileen M" uniqKey="Davis A" first="Aileen M." last="Davis">Aileen M. Davis</name></author><author><name sortKey="Giacovelli, Giampaolo" sort="Giacovelli, Giampaolo" uniqKey="Giacovelli G" first="Giampaolo" last="Giacovelli">Giampaolo Giacovelli</name></author><author><name sortKey="Gunther, Klaus Peter" sort="Gunther, Klaus Peter" uniqKey="Gunther K" first="Klaus-Peter" last="Gunther">Klaus-Peter Gunther</name></author><author><name sortKey="Hawker, Gillian" sort="Hawker, Gillian" uniqKey="Hawker G" first="Gillian" last="Hawker">Gillian Hawker</name></author><author><name sortKey="Hochberg, Marc C" sort="Hochberg, Marc C" uniqKey="Hochberg M" first="Marc C." last="Hochberg">Marc C. Hochberg</name></author><author><name sortKey="Jordan, Joanne M" sort="Jordan, Joanne M" uniqKey="Jordan J" first="Joanne M." last="Jordan">Joanne M. Jordan</name></author><author><name sortKey="Katz, Jeffrey N" sort="Katz, Jeffrey N" uniqKey="Katz J" first="Jeffrey N." last="Katz">Jeffrey N. Katz</name></author><author><name sortKey="Kloppenburg, Margreet" sort="Kloppenburg, Margreet" uniqKey="Kloppenburg M" first="Margreet" last="Kloppenburg">Margreet Kloppenburg</name></author><author><name sortKey="Lanzarotti, Arturo" sort="Lanzarotti, Arturo" uniqKey="Lanzarotti A" first="Arturo" last="Lanzarotti">Arturo Lanzarotti</name></author><author><name sortKey="Lim, Keith" sort="Lim, Keith" uniqKey="Lim K" first="Keith" last="Lim">Keith Lim</name></author><author><name sortKey="Lohmander, L Stefan" sort="Lohmander, L Stefan" uniqKey="Lohmander L" first="L. Stefan" last="Lohmander">L. Stefan Lohmander</name></author><author><name sortKey="Mahomed, Nizar N" sort="Mahomed, Nizar N" uniqKey="Mahomed N" first="Nizar N." last="Mahomed">Nizar N. Mahomed</name></author><author><name sortKey="Maillefert, Jean Francis" sort="Maillefert, Jean Francis" uniqKey="Maillefert J" first="Jean Francis" last="Maillefert">Jean Francis Maillefert</name></author><author><name sortKey="Manno, Rebecca L" sort="Manno, Rebecca L" uniqKey="Manno R" first="Rebecca L." last="Manno">Rebecca L. Manno</name></author><author><name sortKey="March, Lyn M" sort="March, Lyn M" uniqKey="March L" first="Lyn M." last="March">Lyn M. March</name></author><author><name sortKey="Mazzuca, Steven A" sort="Mazzuca, Steven A" uniqKey="Mazzuca S" first="Steven A." last="Mazzuca">Steven A. Mazzuca</name></author><author><name sortKey="Pavelka, Karel" sort="Pavelka, Karel" uniqKey="Pavelka K" first="Karel" last="Pavelka">Karel Pavelka</name></author><author><name sortKey="Punzi, Leonardo" sort="Punzi, Leonardo" uniqKey="Punzi L" first="Leonardo" last="Punzi">Leonardo Punzi</name></author><author><name sortKey="Roos, Ewa M" sort="Roos, Ewa M" uniqKey="Roos E" first="Ewa M." last="Roos">Ewa M. Roos</name></author><author><name sortKey="Rovati, Lucio C" sort="Rovati, Lucio C" uniqKey="Rovati L" first="Lucio C." last="Rovati">Lucio C. Rovati</name></author><author><name sortKey="Shi, Helen" sort="Shi, Helen" uniqKey="Shi H" first="Helen" last="Shi">Helen Shi</name></author><author><name sortKey="Singh, Jasvinder A" sort="Singh, Jasvinder A" uniqKey="Singh J" first="Jasvinder A." last="Singh">Jasvinder A. Singh</name></author><author><name sortKey="Suarez Almazor, Maria E" sort="Suarez Almazor, Maria E" uniqKey="Suarez Almazor M" first="Maria E." last="Suarez-Almazor">Maria E. Suarez-Almazor</name></author><author><name sortKey="Tajana Messi, Eleonora" sort="Tajana Messi, Eleonora" uniqKey="Tajana Messi E" first="Eleonora" last="Tajana-Messi">Eleonora Tajana-Messi</name></author><author><name sortKey="Dougados, Maxime" sort="Dougados, Maxime" uniqKey="Dougados M" first="Maxime" last="Dougados">Maxime Dougados</name></author></titleStmt><publicationStmt><idno type="wicri:source">PMC</idno><idno type="pmid">21807799</idno><idno type="pmc">3260473</idno><idno type="url">http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3260473</idno><idno type="RBID">PMC:3260473</idno><idno type="doi">10.3899/jrheum.110403</idno><date when="2011">2011</date><idno type="wicri:Area/Pmc/Corpus">001545</idno><idno type="wicri:explorRef" wicri:stream="Pmc" wicri:step="Corpus" wicri:corpus="PMC">001545</idno></publicationStmt><sourceDesc><biblStruct><analytic><title xml:lang="en" level="a" type="main">OARSI/OMERACT Initiative to Define States of Severity and Indication for Joint Replacement in Hip and Knee Osteoarthritis. An OMERACT 10 Special Interest Group</title><author><name sortKey="Gossec, Laure" sort="Gossec, Laure" uniqKey="Gossec L" first="Laure" last="Gossec">Laure Gossec</name></author><author><name sortKey="Paternotte, Simon" sort="Paternotte, Simon" uniqKey="Paternotte S" first="Simon" last="Paternotte">Simon Paternotte</name></author><author><name sortKey="Bingham, Clifton O" sort="Bingham, Clifton O" uniqKey="Bingham C" first="Clifton O." last="Bingham">Clifton O. Bingham</name></author><author><name sortKey="Clegg, Daniel O" sort="Clegg, Daniel O" uniqKey="Clegg D" first="Daniel O." last="Clegg">Daniel O. Clegg</name></author><author><name sortKey="Coste, Philippe" sort="Coste, Philippe" uniqKey="Coste P" first="Philippe" last="Coste">Philippe Coste</name></author><author><name sortKey="Conaghan, Philip G" sort="Conaghan, Philip G" uniqKey="Conaghan P" first="Philip G." last="Conaghan">Philip G. Conaghan</name></author><author><name sortKey="Davis, Aileen M" sort="Davis, Aileen M" uniqKey="Davis A" first="Aileen M." last="Davis">Aileen M. Davis</name></author><author><name sortKey="Giacovelli, Giampaolo" sort="Giacovelli, Giampaolo" uniqKey="Giacovelli G" first="Giampaolo" last="Giacovelli">Giampaolo Giacovelli</name></author><author><name sortKey="Gunther, Klaus Peter" sort="Gunther, Klaus Peter" uniqKey="Gunther K" first="Klaus-Peter" last="Gunther">Klaus-Peter Gunther</name></author><author><name sortKey="Hawker, Gillian" sort="Hawker, Gillian" uniqKey="Hawker G" first="Gillian" last="Hawker">Gillian Hawker</name></author><author><name sortKey="Hochberg, Marc C" sort="Hochberg, Marc C" uniqKey="Hochberg M" first="Marc C." last="Hochberg">Marc C. Hochberg</name></author><author><name sortKey="Jordan, Joanne M" sort="Jordan, Joanne M" uniqKey="Jordan J" first="Joanne M." last="Jordan">Joanne M. Jordan</name></author><author><name sortKey="Katz, Jeffrey N" sort="Katz, Jeffrey N" uniqKey="Katz J" first="Jeffrey N." last="Katz">Jeffrey N. Katz</name></author><author><name sortKey="Kloppenburg, Margreet" sort="Kloppenburg, Margreet" uniqKey="Kloppenburg M" first="Margreet" last="Kloppenburg">Margreet Kloppenburg</name></author><author><name sortKey="Lanzarotti, Arturo" sort="Lanzarotti, Arturo" uniqKey="Lanzarotti A" first="Arturo" last="Lanzarotti">Arturo Lanzarotti</name></author><author><name sortKey="Lim, Keith" sort="Lim, Keith" uniqKey="Lim K" first="Keith" last="Lim">Keith Lim</name></author><author><name sortKey="Lohmander, L Stefan" sort="Lohmander, L Stefan" uniqKey="Lohmander L" first="L. Stefan" last="Lohmander">L. Stefan Lohmander</name></author><author><name sortKey="Mahomed, Nizar N" sort="Mahomed, Nizar N" uniqKey="Mahomed N" first="Nizar N." last="Mahomed">Nizar N. Mahomed</name></author><author><name sortKey="Maillefert, Jean Francis" sort="Maillefert, Jean Francis" uniqKey="Maillefert J" first="Jean Francis" last="Maillefert">Jean Francis Maillefert</name></author><author><name sortKey="Manno, Rebecca L" sort="Manno, Rebecca L" uniqKey="Manno R" first="Rebecca L." last="Manno">Rebecca L. Manno</name></author><author><name sortKey="March, Lyn M" sort="March, Lyn M" uniqKey="March L" first="Lyn M." last="March">Lyn M. March</name></author><author><name sortKey="Mazzuca, Steven A" sort="Mazzuca, Steven A" uniqKey="Mazzuca S" first="Steven A." last="Mazzuca">Steven A. Mazzuca</name></author><author><name sortKey="Pavelka, Karel" sort="Pavelka, Karel" uniqKey="Pavelka K" first="Karel" last="Pavelka">Karel Pavelka</name></author><author><name sortKey="Punzi, Leonardo" sort="Punzi, Leonardo" uniqKey="Punzi L" first="Leonardo" last="Punzi">Leonardo Punzi</name></author><author><name sortKey="Roos, Ewa M" sort="Roos, Ewa M" uniqKey="Roos E" first="Ewa M." last="Roos">Ewa M. Roos</name></author><author><name sortKey="Rovati, Lucio C" sort="Rovati, Lucio C" uniqKey="Rovati L" first="Lucio C." last="Rovati">Lucio C. Rovati</name></author><author><name sortKey="Shi, Helen" sort="Shi, Helen" uniqKey="Shi H" first="Helen" last="Shi">Helen Shi</name></author><author><name sortKey="Singh, Jasvinder A" sort="Singh, Jasvinder A" uniqKey="Singh J" first="Jasvinder A." last="Singh">Jasvinder A. Singh</name></author><author><name sortKey="Suarez Almazor, Maria E" sort="Suarez Almazor, Maria E" uniqKey="Suarez Almazor M" first="Maria E." last="Suarez-Almazor">Maria E. Suarez-Almazor</name></author><author><name sortKey="Tajana Messi, Eleonora" sort="Tajana Messi, Eleonora" uniqKey="Tajana Messi E" first="Eleonora" last="Tajana-Messi">Eleonora Tajana-Messi</name></author><author><name sortKey="Dougados, Maxime" sort="Dougados, Maxime" uniqKey="Dougados M" first="Maxime" last="Dougados">Maxime Dougados</name></author></analytic><series><title level="j">The Journal of Rheumatology</title><idno type="ISSN">0315-162X</idno><idno type="eISSN">0315-162X</idno><imprint><date when="2011">2011</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en"><sec id="S1"><title>Objective</title><p id="P2">To define pain and physical function cutpoints that would, coupled with structural severity, define a surrogate measure of “need for joint replacement surgery,” for use as an outcome measure for potential structure-modifying interventions for osteoarthritis (OA).</p></sec><sec sec-type="methods" id="S2"><title>Methods</title><p id="P3">New scores were developed for pain and physical function in knee and hip OA. A cross-sectional international study in 1909 patients was conducted to define data-driven cutpoints corresponding to the orthopedic surgeons’ indication for joint replacement. A post hoc analysis of 8 randomized clinical trials (1379 patients) evaluated the prevalence and validity of cutpoints, among patients with symptomatic hip/knee OA.</p></sec><sec id="S3"><title>Results</title><p id="P4">In the international cross-sectional study, there was substantial overlap in symptom levels between patients with and patients without indication for joint replacement; indeed, it was not possible to determine cutpoints for pain and function defining this indication. The post hoc analysis of trial data showed that the prevalence of cases that combined radiological progression, high level of pain, and high degree of function impairment was low (2%–12%). The most discriminatory cutpoint to define an indication for joint replacement was found to be [pain (0–100) + physical function (0–100) > 80].</p></sec><sec id="S4"><title>Conclusion</title><p id="P5">These results do not support a specific level of pain or function that defines an indication for joint replacement. However, a tentative cutpoint for pain and physical function levels is proposed for further evaluation. Potentially, this symptom level, coupled with radiographic progression, could be used to define “nonresponders” to disease-modifying drugs in OA clinical trials.</p></sec></div></front></TEI><pmc article-type="research-article" xml:lang="en"><pmc-comment>The publisher of this article does not allow downloading of the full text in XML form.</pmc-comment>
<pmc-dir>properties manuscript</pmc-dir>
<front><journal-meta><journal-id journal-id-type="nlm-journal-id">7501984</journal-id><journal-id journal-id-type="pubmed-jr-id">5243</journal-id><journal-id journal-id-type="nlm-ta">J Rheumatol</journal-id><journal-title-group><journal-title>The Journal of Rheumatology</journal-title></journal-title-group><issn pub-type="ppub">0315-162X</issn><issn pub-type="epub">0315-162X</issn></journal-meta><article-meta><article-id pub-id-type="pmid">21807799</article-id><article-id pub-id-type="pmc">3260473</article-id><article-id pub-id-type="doi">10.3899/jrheum.110403</article-id><article-id pub-id-type="manuscript">NIHMS348288</article-id><article-categories><subj-group subj-group-type="heading"><subject>Article</subject></subj-group></article-categories><title-group><article-title>OARSI/OMERACT Initiative to Define States of Severity and Indication for Joint Replacement in Hip and Knee Osteoarthritis. An OMERACT 10 Special Interest Group</article-title></title-group><contrib-group><contrib contrib-type="author"><name><surname>GOSSEC</surname><given-names>LAURE</given-names></name></contrib><contrib contrib-type="author"><name><surname>PATERNOTTE</surname><given-names>SIMON</given-names></name></contrib><contrib contrib-type="author"><name><surname>BINGHAM</surname><given-names>CLIFTON O.</given-names><suffix>III</suffix></name></contrib><contrib contrib-type="author"><name><surname>CLEGG</surname><given-names>DANIEL O.</given-names></name></contrib><contrib contrib-type="author"><name><surname>COSTE</surname><given-names>PHILIPPE</given-names></name></contrib><contrib contrib-type="author"><name><surname>CONAGHAN</surname><given-names>PHILIP G.</given-names></name></contrib><contrib contrib-type="author"><name><surname>DAVIS</surname><given-names>AILEEN M.</given-names></name></contrib><contrib contrib-type="author"><name><surname>GIACOVELLI</surname><given-names>GIAMPAOLO</given-names></name></contrib><contrib contrib-type="author"><name><surname>GUNTHER</surname><given-names>KLAUS-PETER</given-names></name></contrib><contrib contrib-type="author"><name><surname>HAWKER</surname><given-names>GILLIAN</given-names></name></contrib><contrib contrib-type="author"><name><surname>HOCHBERG</surname><given-names>MARC C.</given-names></name></contrib><contrib contrib-type="author"><name><surname>JORDAN</surname><given-names>JOANNE M.</given-names></name></contrib><contrib contrib-type="author"><name><surname>KATZ</surname><given-names>JEFFREY N.</given-names></name></contrib><contrib contrib-type="author"><name><surname>KLOPPENBURG</surname><given-names>MARGREET</given-names></name></contrib><contrib contrib-type="author"><name><surname>LANZAROTTI</surname><given-names>ARTURO</given-names></name></contrib><contrib contrib-type="author"><name><surname>LIM</surname><given-names>KEITH</given-names></name></contrib><contrib contrib-type="author"><name><surname>LOHMANDER</surname><given-names>L. STEFAN</given-names></name></contrib><contrib contrib-type="author"><name><surname>MAHOMED</surname><given-names>NIZAR N.</given-names></name></contrib><contrib contrib-type="author"><name><surname>MAILLEFERT</surname><given-names>JEAN FRANCIS</given-names></name></contrib><contrib contrib-type="author"><name><surname>MANNO</surname><given-names>REBECCA L.</given-names></name></contrib><contrib contrib-type="author"><name><surname>MARCH</surname><given-names>LYN M.</given-names></name></contrib><contrib contrib-type="author"><name><surname>MAZZUCA</surname><given-names>STEVEN A.</given-names></name></contrib><contrib contrib-type="author"><name><surname>PAVELKA</surname><given-names>KAREL</given-names></name></contrib><contrib contrib-type="author"><name><surname>PUNZI</surname><given-names>LEONARDO</given-names></name></contrib><contrib contrib-type="author"><name><surname>ROOS</surname><given-names>EWA M.</given-names></name></contrib><contrib contrib-type="author"><name><surname>ROVATI</surname><given-names>LUCIO C.</given-names></name></contrib><contrib contrib-type="author"><name><surname>SHI</surname><given-names>HELEN</given-names></name></contrib><contrib contrib-type="author"><name><surname>SINGH</surname><given-names>JASVINDER A.</given-names></name></contrib><contrib contrib-type="author"><name><surname>SUAREZ-ALMAZOR</surname><given-names>MARIA E.</given-names></name></contrib><contrib contrib-type="author"><name><surname>TAJANA-MESSI</surname><given-names>ELEONORA</given-names></name></contrib><contrib contrib-type="author"><name><surname>DOUGADOS</surname><given-names>MAXIME</given-names></name></contrib><on-behalf-of>For the OARSI-OMERACT Task Force Total Articular Replacement as Outcome Measure in OA</on-behalf-of><aff id="A1">Paris Descartes University, Medicine Faculty; APHP, Rheumatology B Department, Cochin Hospital, Paris, France; Divisions of Rheumatology and Allergy and Clinical Immunology, Johns Hopkins University, Baltimore, Maryland, USA; Division of Rheumatology, Department of Internal Medicine, University of Utah School of Medicine, Salt Lake City, Utah, USA; Expansciences Laboratories, Courbevoie, France; Section of Musculoskeletal Disease, University of Leeds and NIHR Leeds Musculoskeletal Biomedical Research Unit, Leeds, United Kingdom; Division of Health Care and Outcomes Research and Arthritis and Community Research and Evaluation Unit, Toronto Western Research Institute, and Departments of Rehabilitation Science and Health Policy, Management and Evaluation, University of Toronto, Toronto, Ontario, Canada; Department of Biostatistics, Department of Clinical Pharmacology, Rottapharm-Madaus, Monza, Italy; Department of Orthopaedic Surgery, University of Dresden, Dresden, Germany; Division of Rheumatology, Department of Medicine, Women’s College Hospital; Clinical Epidemiology and Health Care Research Program, Department of Health Policy, Management and Evaluation, Faculty of Medicine, University of Toronto, Canada; Division of Rheumatology and Clinical Immunology, Department of Medicine, and Division of Gerontology, Department of Epidemiology and Preventive Medicine, University of Maryland School of Medicine, Baltimore, MD, USA; Division of Rheumatology, Allergy and Immunology, Department of Medicine, Thurston Arthritis Research Center, University of North Carolina School of Medicine, Chapel Hill, North Carolina, USA; Department of Orthopedic Surgery and Division of Rheumatology, Immunology and Allergy, Brigham and Women’s Hospital, Harvard Medical School; and Department of Epidemiology, Harvard School of Public Health, Boston, Massachusetts, USA; Department of Rheumatology, Department of Clinical Epidemiology, Leiden University Medical Center, Leiden, The Netherlands; R&D Department, IBSA Institut Biochimique SA, Pambio-Noranco, Switzerland; Department of Rheumatology, St. Vincent’s Hospital and Western Hospital, Melbourne, Australia; Department of Orthopaedics, Clinical Sciences Lund, Lund University, Lund, Sweden; Division of Orthopaedic Surgery, University of Toronto, Toronto Western Hospital, Toronto, Canada; Department of Rheumatology, Dijon University Hospital; University of Burgundy; and INSERM U887, Dijon, France; Institute of Bone and Joint Research, University of Sydney, Royal North Shore Hospital, St. Leonards, Australia; Indiana University School of Medicine, Indianapolis, Indiana, USA; Institute of Rheumatology, Charles University, Prague, Czech Republic; Rheumatology Unit, Department of Clinical and Experimental Medicine, University of Padova, Padova, Italy; Institute of Sports and Clinical Biomechanics, University of Southern Denmark, Odense, Denmark; VA Cooperative Studies Program Coordinating Center, Hines, Illinois, USA; Birmingham VA Medical Center and University of Alabama, Birmingham, AL, USA; and Section of Rheumatology, University of Texas, M.D. Anderson Cancer Center, Houston, Texas, USA.</aff></contrib-group><author-notes><corresp id="CR1">Address correspondence to Prof. Dougados. <email>maxime.dougados@cch.aphp.fr</email></corresp><fn id="FN1"><p id="P1">L. Gossec, MD, PhD; S. Paternotte, MSc; M. Dougados, MD, Paris Descartes University, Medicine Faculty; APHP, Rheumatology B Department, Cochin Hospital; C.O. Bingham, MD, Associate Professor of Medicine, Divisions of Rheumatology and Allergy and Clinical Immunology, Johns Hopkins University; D.O. Clegg, MD, Professor of Medicine, Division of Rheumatology, Department of Internal Medicine, University of Utah School of Medicine; P. Coste, MD, Medical Director, Expansciences Laboratories; P.G. Conaghan, MBBS, PhD, FRACP, FRCP, Professor of Musculoskeletal Medicine, Section of Musculoskeletal Disease, University of Leeds and NIHR Leeds Musculoskeletal Biomedical Research Unit; A.M. Davis, PhD, Senior Scientist and Professor, Division of Health Care and Outcomes Research and Arthritis and Community Research and Evaluation Unit, Toronto Western Research Institute, Departments of Rehabilitation Science and Health Policy, Management and Evaluation, University of Toronto; G. Giacovelli, PhD, Director of Biostatistics, Department of Biostatistics, Rottapharm-Madaus; K-P. Gunther, MD, Professor and Chair, Department of Orthopaedic Surgery, University of Dresden; G. Hawker, MD, MSc, Division of Rheumatology, Department of Medicine, Women’s College Hospital; Clinical Epidemiology and Health Care Research Program, Department of Health Policy, Management and Evaluation, Faculty of Medicine, University of Toronto; M.C. Hochberg, MD, MPH, Professor of Medicine, Division of Rheumatology and Clinical Immunology, Department of Medicine and Division of Gerontology, Department of Epidemiology and Preventive Medicine, University of Maryland School of Medicine; J.M. Jordan, MD, MPH, Division of Rheumatology, Allergy and Immunology, Department of Medicine, Thurston Arthritis Research Center, University of North Carolina School of Medicine; J.N. Katz, MD, MS, Professor of Surgery and Orthopedic Medicine, Department of Orthopedic Surgery and Division of Rheumatology, Immunology and Allergy, Brigham and Women’s Hospital, Harvard Medical School; and Department of Epidemiology, Harvard School of Public Health; M. Kloppenburg, MD, PhD, Department of Rheumatology, Department of Clinical Epidemiology, Leiden University Medical Center; A. Lanzarotti, MSc, Statistician, R&D Department, IBSA Institut Biochimique SA; K. Lim, MBBS, MD, FRACP, FRCP, Director of Rheumatology, Department of Rheumatology, St. Vincent’s Hospital and Western Hospital; L.S. Lohmander, Department of Orthopaedics, Clinical Sciences Lund, Lund University; N.N. Mahomed, MD, ScD, Smith and Nephew Chair in Orthopaedic Surgery, Associate Professor, Department of Surgery, Director, Division of Orthopaedic Surgery, University of Toronto, Toronto Western Hospital; J.F. Maillefert, MD, PhD, Associate Professor of Rheumatology, Department of Rheumatology, Dijon University Hospital; University of Burgundy; INSERM U887; R.L. Manno, MD, Senior Rheumatology Fellow, Division of Rheumatology, Johns Hopkins University; L.M. March, MD, PhD, Professor of Medicine and Public Health, Institute of Bone and Joint Research, University of Sydney, Royal North Shore Hospital; S.A. Mazzuca, PhD, Senior Scientist, Indiana University School of Medicine; K. Pavelka, Institute of Rheumatology, Charles University; L. Punzi, MD, PhD, Rheumatology Unit, Department of Clinical and Experimental Medicine, University of Padova; E.M. Roos, PT, PhD, Professor of Musculoskeletal Function and Physical Therapy, Institute of Sports and Clinical Biomechanics, University of Southern Denmark; L.C. Rovati, MD, Chief Scientific Officer, Professor of Clinical Pharmacology, Department of Clinical Pharmacology, Rottapharm; H. Shi, MS, Hines VA Cooperative Studies Program Coordinating Center; J.A. Singh, MD, MPH, Associate Professor of Medicine, Birmingham VA Medical Center and University of Alabama; M.E. Suarez-Almazor, MD, PhD, Professor of Medicine, Section of Rheumatology, University of Texas, M.D. Anderson Cancer Center; E. Tajana-Messi, MSc, PhD, Clinical Research Senior Manager, R&D Department, IBSA Institut Biochimique SA.</p></fn></author-notes><pub-date pub-type="nihms-submitted"><day>9</day><month>1</month><year>2012</year></pub-date><pub-date pub-type="ppub"><month>8</month><year>2011</year></pub-date><pub-date pub-type="pmc-release"><day>1</day><month>8</month><year>2012</year></pub-date><volume>38</volume><issue>8</issue><fpage>1765</fpage><lpage>1769</lpage><permissions><copyright-statement>Copyright © 2011. All rights reserved.</copyright-statement><copyright-year>2011</copyright-year></permissions><abstract><sec id="S1"><title>Objective</title><p id="P2">To define pain and physical function cutpoints that would, coupled with structural severity, define a surrogate measure of “need for joint replacement surgery,” for use as an outcome measure for potential structure-modifying interventions for osteoarthritis (OA).</p></sec><sec sec-type="methods" id="S2"><title>Methods</title><p id="P3">New scores were developed for pain and physical function in knee and hip OA. A cross-sectional international study in 1909 patients was conducted to define data-driven cutpoints corresponding to the orthopedic surgeons’ indication for joint replacement. A post hoc analysis of 8 randomized clinical trials (1379 patients) evaluated the prevalence and validity of cutpoints, among patients with symptomatic hip/knee OA.</p></sec><sec id="S3"><title>Results</title><p id="P4">In the international cross-sectional study, there was substantial overlap in symptom levels between patients with and patients without indication for joint replacement; indeed, it was not possible to determine cutpoints for pain and function defining this indication. The post hoc analysis of trial data showed that the prevalence of cases that combined radiological progression, high level of pain, and high degree of function impairment was low (2%–12%). The most discriminatory cutpoint to define an indication for joint replacement was found to be [pain (0–100) + physical function (0–100) > 80].</p></sec><sec id="S4"><title>Conclusion</title><p id="P5">These results do not support a specific level of pain or function that defines an indication for joint replacement. However, a tentative cutpoint for pain and physical function levels is proposed for further evaluation. Potentially, this symptom level, coupled with radiographic progression, could be used to define “nonresponders” to disease-modifying drugs in OA clinical trials.</p></sec></abstract><kwd-group><kwd>OSTEOARTHRITIS</kwd><kwd>SEVERITY</kwd><kwd>PAIN</kwd><kwd>FUNCTION</kwd><kwd>STRUCTURE OUTCOME MEASURE</kwd></kwd-group><funding-group><award-group><funding-source country="United States">National Institute of Arthritis and Musculoskeletal and Skin Diseases : NIAMS</funding-source><award-id>K24 AR002123-03 || AR</award-id></award-group></funding-group></article-meta></front></pmc></record>Pour manipuler ce document sous Unix (Dilib)
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