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. 2023 Dec 16;6(1):100428.
doi: 10.1016/j.ocarto.2023.100428. eCollection 2024 Mar.

"You don't put it down to arthritis": A qualitative study of the first symptoms recalled by individuals with knee osteoarthritis

Affiliations

"You don't put it down to arthritis": A qualitative study of the first symptoms recalled by individuals with knee osteoarthritis

L K King et al. Osteoarthr Cartil Open. .

Abstract

Objective: As part of the first phase of the OARSI Early-stage Symptomatic Knee Osteoarthritis (EsSKOA) initiative, we explored the first symptoms and experiences recalled by individuals with knee osteoarthritis (OA).

Design: This qualitative study, informed by qualitative description, was a secondary analysis of focus groups (n ​= ​17 groups) and one-on-one interviews (n ​= ​3) conducted in 91 individuals living with knee OA as part of an international study to better understand the OA pain experience. In each focus group or interview, participants were asked to describe their first symptoms of knee OA. We inductively coded these transcripts and conducted thematic analysis.

Results: Mean age of participants was 70 years (range 47-92) and 68 ​% were female. We developed four overarching themes: Insidious and Episodic Onset, Diverse Early Symptoms, Must be Something Else, and Adjustments. Participants described the gradual and intermittent way in which symptoms of knee OA developed over many years; many could not identify a specific starting point. Participants described diverse initial knee symptoms, including activity-exacerbated joint pain, stiffness and crepitus. Most participants dismissed early symptoms or rationalized their presence, employing various strategies to enable continued participation in recreational and daily activities. Few sought medical attention until physical functioning was demonstrably impacted.

Conclusions: The earliest symptoms of knee OA are frequently insidious in onset, episodic and present long before individuals present to health professionals. These results highlight challenges to identifying people with knee OA early and support the development of specific classification criteria for EsSKOA to capture individuals at an early stage.

Keywords: Knee osteoarthritis; Patient-orientated research; Qualitative research; Symptoms.

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Conflict of interest statement

LKK reports support from Canadian Institutes of Health Research Doctoral Award, and grant funding from Physician Services Incorporated (PSI) Resident Grant; JWL reports a Pfizer research grant completed in 2021, unrelated to this work; QW reports support from Osteoarthritis and Cartilage as an Associate Editor for statistics; AT reports support from Osteoarthritis and Cartilage as an Associate Editor for statistics, IKH reports consulting fees from AbbVie, GSK and Grünenthal, and leadership role as the OARSI Board of Directors Secretary; CTA reports grant funding and consulting/honoraria from AbbVie, Novartis, Pfizer, and Servier; LSL reports consulting/honoraria from Arthro Therapeutics AB, Sweden, and participation on a DSMB board for AstraZeneca; ME reports grant funding from Swedish Research Council, ERC, ALF, Kock Foundations, Gustav V 80 ​Year ​B-day foundation, NORDFORSK, FOREUM, Foundation for support to people with movement disability in Skåne, Österlund Foundation, SUS donations, consulting from Cellcolabs AB, and leadership role as the OARSI President-elect; JR reports a leadership role on the OARSI Ethics & Governance Committee, Nominating Committee; and TN reports grant funding and consulting/honoraria from Pfizer/Lilly, Regeneron and Novartis. All other authors report no competing interests.

References

    1. Safiri S., Kolahi A.-A., Smith E., et al. Global, regional and national burden of osteoarthritis 1990-2017: a systematic analysis of the Global Burden of Disease Study 2017. Ann. Rheum. Dis. 2020;79(6):819–828. - PubMed
    1. Oo W.M., Little C., Duong V., Hunter D.J. The development of disease-modifying therapies for osteoarthritis (DMOADs): the evidence to date. Drug Des. Dev. Ther. 2021;15:2921–2945. - PMC - PubMed
    1. Liew J.W., King L.K., Mahmoudian A., et al. A scoping review of how early-stage knee osteoarthritis has been defined. Osteoarthritis Cartilage. 2023;31(9):1234–1241. - PMC - PubMed
    1. Kao M.H., Tsai Y.F. Living experiences of middle-aged adults with early knee osteoarthritis in prediagnostic phase. Disabil. Rehabil. 2012;34(21):1827–1834. - PubMed
    1. Hawker G.A., Stewart L., French M.R., et al. Understanding the pain experience in hip and knee osteoarthritis--an OARSI/OMERACT initiative. Osteoarthritis Cartilage. 2008;16(4):415–422. - PubMed