?Generalized Osteoarthritis?: A Systematic Review #MMPMID24461078
Nelson AE; Smith MW; Golightly YM; Jordan JM
Semin Arthritis Rheum 2014[Jun]; 43 (6): 713-20 PMID24461078show ga
Objectives: Given the conflicting definitions of ?generalized osteoarthritis? (GOA) in the literature, we performed a systematic review of GOA definitions, risk factors, and outcomes. Methods: We searched the Medline literature with terms: osteoarthritis, generalized, polyarticular, multiple joint, and multi-joint, to obtain articles related to GOA, following evidence-based guidelines. Titles and abstracts of 948 articles were reviewed, with full text review of 108. Data were extracted based on pre-specified criteria for 74 articles plus 24 identified through bibliographic review (total=98). Results: Twenty-four large cohorts (n~30,000) were represented along with numerous clinical series (n~9000), across 22 countries and 60 years (1952?2012). No less than 15 definitions of GOA were given in 30 studies with a stated GOA definition; at least 6 groups used a summed score of joints or radiographic grades. Prevalence estimates based on these GOA definitions were 1?80%, although most were 5?25%. Increased risk and progression of GOA was associated with age, female sex, and genetic/familial factors. Associations with increased body mass index or bone mineral density were not consistent. One study estimated the heritability of GOA at 42%. Collagen biomarker levels increased with number of involved joints. Increased OA burden was associated with increased mortality and disability, poorer health and function. Conclusion: While there remains no standard definition of GOA, this term is commonly used. The impact on health may be greater when OA is in more than one joint. A descriptive term, such as multi-joint or polyarticular OA, designating OA of multiple joints or joint groups, is recommended.
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Semin+Arthritis+Rheum 2014 ; 43 (6): 713-20
