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Osteoarthritis Cartilage. 2016 Apr;24(4):597-604. doi: 10.1016/j.joca.2015.11.003. Epub 2015 Nov 10.

Long term use of analgesics and risk of osteoarthritis progressions and knee replacement: propensity score matched cohort analysis of data from the Osteoarthritis Initiative.

Author information

1
Russell H. Morgan Department of Radiology, Johns Hopkins University, Baltimore, MD, USA. Electronic address: nhafezi1@jhmi.edu.
2
Quantitative Imaging Center, Department of Radiology, Boston University School of Medicine, Boston, MA, USA.
3
Quantitative Imaging Center, Department of Radiology, Boston University School of Medicine, Boston, MA, USA; Department of Radiology, University of Erlangen-Nuremberg, Erlangen, Germany.
4
Russell H. Morgan Department of Radiology, Johns Hopkins University, Baltimore, MD, USA.
5
Department of Orthopedic Surgery, Johns Hopkins University, Baltimore, MD, USA.

Abstract

OBJECTIVES:

To determine the association between the long-term use of analgesics and progression of osteoarthritis (OA) as evidenced by up to 3-years follow-up worsening of radiographic Kellgren-Lawrence (KL) grade and incidence of knee replacement (KR).

DESIGN:

Using nearest neighbor matching of the propensity scores with caliper in the Osteoarthritis Initiative (OAI) cohort, 173 index (Analgesic +) and 173 referent (Analgesic -) subjects were included. Analgesic + and - subjects had analgesics in all and none of their visits, respectively. Analgesic + and - subjects were balanced in their demographics, baseline, first, second and third year body mass index (BMI), Western Ontario and McMaster (WOMAC) total score, Physical and Mental health summary scales (SF-12), Physical Activity Scale for the Elderly (PASE) and Charleston Comorbidity Scale. Analgesic + and - subjects were also matched for baseline radiographic KL grade. Interval increase in the KL grade and incidence of KR were defined as the outcome.

RESULTS:

Included subjects had average 6.5 years of follow-up. By the third year, 44 subjects had an interval increase in the KL grade; 29 in Analgesic + and 15 among Analgesic - subjects (P = 0.024). By the eighth-year, 41 subjects had their first KR; 29 in Analgesic + and 12 among Analgesic - subjects (P = 0.005). Hazard Ratio (HR) of OA progression and KR for Analgesic + subjects was 1.91 (1.02-3.57) and 2.57 (1.31-5.04), respectively.

CONCLUSIONS:

Long-term use of analgesics may be associated with radiographic progression of knee OA and increased risk of future KR.

KEYWORDS:

Analgesics; Knee replacement; Osteoarthritis progression; Propensity score matching

PMID:
26564576
DOI:
10.1016/j.joca.2015.11.003
[Indexed for MEDLINE]
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