Risk stratification for knee osteoarthritis progression: a narrative review

Objective: A narrative review describing the assessment of osteoarthritis (OA) progression, and more specifically the risk factors which assist in delineating strata of individuals at greatest risk for more rapid progression. Design: A narrative review based on selected recent medical literature Results: With little currently available in the treatment of this disease, better understanding of responsive and valid endpoints is essential to identifying potential new interventions for treatment of OA. Efforts to stratify those at greatest risk for progression can use a number of systemic or local risk factors that may assist in delineating populations at greater risk for progression. Conclusions: Current data suggests that stratification of risk is feasible to ascertain those at risk for rapid progression using a number of different metrics including knee alignment, meniscal damage, bone marrow lesions and late stage disease. Identifying persons at greatest risk for progression has important implications for clinical trial planning and can enhance study efficiency. (C) 2009 Ostecarthritis Research Society International. Published by Elsevier Ltd. All rights reserved.