Defining acute flares in knee osteoarthritis: a systematic review

BMJ Open
Emma L ParryGeorge Peat

Abstract

To identify and critically synthesise definitions of acute flares in knee osteoarthritis (OA) reported in the medical literature. Systematic review and narrative synthesis. We searched Medline, EMBASE, Web of science and six other electronic databases (inception to July 2017) for original articles and conference abstracts reporting a definition of acute flare (or synonym) in humans with knee OA. There were no restrictions by language or study design (apart from iatrogenic-induced flare-ups, eg, injection-induced). Data extraction comprised: definition, pain scale used, flare duration or withdrawal period, associated symptoms, definition rationale, terminology (eg, exacerbation or flare), baseline OA severity, age, gender, sample size and study design. Sixty-nine articles were included (46 flare design trials, 17 observational studies, 6 other designs; sample sizes: 15-6085). Domains used to define flares included: worsening of signs and symptoms (61 studies, 27 different measurement tools), specifically increased pain intensity; minimum pain threshold at baseline (44 studies); minimum duration (7 studies, range 8-48 hours); speed of onset (2 studies, defined as 'sudden' or 'quick'); requirement for increased medication (2 studi...Continue Reading

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Citations

Dec 18, 2018·Industrial Health·Jessica StanhopePhilip Weinstein
Jan 21, 2021·Scandinavian Journal of Rheumatology·I AtukoralaD J Hunter
Jan 29, 2020·Osteoarthritis and Cartilage·M J Thomas, T Neogi
Feb 16, 2021·American Journal of Physical Medicine & Rehabilitation·Jeffrey D Smith, Allison N Schroeder

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