Elucidating the initial symptoms and experiences of knee osteoarthritis: An international patient survey

Abstract

Objectives: Within the first phase of developing classification criteria for Early-stage Symptomatic Knee Osteoarthritis, among individuals with knee osteoarthritis (OA) we explored: 1) symptoms within the first year of noticing their knee(s); 2) features that indicated OA was the cause; and 3) timing and reasons that initially prompted seeking healthcare. Design: We conducted a cross-sectional online survey of individuals with knee OA recruited from Australia, Canada, the Netherlands, and the USA. Only individuals who indicated they recalled their first symptoms were eligible. Using free-text, participants described changes in how their knee looked, felt, moved, their overall state within the first year of noticing their knee(s), features perceived to indicate knee OA was the cause, and reasons for initially seeking healthcare. We assessed the timing of seeking care by an ordinal scale. Data were analyzed using descriptive statistics and summative content analysis. Results: We included 92 participants (median age 67 years [interquartile range (IQR) 59,75], 69% women, median body mass index (BMI) 26 kg/m2 [IQR 24,30]). Within the first year from onset, frequently reported symptoms were knee pain (70%), swelling (58%), crepitus (42%), stiffness (29%), and instability (24%). While few could provide specific clinical features, approximately half (53%) perceived medical imaging as important to indicate OA. Only 35% sought healthcare within the first year of experiencing symptoms. Conclusions: Individuals with knee OA recalled varied knee symptoms within the first year and few sought healthcare. We were unable to ascertain, from the perspective of patients, specific clinical features that indicated they had OA and not another condition.