The focus of the research is on the identification of new clinical subgroups (‘subgroup phenotyping’) in patients with knee osteoarthritis (KOA). This is necessary because a large heterogeneity exists among KOA patients. This heterogeneity led to poor outcome in some groups of patients that instead could have benefited from specific treatment based on the characteristics of the specific subgroup. Subgroup phenotyping is a new approach in KJOA with early explorative studies now emerging.
The aim of this project is to further identify and validate subgroups of knee osteoarthritis patients that share common characteristics. Particular effort will be done to identify biomechanical pathways that could help us to expand our knowledge related to KOA pathogenesis and create targeted treatment. However this research will try to identify other (non-biomechanical) subgroups fundamental for the understanding of knee disease.
Research design and methodology
This research is composed by two stages. In the first one a systematic review will be carried on to gain a deep knowledge helpful to address the future efforts to subgroups with stronger consistence. Furthermore a secondary analysis of data from the OAI (Osteoarthritis Initiative) database will be done to validate these subgroups. The second stage of the research will involve primary data collection in KOA patients with lab-based data acquisitions with. A cross-sectional study will be carried out, with results from the previous stage informing this phase of the research toward the gap present in the actual knowledge
Contribution to knowledge and impact
KOA is one of the main sources of disability. For these reasons it is important try to gain an in depth knowledge related to this disease. Finding common pathways and creating a strong sub-classification will help us to understand which factors are responsible for poor outcome in KOA. This research will produce:
1) A systematic review of the literature identifying subgroups with strong supporting evidence.
2) A secondary data analysis study that analyses the importance of several variable in knee OA sub-classification and verify the statistical significance a subgroup approach.
3) A cross sectional study with KOA patients addressed to the existent gap in the knowledge and verify the existence of the subgroup in a random sample. The results of this research could help the clinicians in their diagnosis and in a more appropriate allocation of treatment for that specific patient. This would lead to an improvement of outcomes in KOA patients. Furthermore this research could address the future studies related to treatment. If we know the characteristics that could influence the outcome, we could focus the future effort and develop better treatment for specific groups of patients.