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Symptomatic Progression of Knee and Hip Osteoarthritis in Primary Care

Alex Bastick

Osteoarthritis (OA) is one of the most common chronic diseases and is one of the leading causes of pain and disability worldwide. OA can occur in many joints in the body, but patient consultation rates due to knee and hip OA are the highest in primary care. The main symptoms of both knee and hip OA are joint pain and stiffness, varying from mild to severe or disabling symptoms. Consequently, patients are restricted in their daily activities which has an impact on an individual’s quality of life. Until recently, the available evidence showed that only physical work load is a risk factor for incident knee OA. Obesity, occupational factors, physical sporting activity and hip dysplasia are risk factors for incident hip OA. Known prognostic factors for knee OA are serum hyaluronic acid levels, generalized OA and malalignment. For hip OA these are superolateral migration of the hip, decreased joint space width and atrophic bone response. However, the evidence for the majority of these factors is nearly a decade old and is often not based on primary care patients with OA or those in an early symptomatic phase of the disease. These were the main reasons to write this thesis.

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