Genetic variants near insulin-like growth factor binding protein 3 (IGFBP3) are associated with hip osteoarthritis

Abstract

s / Osteoarthritis and Cartilage 21 (2013) S9–S62 S26 outcome measures were compared by Wilcoxon Signed Ranks Test (2tailed), firstly in the whole study population, and secondly the predefined subgroup with contralateral ‘perfect match’ control. Results: Of 26 subjects, 23 were women, 3 men; mean age was 63 years (51-78); mean time from diagnosis 6.5 years; mean BMI 26. At baseline, the median average pain score in the preceding 2 weeks was similar in the intervention (6/10) and control joints (5/10). 24 subjects completed the study. A further patient required a hand steroid injection and was excluded from analysis. The average pain (primary outcome measure) and worst pain scores in the intervention joint were significantly lower at 3 months compared with baseline (p1⁄40.002, p1⁄40.02 respectively). Change in joint deviation on X-ray (radiologist blinded to intervention digit) approached, but did not achieve significance at 3 months (p1⁄40.076). When nominated intervention and control joints were compared in all 23 patients, differences did not reach significance. In the subgroup who had a contralateral, ‘perfect match’ control digit, average pain was significantly lower in the intervention joint at 3 months (p1⁄40.035) and extension lag was significantly improved (p1⁄40.016). However, no significant difference in functional outcome measures, such as active range of motion or pinch grip was evident. 2 serious adverse events occurred during the study period, neither of which appeared to relate to the intervention. Conclusions: DIP joint OA can lead to significant hand pain, deformity and disability. Short-term DIP joint splinting is a safe, simple, inexpensive treatment modality which reduces DIP joint pain and improves ability to extend the digit. It does not, if carried out nightly, give rise to non-compliance, increased stiffness or restriction of range of motion. The lack of a suitable placebo intervention to which investigator and patient are blinded is a recognised weakness in this type of study. Whilst powered to detect a difference in average pain, it is likely that SNP association results in discovery and replication cohorts.