ArticleOsteoarthritis and cartilage2021
Triggers for acute flare in adults with, or at risk of, knee osteoarthritis: a web-based case-crossover study in community-dwelling adults.
Article in Osteoarthritis and cartilage, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 14 papers.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
14 citing papers in PubMed, 23 citations in OpenAlex.
- Identifying clinically relevant subgroups of patients with knee pain flares for ibuprofen treatment: a secondary analysis.Clinical rheumatology · 2025Trial
- Effects of Non-Immersive Virtual Reality Exercise on Self-Reported Pain and Mechanical Hyperalgesia in Older Adults with Knee and Hip Osteoarthritis: A Secondary Analysis of a Randomized Controlled Trial.Medicina (Kaunas, Lithuania) · 2025Trial
- Climate Change and Air Pollution-Related Health Effects on Pain.International journal of environmental research and public health · 2025Review
- Association of COVID-19 vaccinations with osteoarthritis flares: A case-crossover study.Osteoarthritis and cartilage · 2025Article
- Activity-related pain and sensitization predict within- and between-person pain experience in people with knee osteoarthritis: An ecological momentary assessment study.Osteoarthritis and cartilage open · 2024Article
- The Natural History of Knee Osteoarthritis Pain Experience and Risk Profiles.The journal of pain · 2023Observational
- Interventional pain physician beliefs on climate change: A Spine Intervention Society (SIS) survey.Interventional pain medicine · 2023Article
- Assessment of Pain in Osteoarthritis of the Knee.Journal of personalized medicine · 2023Review
- Quantifying sustained pain worsening in knee osteoarthritis.Osteoarthritis and cartilage · 2023Article
- An Evaluation of Different Strategies for Sampling Controls in an Online Case-Crossover Study of Acute Flares in Knee Osteoarthritis.Clinical epidemiology · 2023Article
- Symmetry Function: The Differences between Active and Non-Active Above-the-Knee Amputees.Sensors (Basel, Switzerland) · 2022Article
- Osteoarthritis Flares.Clinics in geriatric medicine · 2022Review
- Case report: Electroacupuncture for acute pain flare-up of knee osteoarthritis.Frontiers in neurology · 2022Article
- Proposed Canadian Consensus Guidelines on Osteoarthritis Treatment Based on OA-COAST Stages 1-4.Frontiers in veterinary science · 2022Review
Corrections and comments
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Authors and funding
6 authors at 3 institutions in 2 countries.
Funding
Abstract
objectiveTo identify proximate causes ('triggers') of flares in adults with, or at risk of, knee osteoarthritis (OA), estimate their course and consequences, and determine higher risk individuals.
methodsIn this 13-week web-based case-crossover study adults aged ≥40 years, with or without a recorded diagnosis of knee OA, and no inflammatory arthropathy who self-reported a knee flare completed a questionnaire capturing information on exposure to 21 putative activity-related, psychosocial and environmental triggers (hazard period, ≤72 h prior). Comparisons were made with identical exposure measurements at four 4-weekly scheduled time points (non-flare control period) using conditional logistic regression. Flare was defined as a sudden onset of worsening signs and symptoms, sustained for ≥24 h. Flare characteristics, course and consequence were analysed descriptively. Associations between flare frequency and baseline characteristics were estimated using Poisson regression.
resultsOf 744 recruited participants (mean age [SD] 62.1 [10.2] years; 61% female), 376 reported 568 flares (hazards) and provided 867 valid control period measurements. Thirteen exposures (eight activity-related, five psychosocial/environmental) were positively associated with flare onset within 24 h (strongest odds ratio estimate, knee buckling: 9.06: 95% confidence interval [CI] 5.86, 13.99; weakest, cold/damp weather: 1.45: 95%CI 1.12, 1.87). Median flare duration was 5 days (IQR 3, 8), less common if older (incident rate ratio [IRR] 0.98: 95%CI 0.97, 0.99), more common if female (IRR 1.85: 95%CI 1.43, 2.39).
conclusionsMultiple activity-related, psychosocial and environmental exposures are implicated in triggering flares. This evidence can help inform prevention and acute symptom management for patients and clinicians.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.