P256 EARLY OSTEOARTHRITIS: HOW TO DEFINE, DIAGNOSE, AND MANAGE − A SYSTEMATIC REVIEW

Objective: Osteoarthritis (OA) is the major cause of joint pain and impaired mobility resulting in a marked reduction of quality of life (QoL) [1]. It would be of crucial importance to have a clear definition of early OA (EOA) in order to adopt proper preventive measures that might result in better long-term quality of life of affected patients and reduce or delay the need of joint replacement interventions, with the related implications in terms of economic impact on healthcare services. Aim of this systematic review (SR) was to define the “state of the art” on definition, diagnosis, and management of EOA. Methods:We carried out an updated systematic review on both PubMed and Embase databases searching for all the studies and researches published in literature – up to 31December 2015 – whichwere addressing the issues of EOA definition, diagnosis, and management. The systematic review has been carried out following the 5 steps summarized by Khan and colleagues in 2003 [2]. Results: Our SR found 211 and 447 (published from1973-2015) articles, when searching on PubMed and Embase database, respectively. Among the 132 papers that met our inclusion criteria, only 1 article explicitly addressed the issue of EOA definition [3], but it was only an expert opinion, while all the other researches were focused on diagnosis or management of EOA. EOA has been defined with regards to the younger age of osteoarthritis onset and radiological damage (grade I-II of the Kellgren-Lawrence classification). Conclusion: Until now, EOA has been defined with regards to the age of the patient and the precocity of radiologically measureable damages. A more clear classification of EOA (especially hip and knee EOA), based on characteristics and symptoms of affected patients, should be delivered by scientific community in order to better identify subjects who might benefit from innovative therapeutic approaches. References: 1. World Health Organisation (WHO). The burden of musculoskeletal conditions at the start of the new millennium (WHO Technical Report Series 919). Geneva: World Health Organisation; 2003. 2. Khan KS et al. J R Soc Med 2003;96:118 3. Luyten FP et al. Knee Surg Sports Traumatol Arthrosc 2012;20:401