Abstract
Purpose
A few new criteria for early detection and prevention of early knee osteoarthritis (EKOA) have been proposed. However, its prevalence, risk factors, relationship with function and prognosis have not been clarified. The purpose of this study was to investigate the prevalence of EKOA and its risk factors in the Japanese general population.
Methods
A total of 1104 volunteers (443 males, 661 females) who participated in the Iwaki cohort study in Japan were enrolled in this cross-sectional study. Their bilateral weight-bearing anterior–posterior knee radiographs were classified by Kellgren–Lawrence (KL) grade. EKOA (KL grade 0/1) was defined according to the following criteria: knee injury and osteoarthritis outcome score < 85%, joint line tenderness, and crepitus and its prevalence among age-sex groups was calculated. Logistic regression analyses were performed to determine the risk factors for EKOA.
Results
Eight hundred and twenty-two participants had KL grade 0/1, and the EKOA prevalence was 9.5% in males and 15.0% in females (p = 0.011). The prevalence of EKOA increased with age. The highest prevalence was noted in females aged 50–59 years. Logistic regression analysis showed that the risk factors for EKOA were age (p < 0.001, odds ratio (OR) 1.1), female sex (p = 0.002, OR 2.5), high body mass index (p < 0.001, OR 1.2), and history of knee injury (p < 0.001, OR 21.7).
Conclusions
The highest EKOA prevalence was observed in middle adult females (50–59 years old). The risk factors for EKOA were female sex, ageing, obesity and knee injury history, which were extremely similar to those of definitive knee osteoarthritis.
Level of evidence
Level I in diagnostic studies—investigating a diagnostic test.
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References
Amin S, LaValley MP, Guermazi A, Grigoryan M, Hunter DJ, Clancy M, Niu J, Gale DR, Felson DT (2018) The relationship between cartilage loss on magnetic resonance imaging and radiographic progression in men and women with knee osteoarthritis. Arthritis Rheum 52:3152–3159
Arendt EA, Berruto M, Filardo G, Ronga M, Zaffagnini S, Farr J, Ferrua P, Grassi A, Condello V (2016) Early osteoarthritis of the patellofemoral joint. Knee Surg Sports Traumatol Arthrosc 24:1836–1844
Baker K, Grainger A, Niu J, Clancy M, Guermazi A, Crema M, Hughes L, Buckwalter J, Wooley A, Nevitt M, Felson DT (2010) Relation of synovitis to knee pain using contrast-enhanced MRIs. Ann Rheum Dis 69:1779–1783
Bekkers JE, de Windt TS, Raijmakers NJ, Dhert WJ, Saris DB (2009) Validation of the knee injury and osteoarthritis outcome score (KOOS) for the treatment of focal cartilage lesions. Osteoarthr Cartilage 17:1434–1439
Cameron KL, Thompson BS, Peck KY, Owens BD, Marshall SW, Svoboda SJ (2013) Normative values for the KOOS and WOMAC in a young athletic population: history of knee ligament injury is associated with lower scores. Am J Sports Med 41:582–589
Chiba D, Wada K, Tanaka T, Kumagai G, Sasaki E, Takahashi I, Nakaji S, Ishibashi Y (2017) Serum pentosidine concentration is associated with radiographic severity of lumbar spondylosis in a general Japanese population. J Bone Miner Metab 35:65–72
Coggon D, Croft P, Kellingray S, Barrett D, McLaren M, Cooper C (2000) Occupational physical activities and osteoarthritis of the knee. Arthritis Rheum 43:1443–1449
Collins NJ, Misra D, Felson DT, Crossley KM, Roos EM (2011) Measures of knee function: international knee documentation committee (IKDC) subjective knee evaluation form, knee injury and osteoarthritis outcome score (KOOS), knee injury and osteoarthritis outcome score physical function short form (KOOS-PS), knee outcome survey activities of daily living scale (KOS-ADL), lysholm knee scoring scale, oxford knee score (OKS), western ontario and mcmaster universities osteoarthritis index (WOMAC), activity rating scale (ARS), and tegner activity score (TAS). Arthritis Care Res (Hoboken) 63:S208–S228
Creamer P, Keen M, Zananiri F, Waterton JC, Maciewicz RA, Oliver C, Dieppe P, Watt I (1997) Quantitative magnetic resonance imaging of the knee: a method of measuring response to intra-articular treatments. Ann Rheum Dis 56:378–381
Farrell M, Richards JG (1986) Analysis of the reliability and validity of the kinetic communicator exercise device. Med Sci Sports Exerc 18:44–49
Felson DT, Niu J, Guermazi A, Sack B, Aliabadi P (2011) Defining radiographic incidence and progression of knee osteoarthritis: suggested modifications of the Kellgren and Lawrence scale. Ann Rheum Dis 70:1884–1886
Felson DT, Zhang Y, Hannan MT, Naimark A, Weissman BN, Aliabadi P, Levy D (1995) The incidence and natural history of knee osteoarthritis in the elderly. The framingham osteoarthritis study. Arthritis Rheum 38:1500–1505
Fernandes GS, Bhattacharya A, McWilliams DF, Ingham SL, Doherty M, Zhang W (2017) Risk prediction model for knee pain in the Nottingham community: a Bayesian modelling approach. Arthritis Res Ther 19:59
Fukuhara S, Bito S, Green J, Hsiao A, Kurokawa K (1998) Translation, adaptation, and validation of the SF-36 Health Survey for use in Japan. J Clin Epidemiol 51:1037–1044
Golightly YM, Marshall SW, Kraus VB, Renner JB, Villaveces A, Casteel C, Jordan JM (2011) Biomarkers of incident radiographic knee osteoarthritis: do they vary by chronic knee symptoms? Arthritis Rheum 63:2276–2283
Grindrod KA, Marra CA, Colley L, Cibere J, Tsuyuki RT, Esdaile JM, Gastonguay L, Kopec J (2010) After patients are diagnosed with knee osteoarthritis, what do they do? Arthritis Care Res (Hoboken) 62:510–515
Hada S, Ishijima M, Kaneko H, Kinoshita M, Liu L, Sadatsuki R, Futami I, Yusup A, Takamura T, Arita H, Shiozawa J, Aoki T, Takazawa Y, Ikeda H, Aoki S, Kurosawa H, Okada Y, Kaneko K (2017) Association of medial meniscal extrusion with medial tibial osteophyte distance detected by T2 mapping MRI in patients with early-stage knee osteoarthritis. Arthritis Res Ther 19:201
Hayashi D, Roemer FW, Katur A, Felson DT, Yang SO, Alomran F, Guermazi A (2011) Imaging of synovitis in osteoarthritis: current status and outlook. Semin Arthritis Rheum 41:116–130
Hiligsmann M, Cooper C, Arden N, Boers M, Branco JC, Luisa Brandi M, Bruyère O, Guillemin F, Hochberg MC, Hunter DJ, Kanis JA, Kvien TK, Laslop A, Pelletier JP, Pinto D, Reiter-Niesert S, Rizzoli R, Rovati LC, Severens JL, Silverman S, Tsouderos Y, Tugwell P, Reginster JY (2013) Health economics in the field of osteoarthritis: an expert’s consensus paper from the European society for clinical and economic aspects of osteoporosis and osteoarthritis (ESCEO). Semin Arthritis Rheum 43:303–313
Hill CL, Hunter DJ, Niu J, Clancy M, Guermazi A, Genant H, Gale D, Grainger A, Conaghan P, Felson DT (2007) Synovitis detected on magnetic resonance imaging and its relation to pain and cartilage loss in knee osteoarthritis. Ann Rheum Dis 66:1599–1603
Iijima H, Fukutani N, Aoyama T, Fukumoto T, Uritani D, Kaneda E, Ota K, Kuroki H, Matsuda S (2016) Clinical impact of coexisting patellofemoral osteoarthritis in Japanese patients with medial knee osteoarthritis. Arthritis Care Res (Hoboken). 68:493–501
Inoue R, Ishibashi Y, Tsuda E, Yamamoto Y, Matsuzaka M, Takahashi I, Danjo K, Umeda T, Nakaji S, Toh S (2011) Medical problems and risk factors of metabolic syndrome among radiographic knee osteoarthritis patients in the Japanese general population. J Orthop Sci 16:704–709
Ishijima M, Watari T, Naito K, Kaneko H, Futami I, Yoshimura-Ishida K, Tomonaga A, Yamaguchi H, Yamamoto T, Nagaoka I, Kurosawa H, Poole RA, Kaneko K (2011) Relationships between biomarkers of cartilage, bone, synovial metabolism and knee pain provide insights into the origins of pain in early knee osteoarthritis. Arthritis Res Ther 13:R22
Kellgren JH, Lawrence RC (1957) Radiological assessment of osteo-arthrosis. Ann Rheum Dis 16:494–502
Kraus VB, Kepler TB, Stabler T, Renner J, Jordan J (2010) First qualification study of serum biomarkers as indicators of total body burden of osteoarthritis. PLoS One 5:e9739
Lane NE, Brandt K, Hawker G, Peeva E, Schreyer E, Tsuji W, Hochberg MC (2011) OARSI-FDA initiative: defining the disease state of osteoarthritis. Osteoarthr Cartilage 19:478–482
Lawrence RC, Helmick CG, Arnett FC, Deyo RA, Felson DT, Giannini EH, Heyse SP, Hirsch R, Hochberg MC, Hunder GG, Liang MH, Pillemer SR, Steen VD, Wolfe F (1998) Estimates of the prevalence of arthritis and selected musculoskeletal disorders in the United States. Arthritis Rheum 41:778–799
Leyland KM, Hart DJ, Javaid MK, Judge A, Kiran A, Soni A, Goulston LM, Cooper C, Spector TD, Arden NK (2012) The natural history of radiographic knee osteoarthritis: a fourteen-year population-based cohort study. Arthritis Rheum 64:2243–2251
Luyten FP, Bierma-Zeinstra S, Dell’Accio F, Kraus VB, Nakata K, Sekiya I, Arden NK, Lohmander LS (2018) Toward classification criteria for early osteoarthritis of the knee. Semin Arthritis Rheum 47:457–463
Luyten FP, Denti M, Filardo G, Kon E, Engebretsen L (2012) Definition and classification of early osteoarthritis of the knee. Knee Surg Sports Traumatol Arthrosc 20:401–406
Magnusson K, Kumm J, Turkiewicz A, Englund M (2018) A naturally aging knee, or development of early knee osteoarthritis? Osteoarthr Cartilage 26:1447–1452
Migliore A, Scirè CA, Carmona L, Herrero-Beaumont G, Bizzi E, Branco J, Carrara G, Chevalier X, Collaku L, Aslanidis S, Denisov L, Di Matteo L, Bianchi G, Diracoglu D, Frediani B, Maheu E, Martusevich N, Bagnato GF, Scarpellini M, Minisola G, Akkoc N, Ramonda R, Barskova T, Babic-Naglic D, Muelas JVM, Ionescu R, Rashkov R, Damjanov N, Cerinic MM (2017) The challenge of the definition of early symptomatic knee osteoarthritis: a proposal of criteria and red flags from an international initiative promoted by the Italian Society for Rheumatology. Rheumatol Int 37:1227–1236
Misra D, Fielding RA, Felson DT, Niu J, Brown C, Nevitt M, Lewis CE, Torner J, Neogi T (2019) multicenter osteoarthritis (MOST) study. Risk of knee oa with obesity, sarcopenic obesity and sarcopenia. Arthritis Rheumatol 71:232–237
Mündermann A, Dyrby CO, Hurwitz DE, Sharma L, Andriacchi TP (2004) Potential strategies to reduce medial compartment loading in patients with knee osteoarthritis of varying severity: reduced walking speed. Arthritis Rheum 50:1172–1178
Muraki S, Akune T, Oka H, Ishimoto Y, Nagata K, Yoshida M, Tokimura F, Nakamura K, Kawaguchi H, Yoshimura N (2012) Incidence and risk factors for radiographic knee osteoarthritis and knee pain in Japanese men and women: a longitudinal population-based cohort study. Arthritis Rheum 64:1447–1456
Nakamura N, Takeuchi R, Sawaguchi T, Ishikawa H, Saito T, Goldhahn S (2011) Cross-cultural adaptation and validation of the Japanese knee injury and osteoarthritis outcome score (KOOS). J Orthop Sci 16:516–523
Øiestad BE, Juhl CB, Eitzen I, Thorlund JB (2015) Knee extensor muscle weakness is a risk factor for development of knee osteoarthritis. A systematic review and meta-analysis. Osteoarthr Cartilage 23:171–177
Oishi K, Tsuda E, Yamamoto Y, Maeda S, Sasaki E, Chiba D, Takahashi I, Nakaji S, Ishibashi Y (2016) The knee injury and osteoarthritis outcome score reflects the severity of knee osteoarthritis better than the revised knee society score in a general Japanese population. Knee 23:35–42
Ota S, Chiba D, Sasaki E, Kumagai G, Yamamoto Y, Nakaji S, Tsuda E, Ishibashi Y (2019) Symptomatic bone marrow lesions induced by reduced bone mineral density in middle-aged women: a cross-sectional Japanese population study. Arthritis Res Ther 21:113
Paradowski PT, Bergman S, Sundén-Lundius A, Lohmander LS, Roos EM (2006) Knee complaints vary with age and gender in the adult population Population-based reference data for the knee injury and osteoarthritis outcome score (KOOS). BMC Musculoskelet Disord 7:38
Roemer FW, Kassim Javaid M, Guermazi A, Thomas M, Kiran A, Keen R, King L, Arden NK (2010) Anatomical distribution of synovitis in knee osteoarthritis and its association with joint effusion assessed on non-enhanced and contrast-enhanced MRI. Osteoarthr Cartilage 18:1269–1274
Roos EM, Toksvig-Larsen S (2003) Knee injury and osteoarthritis outcome score (KOOS) evalidation and comparison to the WOMAC in total knee replacement. Health Qual Life Outcomes 1:17–26
Sasaki E, Sasaki S, Chiba D, Yamamoto Y, Nawata A, Tsuda E, Nakaji S, Ishibashi Y (2018) Age-related reduction of trunk muscle torque and prevalence of trunk sarcopenia in community-dwelling elderly: validity of a portable trunk muscle torque measurement instrument and its application to a large sample cohort study. PLoS One 13:e0192687
Sasaki E, Tsuda E, Yamamoto Y, Iwasaki K, Inoue R, Takahashi I, Sawada K, Fujita H, Umeda T, Nakaji S, Ishibashi Y (2013) Serum hyaluronan levels increase with the total number of osteoarthritic joints and are strongly associated with the presence of knee and finger osteoarthritis. Int Orthop 37:925–930
Sasaki E, Tsuda E, Yamamoto Y, Maeda S, Inoue R, Chiba D, Fujita H, Takahashi I, Umeda T, Nakaji S, Ishibashi Y (2015) Serum hyaluronic acid concentration predicts the progression of joint space narrowing in normal knees and established knee osteoarthritis–a five-year prospective cohort study. Arthritis Res Ther 17:283
Sellam J, Berenbaum F (2010) The role of synovitis in pathophysiology and clinical symptoms of osteoarthritis. Nat Rev Rheumatol 6:625–635
Shimura Y, Kurosawa H, Sugawara Y, Tsuchiya M, Sawa M, Kaneko H, Futami I, Liu L, Sadatsuki R, Hada S, Iwase Y, Kaneko K, Ishijima M (2013) The factors associated with pain severity in patients with knee osteoarthritis vary according to the radiographic disease severity: a cross-sectional study. Osteoarthr Cartilage 21:1179–1184
Soni A, Kiran A, Hart DJ, Leyland KM, Goulston L, Cooper C, Javaid MK, Spector TD, Arden NK (2012) Prevalence of reported knee pain over twelve years in a community-based cohort. Arthritis Rheum 64:1145–1152
Takagi S, Omori G, Koga H, Endo K, Koga Y, Nawata A, Endo N (2018) Quadriceps muscle weakness is related to increased risk of radiographic knee OA but not its progression in both women and men: the Matsudai knee osteoarthritis survey. Knee Surg Sports Traumatol Arthrosc 26:2607–2614
Taniguchi N, Matsuda S, Kawaguchi T, Tabara Y, Ikezoe T, Tsuboyama T, Ichihashi N, Nakayama T, Matsuda F, Ito H (2015) The KSS 2011 reflects symptoms, physical activities, and radiographic grades in a Japanese population. Clin Orthop Relat Res 473:70–75
Thorlund JB, Felson DT, Segal NA, Nevitt MC, Niu J, Neogi T, Lewis CE, Guermazi A, Roemer F, Englund M (2016) Effect of knee extensor strength on incident radiographic and symptomatic knee osteoarthritis in individuals with meniscal pathology: data From the multicenter osteoarthritis study. Arthritis Care Res (Hoboken) 68:1640–1646
Ware JE Jr, Sherbourne CD (1992) The MOS 36-item short-form health survey (SF-36). I. Conceptual framework and item selection. Med Care 30:473–483
Warner WL, Meeker M, Eells K (1949) Social class in America. Science Research, New York
Yoshimura N, Muraki S, Oka H, Mabuchi A, En-Yo Y, Yoshida M, Saika A, Yoshida H, Suzuki T, Yamamoto S, Ishibashi H, Kawaguchi H, Nakamura K, Akune T (2009) Prevalence of knee osteoarthritis, lumbar spondylosis, and osteoporosis in Japanese men and women: the research on osteoarthritis/osteoporosis against disability study. J Bone Miner Metab 27:620–628
Acknowledgements
We would like to thank Editage (www.editage.jp) for English language editing.
Funding
This study was supported in part by a Grant-in-Aid from the Japanese Society for the Promotion of Science (Nos. 21500676, 18K16606, 18K09091), Health Labor Sciences Research Grant, JOA-Subsidized Science Project Research from the Japanese Orthopedic Association, and the Centre of Innovation Program from the Japan Science and Technology Agency.
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Sasaki, E., Ota, S., Chiba, D. et al. Early knee osteoarthritis prevalence is highest among middle-aged adult females with obesity based on new set of diagnostic criteria from a large sample cohort study in the Japanese general population. Knee Surg Sports Traumatol Arthrosc 28, 984–994 (2020). https://doi.org/10.1007/s00167-019-05614-z
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DOI: https://doi.org/10.1007/s00167-019-05614-z