Rheumatology International

, Volume 33, Issue 4, pp 903–911

The value of cartilage biomarkers in progressive knee osteoarthritis: cross-sectional and 6-year follow-up study in middle-aged subjects

Original Article


To determine the possible diagnostic and prognostic value of cartilage biomarkers in early-stage progressive and nonprogressive knee osteoarthritis (OA) in a population-based cohort of middle-aged subjects with chronic knee pain. Design tibiofemoral (TF) and patellofemoral (PF) radiographs were graded in 128 subjects (mean age at baseline, 45 ± 6.2 years) in 2002, 2005, and 2008. Cartilage degradation was assessed by urinary C-telopeptide fragments of type II collagen (uCTx-II), synthesis by serum type II A procollagen N-terminal propeptide (sPIIANP), and articular tissue turnover in general by cartilage oligomeric matrix protein (sCOMP). Several diagnostic associations were found between all studied biomarkers and progressive osteophytosis. COMP and CTx-II had a predictive value for subsequent progressive osteophytosis in multiple knee compartments and in case of CTx-II—also for progressive JSN. Over the first 3 years (2002–2005), significant associations were observed between COMP and progressive osteophytosis, whereas 3 years later (2005–2008) between CTx-II and progressive JSN. Thus, the associations between cartilage markers (COMP, CTx-II) and progression of radiographic OA features—osteophytes and JSN—were different between 2002–2005 and 2005–2008. Logistic regression revealed that for every unit increase in COMP level, there was 33 % higher risk for TF osteophyte progression. During early-stage OA, the presence and progression of osteophytosis is accompanied by increased level of cartilage biomarkers. This is the first study to demonstrate biochemical differences over the course of knee OA, illustrating a phasic nonpersistent character of OA with periods of progression and stabilization.


Osteoarthritis Knee Cartilage biomarkers Radiographic progression Osteophyte 


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Copyright information

© Springer-Verlag 2012

Authors and Affiliations

  • Jaanika Kumm
    • 1
    • 2
  • Ann Tamm
    • 3
  • Mare Lintrop
    • 4
  • Agu Tamm
    • 5
  1. 1.Clinic of Internal MedicineUniversity of TartuTartuEstonia
  2. 2.Clinic of RadiologyUniversity of TartuTartuEstonia
  3. 3.Clinic of Sports Medicine and RehabilitationUniversity of TartuTartuEstonia
  4. 4.Clinic of RadiologyUniversity of TartuTartuEstonia
  5. 5.Clinic of Internal MedicineUniversity of TartuTartuEstonia

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