Abstract
The objective of this study was to identify risk factors for knee osteoarthritis (OA) development in a young to middle-aged population with sub-acute knee complaints. This, in order to define high risk patients who may benefit from early preventive or future disease modifying therapies. Knee OA development visible on radiographs and MR in 319 patients (mean age 41.5 years) 10 years after sub-acute knee complaints and subjective knee function (KOOS score) was studied. Associations between OA development and age, gender, activity level, BMI, meniscal or anterior cruciate ligament (ACL) lesions, OA in first-degree relatives and radiographic hand OA were determined using multivariable logistic regression analysis. OA on radiographs and MR in the TFC is associated with increased age (OR: 1.10, 95 % 1.04–1.16 and OR: 1.07, 95 % 1.02–1.13). TFC OA on radiographs only is associated with ACL and/or meniscal lesions (OR: 5.01, 95 % 2.14–11.73), presence of hand OA (OR: 4.69, 95 % 1.35–16.32) and higher Tegner activity scores at baseline before the complaints (OR: 1.20, 95 % 1.01–1.43). The presence of OA in the TFC diagnosed only on MRI is associated with a family history of OA (OR: 2.44, 95 % 1.18–5.06) and a higher BMI (OR: 1.13, 95 % 1.04–1.23). OA in the PFC diagnosed on both radiographs and MR is associated with an increased age (OR: 1.06, 95 % 1.02–1.12 and OR: 1.05, 95 % 1.00–1.09). PFC OA diagnosed on radiographs only is associated with a higher BMI (OR: 1.12, 95 % 1.02–1.22). The presence of OA in the PFC diagnosed on MR only is associated with the presence of hand OA (OR: 3.39, 95 % 1.10–10.50). Compared to normal reference values, the study population had significantly lower KOOS scores in the different subscales. These results show that knee OA development in young to middle aged patients with a history of sub-acute knee complaints is associated with the presence of known risk factors for knee OA. OA is already visible on radiographs and MRI after 10 years. These high risk patients may benefit from adequate OA management early in life.
Similar content being viewed by others
Abbreviations
- AC:
-
Anterior cruciate ligament
- OA:
-
Osteoarthritis
- JSN:
-
Joint space narrowing
- JSW:
-
Joint space width
References
Neogi T, Zhang Y (2013) Epidemiology of osteoarthritis. Rheum Dis Clin N Am 39(1):1–19
Grotle M, Hagen KB, Natvig B, Dahl FA, Kvien TK (2008) Obesity and osteoarthritis in knee, hip and/or hand: an epidemiological study in the general population with 10 years follow-up. BMC Musculoskelet Disord 35(4):132
Kalichman L, Hernandez-Molina G (2010) Hand osteoarthritis: an epidemiological perspective. Semin Arthritis Rheum 39(6):465–476
Bierma-Zeinstra SM, Koes BW. Risk factors and prognostic factors of hip and knee osteoarthritis. Nat.Clin.Pract.Rheumatol. 2007;78–85
Blagojevic M, Jinks C, Jeffery A, Jordan KP. Risk factors for onset of osteoarthritis of the knee in older adults: a systematic review and meta-analysis. Osteoarthritis.Cartilage. 2010;24–33
Haugen IK, Englund M, Aliabadi P, Niu J, Clancy M, Kvien TK, Felson DT (2011) Prevalence, incidence and progression of hand osteoarthritis in the general population: the Framingham Osteoarthritis Study. Ann Rheum Dis 70(9):1581–1586
Felson DT, Lawrence RC, Dieppe PA, Hirsch R, Helmick CG, Jordan JM, Kington RS, Lane NE, Nevitt MC, Zhang Y, Sowers M, McAlindon T, Spector TD, Poole AR, Yanovski SZ, Ateshian G, Sharma L, Buckwalter JA, Brandt KD, Fries JF. Osteoarthritis: new insights. Part 1: the disease and its risk factors. Ann.Intern.Med. 2000;635–46
Martel-Pelletier J, Wildi LM, Pelletier JP (2012) Future therapeutics for osteoarthritis. Bone 51(2):297–311
Muthuri SG, McWilliams DF, Doherty M, Zhang W (2011) History of knee injuries and knee osteoarthritis: a meta-analysis of observational studies. Osteoarthr Cartil 19(11):1286–1293
Hirsch R, Lethbridge-Cejku M, Scott WW, Jr., Reichle R, Plato CC, Tobin J, Hochberg MC. Association of hand and knee osteoarthritis: evidence for a polyarticular disease subset. Ann.Rheum.Dis. 1996;25–9
Lohmander LS, Felson D (2004) Can we identify a’high risk’ patient profile to determine who will experience rapid progression of osteoarthritis? Osteoarthr Cart S49-S52
Hochberg MC, Lane NE, Pressman AR, Genant HK, Scott JC, Nevitt MC (1995) The association of radiographic changes of osteoarthritis of the hand and hip in elderly women. J Rheumatol 22(12):2291–2294
Dahaghin S, Bierma-Zeinstra SM, Reijman M, Pols HA, Hazes JM, Koes BW. Does hand osteoarthritis predict future hip or knee osteoarthritis? Arthritis Rheum
Harris PA, Hart DJ, Dacre JE, Huskisson EC, Spector TD (1994) The progression of radiological hand osteoarthritis over ten years: a clinical follow-up study. Osteoarthr Cart 247–52
Valdes AM, Spector TD (2008) The contribution of genes to osteoarthritis. Rheum Dis Clin North Am 581–603
Haugen IK, Cotofana S, Englund M, Kvien TK, Dreher D, Nevitt M, Lane NE, Eckstein F (2012) Hand joint space narrowing and osteophytes are associated with magnetic resonance imaging-defined knee cartilage thickness and radiographic knee osteoarthritis: data from the Osteoarthritis Initiative. J Rheumatol 16(6):161–166
Riyazi N, Rosendaal FR, Slagboom E, Kroon HM, Breedveld FC, Kloppenburg M (2008) Risk factors in familial osteoarthritis: the GARP sibling study. Osteoarthr Cartil 16(6):654–569
Jiang L, Tian W, Wang Y, Rong J, Bao C, Liu Y, Zhao Y, Wang C (2012) Body mass index and susceptibility to knee osteoarthritis: a systematic review and meta-analysis. Joint Bone Spine 79(3):291–297
Jonsson H, Helgadottir GP, Aspelund T, Eiriksdottir G, Sigurdsson S, Siggeirsdottir K, Ingvarsson T, Harris TB, Launer L, Gudnason V (2011) Hand Osteoarthritis Severity is Associated with Total Knee Joint Replacements Independently of BMI. The Ages-Reykjavik Study. Open Rheumatol J 5:7–12
Riyazi N, Meulenbelt I, Kroon HM, Ronday KH, Hellio le Graverand MP, Rosendaal FR, Breedveld FC, Slagboom PE, Kloppenburg M. Evidence for familial aggregation of hand, hip, and spine but not knee osteoarthritis in siblings with multiple joint involvement: the GARP study. Ann.Rheum.Dis. 2005;438–43
Hunter DJ, Hellio Le Graverand-Gastineau MP (2009) How close are we to having structure-modifying drugs available? Med. Clin North Am 93(1):223–234
Rannou F, Poiraudeau S (2010) Non-pharmacological approaches for the treatment of osteoarthritis. Best Pract Res Clin Rheumatol 24(1):93–106
Smink AJ, van den Ende CH, Vliet Vlieland TP, Swierstra BA, Kortland JH, Bijlsma JW, Voorn TB, Schers HJ, Bierma-Zeinstra SM, Dekker J (2011) “Beating osteoARThritis“: development of a stepped care strategy to optimize utilization and timing of non-surgical treatment modalities for patients with hip or knee osteoarthritis. Clin Rheumatol 30(12):1623–1629
Vincken PW, ter Braak AP, van Erkel AR, Coerkamp EG, de Rooy TP, de LS, Mallens WM, Coene LN, Bloem RM, van Luijt PA, van den Hout WB, van Houwelingen HC, Bloem JL (2007) MR imaging: effectiveness and costs at triage of patients with nonacute knee symptoms 11. Radiology 85–93
Guermazi A, Burstein D, Conaghan P, Eckstein F, Hellio Le Graverand-Gastineau MP, Keen H, Roemer FW (2008) Imaging in osteoarthritis. Rheum Dis Clin North Am 34(3):645–687
Hunter DJ, Arden N, Conaghan PG, Eckstein F, Gold G, Grainger A, Guermazi A, Harvey W, Jones G, Hellio le Graverand MP, Laredo JD, Lo G, Losina E, Mosher TJ, Roemer F, Zhang W (2011) Definition of osteoarthritis on MRI: results of a Delphi exercise. Osteoarthr Cart 963–9
Altman RD, Hochberg M, Murphy WA, Jr., Wolfe F, Lequesne M (1995) Atlas of individual radiographic features in osteoarthritis. Osteoarthr Cart 3–70
van Saase JL, van Romunde LK, Cats A, Vandenbroucke JP, Valkenburg HA (1989) Epidemiology of osteoarthritis: Zoetermeer survey. Comparison of radiological osteoarthritis in a Dutch population with that in 10 other populations. Ann Rheum Dis 271–80
Huetink K, van ’t KR, Kaptein BL, Watt I, Kloppenburg M, Nelissen RG, Reiber JH, Stoel BC (2012) Automatic radiographic quantification of hand osteoarthritis; accuracy and sensitivity to change in joint space width in a phantom and cadaver study. Skeletal Radiol 41(1): 41–49.
van’t Klooster R, Hendriks EA, Watt I, Kloppenburg M, Reiber JH, Stoel BC (2008) Automatic quantification of osteoarthritis in hand radiographs: validation of a new method to measure joint space width. Osteoarthr Cart 18–25
Paradowski PT, Bergman S, Sunden-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 38
Kornaat PR, Ceulemans RY, Kroon HM, Riyazi N, Kloppenburg M, Carter WO, Woodworth TG, Bloem JL (2005) MRI assessment of knee osteoarthritis: Knee Osteoarthritis Scoring System (KOSS)--inter-observer and intra-observer reproducibility of a compartment-based scoring system. Skeletal Radiol 95–102
Kornaat PR, Watt I, Riyazi N, Kloppenburg M, Bloem JL (2005) The relationship between the MRI features of mild osteoarthritis in the patellofemoral and tibiofemoral compartments of the knee. Eur Radiol 1538–43
Neuman P, Kostogiannis I, Friden T, Roos H, Dahlberg LE, Englund M (2009) Patellofemoral osteoarthritis 15 years after anterior cruciate ligament injury--a prospective cohort study. Osteoarthr Cartil 17(3):284–290
ooper C, McAlindon T, Snow S, Vines K, Young P, Kirwan J, Dieppe P (1994) Mechanical and constitutional risk factors for symptomatic knee osteoarthritis: differences between medial tibiofemoral and patellofemoral disease. J Rheumatol 307–13
Wilder FV, Barrett JP, Farina EJ (2006) Joint-specific prevalence of osteoarthritis of the hand. Osteoarthr Cartil 14(9):953–957
Hinman RS, Crossley KM (2007) Patellofemoral joint osteoarthritis: an important subgroup of knee osteoarthritis. Rheumatology (Oxford) 46(7):1057–1062
Egloff C, Hugle T, Valderrabano V. Biomechanics and pathomechanisms of osteoarthritis. Swiss.Med.Wkly. 2012;w13583
Felson DT, Couropmitree NN, Chaisson CE, Hannan MT, Zhang Y, McAlindon TE, LaValley M, Levy D, Myers RH. Evidence for a Mendelian gene in a segregation analysis of generalized radiographic osteoarthritis: the Framingham Study. Arthritis Rheum. 1998;1064–71
Hirsch R, Lethbridge-Cejku M, Hanson R, Scott WW, Jr., Reichle R, Plato CC, Tobin JD, Hochberg MC. Familial aggregation of osteoarthritis: data from the Baltimore Longitudinal Study on Aging. Arthritis Rheum. 1998;1227–32
Felson DT, Zhang Y, Hannan MT, Naimark A, Weissman B, Aliabadi P, Levy D. Risk factors for incident radiographic knee osteoarthritis in the elderly: the Framingham Study. Arthritis Rheum. 1997;728–33
Franklin J, Ingvarsson T, Englund M, Lohmander LS (2009) Sex differences in the association between body mass index and total hip or knee joint replacement resulting from osteoarthritis. Ann Rheum Dis 68(4):536–540
Vignon E, Valat JP, Rossignol M, Avouac B, Rozenberg S, Thoumie P, Avouac J, Nordin M, Hilliquin P (2006) Osteoarthritis of the knee and hip and activity: a systematic international review and synthesis (OASIS). Joint Bone Spine 73(4):442–455
Roos EM, Lohmander LS (2003) The Knee injury and Osteoarthritis Outcome Score (KOOS): from joint injury to osteoarthritis. Health Qual Life Outcomes 64
Hunter DJ (2008) Advanced imaging in osteoarthritis. Bull NYU Hosp Jt Dis 251–60
Losina E, Daigle ME, Suter LG, Hunter DJ, Solomon DH, Walensky RP, Jordan JM, Burbine SA, Paltiel AD, Katz JN (2013) Disease-modifying drugs for knee osteoarthritis: can they be cost-effective? Osteoarthritis. Cartilage 21(5):655-67
Tegner Y, Lysholm J (1985) Rating systems in the evaluation of knee ligament injuries. Clin Orthop Relat Res 43–9
Kellgren JH, Lawrence JS (1957) Radiological assessment of osteo-arthrosis. Ann Rheum Dis 16(4):494–502
Haara MM, Manninen P, Kroger H, Arokoski JP, Karkkainen A, Knekt P, Aromaa A, Heliovaara M (2003) Osteoarthritis of finger joints in Finns aged 30 or over: prevalence, determinants, and association with mortality. Ann Rheum Dis 62(2):151–158
Mmanipphyty CM, Nicholson H, Baxter GD, Abbott JH. Patient characteristics that predict progression of knee osteoarthritis: A systematic review of prognostic studies. Arthritis Care Res.(Hoboken.) 2011
Goekoop RJ, Kloppenburg M, Kroon HM, Dirkse LE, Huizinga TW, Westendorp RG, Gussekloo J (2011) Determinants of absence of osteoarthritis in old age. Scand J Rheumatol 40(1):68-73
Holliday KL, McWilliams DF, Maciewicz RA, Muir KR, Zhang W, Doherty M (2011) Lifetime body mass index, other anthropometric measures of obesity and risk of knee or hip osteoarthritis in the GOAL case–control study. Osteoarthr Cart 37–43
Acknowledgments
This work was supported by the Dutch Arthritis Foundation (Reumafonds) [Grant number 05–2-302 and LRR] and the Dutch Healthcare Insurance Board (College voor Zorgverzekeringen, CVZ). These funding sources had no involvement in data collection, analysis, or the preparation of this manuscript.
Ethical standards
The study was approved by the Medical Ethics Review Board and a written informed consent was obtained from all patients prior to inclusion.
Conflict of interest
None to declare by any of the authors
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Huétink, K., Stoel, B.C., Watt, I. et al. Identification of factors associated with the development of knee osteoarthritis in a young to middle-aged cohort of patients with knee complaints. Clin Rheumatol 34, 1769–1779 (2015). https://doi.org/10.1007/s10067-014-2774-0
Received:
Revised:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s10067-014-2774-0