A single recent injury is a potent risk factor for the development of accelerated knee osteoarthritis: data from the osteoarthritis initiative

Abstract

We examined the association between previously reported modifiable risk factors for accelerated knee osteoarthritis (AKOA) at the Osteoarthritis Initiative's (OAI) baseline and 48-month visits among adults who develop AKOA between the 48- and 96-month visits . We conducted a case-control study using data from the OAI baseline to the 96 month visit. Participants had no radiographic knee osteoarthritis (KOA) in the index knee at OAI baseline and 48-month visits (Kellgren-Lawrence [KL] <2). We classified 2 groups: 1) AKOA: ≥1 knee developed advance-stage KOA (KL=3 or 4) between 48-and 96-month visits and 2) No KOA: no KOA and no change in radiographic severity bilaterally over 96 months. We used logistic regression models to evaluate the association between the outcome of AKOA (versus no KOA) and several modifiable risk factors collected at OAI baseline and 48-month visits (body mass index (BMI), systolic blood pressure, comorbidity score, and NSAID use). We also explored a new injury from baseline to 48-months and from 48- to 96-months. Adults with greater baseline and 48-month BMI were more likely to develop AKOA. Injury was only associated with AKOA onset when it occurred within 4 years of developing AKOA (prior 2 years: odds ratio=6.21; 95% confidence interval [CI]=3.40, 11.35; 2–4 years prior: odds ratio=4.42, 95% CI=2.06, 9.50)). BMI may consistently predispose an adult to AKOA, but certain injuries are likely a catalyst for AKOA.

Characterizing the distinct structural changes associated with self‐reported knee injury among individuals with incident knee osteoarthritis: Data from the osteoarthritis initiative

“…Accelerated KOA individuals were more likely to experience distinct structural changes and not report an injury compared to common KOA, who frequently reported an injury despite having no observable structural changes. This supports our previous findings that accelerated KOA individuals are more likely to progress after a recent injury as well as potentially underreporting an injury when compared to common KOA (Davis et al, ; Driban et al, ). Those at risk for accelerated KOA and experiencing greater pain should be monitored closely even if they are not reporting a recent injury (Davis et al, ; Driban et al, ).…”

“…It has previously been found that a recent injury is associated with the development of accelerated KOA (Davis et al, 2014(Davis et al, , 2017b. Meniscal pathologies, particularly destabilizing tears (e.g., radial or root tears), are associated with an accelerated onset of KOA (Sung et al, 2013), but reliance on self-reported injury data has made it difficult to identify the type of injury sustained.…”

Risk factors and the natural history of accelerated knee osteoarthritis: a narrative review

“…Numerous factors may contribute to AKOA and help people identify who will develop it. Similar to typical knee osteoarthritis, older age and body mass index (BMI) are related to AKOA onset [1,9,10]. However, two subgroups are at greater risk for AKOA: 1) individuals < 65 years of age with BMI > 32.5 kg/m 2 and 2) individuals > 65 years of age that were typically overweight or obese with BMI < 35 kg/m 2 (only 27% had BMI < 25 kg/m 2 ) [10][11][12].…”

“…If a susceptible knee has large effusion-synovitis or degenerative cruciate ligaments that contribute to altered lower extremity biomechanics, then it is no surprise that these adults also report more knee injuries than their peers. Specifically, a single new injury may be a critical event that leads to joint failure or characterizes the onset of AKOA [1,9,32]. A history of a knee injury several years before the onset of AKOA is unrelated to disease onset [1,9].…”

Meniscal Root Tears and Extrusion Are Significantly Associated with the Development of Accelerated Knee Osteoarthritis: Data from the Osteoarthritis Initiative

“…5,6 Clinical risk factors associated with AKOA have been studied previously. Driban et al [7][8][9] identified higher age, recent knee injury, greater coronal tibial slope, and elevated body mass index (BMI) in subjects younger than 63.5 years as risk factors for AKOA. However, identifying subjects at risk of AKOA remains challenging given that most clinical risk factors are also well-established risk factors for knee OA in general.…”