Association of radiographic hand osteoarthritis with radiographic knee osteoarthritis after meniscectomy

Abstract

Objective. To evaluate the association between radiographic hand osteoarthritis (OA), a disease with marked heredity, and radiographic knee OA in patients treated with meniscectomy.Methods. We retrospectively identified 170 patients (mean age 54 years [range 33-87 years], 23% women) who had undergone isolated meniscectomy an average of 20 years earlier (range 17-22 years). Patients with cruciate ligament injury were excluded. All subjects were examined by standardized knee and hand radiography. Individual joints were considered to have OA when displaying radiographic features corresponding to a Kellgren/Lawrence (K/L) grade >2. Hand OA was considered present if at least 1 of the following criteria was fulfilled: the presence of radiographic OA (K/L grade >2) in at least 1 interphalangeal joint in each hand symmetrically, or in at least 2 distal or proximal interphalangeal joints in the same hand in a pattern consistent with primary OA (in the same row or ray), or in the first carpometacarpal joint bilaterally. The association between radiographic hand OA and radiographic knee OA was evaluated using logistic regression.Results. Radiographic hand OA was present in 57 patients (34%) and radiographic knee OA was identified in 105 patients (62%), within 94 index knees (55%) and 47 contralateral knees (28%). In a multivariate model, radiographic hand OA was associated with an increased likelihood of radiographic OA in the index knee (odds ratio [OR] 3.0, 95% confidence interval [95% CI] 1.2-7.5) and in the nonoperated contralateral knee (OR 3.5, 95% CI 1.0-12.2).Conclusion. The presence of radiographic hand OA is associated with an increased frequency of radiographic knee OA after meniscectomy. This finding confirms and extends that of a single previous study showing an interaction between hereditary and environmental risk factors for OA, a common and genetically complex disease. Accordingly, the development of OA following a meniscal tear and the resulting meniscal surgery should not be regarded to be of secondary origin only.

Risk factors for symptomatic knee osteoarthritis fifteen to twenty‐two years after meniscectomy

“…Other risk factors thus need to be addressed. The contributing influence of heredity has been suggested by the association between radiographic OA of the hand and radiographic OA of the knee found after meniscectomy (13,36). We have previously demonstrated the impact of preexisting early-stage OA (8); in further support of this is the higher frequency of intraoperative cartilage changes seen in conjunction with the degenerative type of meniscal tear in the present study, consistent with previous findings (37,38).…”

“…We have previously demonstrated an interaction between the endogenous risk factor heritable OA and exogenous OA risk in the form of meniscectomy (13), as well as the impact of the type of meniscal tear that may indicate preexisting early-stage knee OA (8). The present study was undertaken to evaluate the influence of additional risk factors for OA in the meniscectomized knee.…”

Epidemiology of Posttraumatic Osteoarthritis

“…75 In the hand, the heritability of OA is more than 60%. 75 Previously, investigators 76 examined the association between hand OA and the risk of knee OA development after meniscectomy performed on average 20 years before study enrollment. The presence of hand OA was associated with a higher rate of knee OA development (OR ¼ 3.0; 95% CI ¼ 1.2, 7.5), thereby suggesting that knee OA development after meniscectomy may not be entirely due to joint trauma and that the patients who developed OA could have been genetically predisposed to develop the disease.…”

“…The presence of hand OA was associated with a higher rate of knee OA development (OR ¼ 3.0; 95% CI ¼ 1.2, 7.5), thereby suggesting that knee OA development after meniscectomy may not be entirely due to joint trauma and that the patients who developed OA could have been genetically predisposed to develop the disease. 76 Similarly, Valdes et al 77 researched the influence of genetic risk factors on total knee and total hip arthroplasty rates among individuals with or without a history of joint injury. Genetic factors contributed to the risk of total knee and hip arthroplasty nearly equally among individuals with or without a history of joint injury.…”

Osteoarthritis Of The Knee: Assessing The Disease

“…All subjects who have developed OA are probably affected by both genetics and environmental factors with individually distributed predominance. It has previously been reported that the risk of post-traumatic OA after a meniscal injury of the knee is strongly affected by a family history of OA, by the presence of generalized OA (like the nodal osteoarthritis of the hand), by obesity, and by sex [8][9][10]. Many subjects with OA in one joint have the disease at different stages in other joints.…”