Does hand osteoarthritis predict future hip or knee osteoarthritis?

Abstract

Objective. To evaluate the risk of future hip or knee osteoarthritis (OA) in subjects with hand OA at baseline and to evaluate whether the concurrent presence of hand OA, other risk factors for OA, or an OA biomarker (type II collagen C-telopeptide degradation product [CTX-II]) further increases the risk.Methods. Radiographs of the hands (baseline) and the hips and knees (baseline and 6.6 years later) were obtained in a randomly selected subset of participants in the Rotterdam Study who were ages 55 years and older. Radiographs were scored for the presence of OA using the Kellgren/Lawrence (K/L) system. A total of 1,235 subjects without OA of the hip/knee (K/L score 0-1) at baseline were included in the study. CTX-II levels were measured at baseline. The independent risk of future hip/knee OA in subjects with hand OA at baseline was assessed by logistic regression, as stratified for age, sex, body mass index, family history of OA, and heavy workload. Conclusion. The presence of hand OA at baseline showed an increased risk of future hip/knee OA (higher for hip OA than for knee OA). The concurrent presence of hand OA and other OA risk factors or high CTX-II levels further increased the risk of future hip/knee OA.Osteoarthritis (OA) is the most common form of arthritis among the elderly and a leading musculoskeletal cause of disability in Western countries (1,2). Due partly to the length of working careers, the substantial prevalence of OA in middle-aged people causes the loss of much working time to illness (3). In terms of pain, disability, and cost, the clinical and societal impact of OA of the weight-bearing joints (i.e., the hips and knees) is greater than that of hand OA (1).It has been suggested that generalized OA may be a distinct disease in which systemic (genetic) predisposition is more important than local (mechanical) factors (1,4). A recent postmortem bone study confirmed the hypothesis that OA is caused primarily by a systemic predisposition to a certain type of bone response to mechanical stresses (5). Hand, hip, and knee OA are thus based partly on a systemic predisposition. While clinically less relevant, the presence of hand OA may therefore predict the more disabling hip or knee OA later in life.Although other cross-sectional studies have addressed the association of hand OA with hip or knee OA (6-10), we know of only 1 study that has examined the link between hand OA earlier in life and knee OA later on (11). No study has evaluated the association between hand OA earlier in life and the occurrence of hip OA later on. By identifying subjects who have a tendency for developing OA and by modifying their risk factors, it

Identification of factors associated with the development of knee osteoarthritis in a young to middle-aged cohort of patients with knee complaints

“…Several publications have shown that the development of knee OA is related to the presence of hand OA [10,13,16,42], the results of our study confirm this relationship in a young middle-aged population with knee complaints 10 years ago for both radiographic OA in the TFC and OA on MRI in the PFC.…”

“…In some patients knee OA develops after knee injury [9], whereas in other patients knee OA develops in a more generalized way without specific trauma, affecting multiple other joints. It has been suggested that these two forms of OA cannot be seen as distinct from each other and that genetic predisposition may play a role in the development of knee OA after trauma [4,5,[10][11][12][13][14][15][16][17]. Studies investigating factors involved in OA development are usually performed in older populations with mean ages ranging from 50 to 80 years [5,[18][19][20].…”

Current evidence on risk factors for knee osteoarthritis in older adults: a systematic review and meta-analysis

“…The I 2 among the remaining twentyfive studies was 99.2% and the resulting pooled OR was 2.10 (CI 1.82e2. 42) showing an increased risk of knee OA in those overweight or obese (Fig. 2).…”

“…Hand OA, usually diagnosed clinically by the presence of Heberden's nodes, was assessed as a risk factor by six cohort studies 14,17,24,34,37,42 . The extent of heterogeneity was moderate and on border of significance at the 5% level (I 2 ¼ 54.7).…”

The Puzzle of Generalized Osteoarthritis (OA) — Is OA a Systemic Enthesopathy?

“…Kellgren and Moore suggested the concept of generalized OA in the early 1950s 3 , and numerous later studies have confirmed an association between hand and knee OA and to a lesser extent hip and spine OA 4,5,6 . Recently, the association was confirmed with modern imaging techniques demonstrating an association between radiographic joint space narrowing in the finger joints and reduced knee cartilage thickness, and between osteophytes in the finger joints and radiographic knee OA 7 .…”