Is lower extremity vein pathology a risk factor for the development of osteoarthritis of the knee joint?

Abstract

The aim of the work was to assess the relationship between venous insufficiency and osteoarthritis of the knee joint. Materials and Methods. The study included 214 knee joints from April 2018 to March 2021 in 107 subjects (19 men, 88 women), mean age of patients was 54.6 ± 8.6 years (range, 40 to 73 years). The study group included 61 patients diagnosed with knee osteoarthritis; the control group included 46 healthy volunteers without knee joint disease complaints. Demographic and clinical characteristics of all study participants were taken into account. The venous system of the lower extremities was assessed by ultrasound Doppler imaging. The results were assessed by standard radiography based on the Kellgren-Lawrence classification and ultrasonography. Pain severity was assessed using the Likert scale, and functioning was assessed by the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC). Results. Venous insufficiency was detected in 40.9% of patients in the group of patients with knee osteoarthritis and in 15.2% of the control group (p=0.007). There was no statistically significant difference in cartilage thickness and Kellgren-Lawrence classification for the presence of venous insufficiency (p>0.05). However, the percentage of radiological medial tibial sclerosis was higher in patients with venous insufficiency in the osteoarthritis group (60%, p>0.05). Overall WOMAC scores were similar in both groups, whereas WOMAC pain scale scores were higher in patients with deep venous insufficiency (p>0.05). Discussion. Previously, researchers have found that patients with knee OA develop symptoms of chronic VH more frequently than their healthy peers, that VH and OA share common risk factors, and that the risk of these diseases increases with age. Our results showed no difference in the incidence of VN between groups after correction depending on age. Our results are consistent with the literature in that deep venous system lesions increase the risk of intraosseous hypertension to a greater extent than superficial venous system lesions. Conclusion. The evidence of increased radiological medial tibial sclerosis and higher WOMAC pain scale scores in patients with venous lesions in osteoarthritis create the hypothesis that venous pathology may affect the intraosseous bone microenvironment, leading to pain and early subchondral bone lesions, which manifest as subchondral sclerosis.