Relationship between radiographic changes and symptoms or physical examination findings in subjects with symptomatic medial knee osteoarthritis: a three-year prospective study

Abstract

BackgroundAlthough osteoarthritis (OA) of the knee joints is the most common and debilitating joint disease in developed countries, the factors that determine the severity of symptoms are not yet understood well. Subjects with symptomatic medial knee OA were followed up prospectively to explore the relationship between radiographic changes and symptoms or physical examination findings.MethodsOne-hundred six OA knees in 68 subjects (mean age 71.1 years; 85% women) were followed up at 6-month intervals over 36 months. At each visit, knee radiographs were obtained, symptoms were assessed by a validated questionnaire, and the result of physical examination was recorded systematically using a specific chart. Correlations between the change of radiographs and clinical data were investigated in a longitudinal manner.ResultsDuring the study period, the narrowing of joint space width (JSW) was observed in 34 joints (32%). Although those knees were clinically or radiographically indistinguishable at baseline from those without JSW narrowing, differences became apparent at later visits during the follow-up. The subjects with knees that underwent JSW narrowing had severer symptoms, and the symptoms tended to be worse for those with higher rates of narrowing. A significant correlation was not found between the severity of symptoms and the growth of osteophytes. For the knees that did not undergo radiographic progression, the range of motion improved during the follow-up period, possibly due to the reduction of knee pain. Such improvement was not observed with the knees that underwent JSW narrowing or osteophyte growth.ConclusionThe result of this study indicates that the symptoms of knee OA patients tend to be worse when JSW narrowing is underway. This finding may explain, at least partly, a known dissociation between the radiographic stage of OA and the severity of symptoms.

Identification of Potential Prognostic Markers for Knee Osteoarthritis by Serum Proteomic Analysis

“…To obtain plasma samples from OA patients who were undergoing disease progression (progressors) and those in a stable condition (nonprogressors), we performed a 2-year follow-up of 29 patients with knee OA. This study was conducted as part of a 3-year follow-up study of knee OA patients including a larger number of patients 5. In this previous study, knee OA patients were recruited from among those visiting a community medical center seeking medical care for symptomatic knee OA.…”

Identifying common trajectories of joint space narrowing over two years in knee osteoarthritis

“…In the Glucosamine/Chondroitin Arthritis Intervention Trial, over 2 years only 19 -22% of participants had JSN Ͼ0.48 mm (15). Over 3 years, in an older group of 68 individuals in Japan, JSN was evident in 32% of knees (16); this was similar to the proportion (31%) of those exhibiting JSN Ͼ2 mm over 3 years in the Bristol OA500 study (17). Sahlstrom et al reevaluated 110 (of 256 individuals) who had radiographs for knee pain between 1970 and 1973 at a university hospital and who remained untreated or conservatively treated.…”

Are Joint Structure and Function Related to Medial Knee OA Pain? A Pilot Study

“…Numerous variables have been studied regarding their usefulness for predicting the progression of knee OA (Table 4) [13,15,23,35,47]; however, amid conflicting reports, few predictive variables have strong supporting evidence [51]. We found that the radiographic medial knee JS and the peak knee adduction angle were the best predictors of knee pain in our study; and that these variables accounted for approximately three-quarters of the model variance (r 2 = 0.73).…”

“…For example, medial JS has been correlated with changes in cartilage volume on MRI [9], bone mineral density [46], body mass [52,55], and severity of knee OA symptoms [15,23], and it has been used routinely in clinical practice to assess the status and progression of medial knee OA [8,41]. However, substantial discordance also has been observed between the severity of patient's symptoms, and radiographic evidence of degenerative changes in knee OA (including JS narrowing).…”