Trajectories of Structural Disease Progression in Knee Osteoarthritis

Abstract

Objective Knee osteoarthritis (OA) is a heterogeneous disease, with most patients experiencing slow disease progression and some with rapid deterioration. We aimed to identify groups of patients with symptomatic knee OA experiencing rapid structural progression. Methods We selected participants from the Osteoarthritis Initiative with baseline Kellgren/Lawrence (K/L) grades 1–3 and knee pain, and with joint space width (JSW) on fixed‐flexion knee radiographs assessed at baseline and with ≥1 follow‐up over 8 years. We used latent class growth analysis to identify subgroups of JSW progression, jointly modeling time to knee replacement (KR) to account for potential informative dropouts. After identifying trajectories, we used logistic regression to assess the association between baseline characteristics and the JSW trajectory group. Results We used data from 1,578 participants. Baseline radiographic severity was K/L grade 1 in 17%, K/L grade 2 in 50%, and K/L grade 3 in 33%. We identified 3 distinct JSW trajectories: 86% stable, 6% with stable JSW followed by late progression, and 8% with early progression. Incorporating information about KR resulted in 47% of KRs initially classified as stable being reclassified to 1 of the progressing trajectories. Prior knee surgery was associated with being in the late‐progressing versus the stable trajectory, while obesity was associated with being in the early‐progressing versus stable trajectory. Conclusion In addition to a subgroup of individuals experiencing early structural progression, 8‐year longitudinal data allowed the identification of a late‐progressing trajectory. Incorporating information about KR was important to properly identify longitudinal structural trajectories in knee OA.

Discovering Knee Osteoarthritis Imaging Features for Diagnosis and Prognosis: Review of Manual Imaging Grading and Machine Learning Approaches

“…Previously, knee OA disease was modelled as a linear process, but this assumption was criticized by multiple researchers [78,79]. Many longitudinal studies were carried out to model the knee OA disease progression [80]. Multiple time-point data on a pool of individual patients were collected to track the disease trajectory over a period of time [80].…”

“…Many longitudinal studies were carried out to model the knee OA disease progression [80]. Multiple time-point data on a pool of individual patients were collected to track the disease trajectory over a period of time [80]. e knee OA progression prediction model could help to distinguish individuals with high risk of rapid disease progression and predict the likeliness of patients to benefit from specific intervention [81].…”

Trajectories of structural disease progression in knee osteoarthritis: comment on the article by Collins et al

“…We read with interest the recently published article by Collins and colleagues (1), which examined trajectories of worsening medial knee compartment joint space width (JSW). Osteoarthritis Initiative (OAI) data from baseline to 8 years of follow-up were used to define 3 JSW trajectories of persons with prevalent symptomatic knee osteoarthritis (OA), based on the presence of baseline pain and Kellgren/Lawrence (K/L) OA grades of 1 to 3.…”

Anatomical Imaging Study on Uneven Settlement of the Proximal Tibia

“…Knee osteoarthritis (OA) is the leading cause of lower limb dysfunction in the middle‐aged and geriatric populations, 1–3 affecting the medial compartment more commonly than the lateral 4,5 . Varus limb alignment significantly contributes to the onset and progression of medial compartment knee OA, which usually requires surgical correction at more advanced stages 6,7 …”

“…4,5 Varus limb alignment significantly contributes to the onset and progression of medial compartment knee OA, which usually requires surgical correction at more advanced stages. 6,7 Among the variables associated with varus alignment, only the medial proximal tibial angle (MPTA) has been reported to be significantly associated with the progression of joint space narrowing in the medial compartment, the odds of which increase by 21% for every 1 decrease in MPTA. 8 MPTA reflects an overall morphological varus inclination of the tibial articular surface relative to the mechanical axis of the tibia.…”