Incident Symptomatic Knee Research Articles

Nottingham knee osteoarthritis risk prediction models

Objectives(1) To develop risk prediction models for knee osteoarthritis (OA) and (2) to estimate the risk reduction that results from modification of potential risk factors.MethodThis was a 12-year retrospective cohort...

Effect of Quadriceps Strength and Proprioception on Risk for Knee Osteoarthritis

Impaired quadriceps strength and joint position sense (JPS) have been linked with knee osteoarthritis (OA) cross-sectionally. Although neither has been independently associated with incident radiographic OA, their combination may mediate risk. The purpose of this study was to determine whether better sensorimotor function protects against the development of incident radiographic or symptomatic knee OA. The Multicenter Osteoarthritis study is a longitudinal study of adults aged 50–79 yr at high risk for knee OA. Participants underwent bilateral, weight-bearing, fixed-flexion radiographs, JPS acuity tests, and isokinetic quadriceps strength tests. The relationships between combinations of the tertiles of sex-specific baseline peak strength and mean JPS and development of incident radiographic (Kellgren–Lawrence (KL) grade Q2) or symptomatic knee OA (KL grade Q2 and frequent knee pain or stiffness) at a 30-month follow-up were evaluated. Secondary analyses defined JPS as the variance during the 10 JPS trials and also assessed the interaction of strength and JPS in predicting each outcome. The study of incident radiographic knee OA included 1390 participants (age = 61.2 ± 7 .9 yr and body mass index = 29.4 ± 5.1 kg·m−²), and the study of incident symptomatic knee OA included 1829 participants (age = 62.2 ± 8.0 yr and body mass index = 30.0 ± 5.4 kg·m−²). Greater strength at baseline protected against incident symptomatic but not radiographic knee OA regardless of JPS tertile. There was no significant relationship between the strength–JPS interaction and the development of radiographic or symptomatic knee OA. The finding that quadriceps strength protected against incident symptomatic but not radiographic knee OA regardless of JPS tertile suggests that strength may be more important than JPS in mediating risk for knee OA.

Association of Leg-Length Inequality With Knee Osteoarthritis

Leg-length inequality is common in the general population and may accelerate development of knee osteoarthritis. To determine whether leg-length inequality is associated with prevalent, incident, and progressive knee osteoarthritis. Prospective observational cohort study. Population samples from Birmingham, Alabama, and Iowa City, Iowa. 3026 participants aged 50 to 79 years with or at high risk for knee osteoarthritis. The exposure was leg-length inequality, measured by full-limb radiography. The outcomes were prevalent, incident, and progressive knee osteoarthritis. Radiographic osteoarthritis was defined as Kellgren and Lawrence grade 2 or greater, and symptomatic osteoarthritis was defined as radiographic disease in a consistently painful knee. Compared with leg-length inequality less than 1 cm, leg-length inequality of 1 cm or more was associated with prevalent radiographic (53% vs. 36%; odds ratio [OR], 1.9 [95% CI, 1.5 to 2.4]) and symptomatic (30% vs. 17%; OR, 2.0 [CI, 1.6 to 2.6]) osteoarthritis in the shorter leg, incident symptomatic osteoarthritis in the shorter leg (15% vs. 9%; OR, 1.7 [CI, 1.2 to 2.4]) and the longer leg (13% vs. 9%; OR, 1.5 [CI, 1.0 to 2.1]), and increased odds of progressive osteoarthritis in the shorter leg (29% vs. 24%; OR, 1.3 [CI, 1.0 to 1.7]). Duration of follow-up may not be long enough to adequately identify cases of incidence and progression. Measurements of leg length, including radiography, are subject to measurement error, which could result in misclassification. Radiographic leg-length inequality was associated with prevalent, incident symptomatic, and progressive knee osteoarthritis. Leg-length inequality is a potentially modifiable risk factor for knee osteoarthritis. National Institute on Aging.

Effect of thigh strength on incident radiographic and symptomatic knee osteoarthritis in a longitudinal cohort

Effect of thigh strength on incident radiographic and symptomatic knee osteoarthritis in a longitudinal cohort

013 IMPAIRMENT OF FUNCTION IS THE MAJOR DETERMINANT OF REDUCED HEALTH-RELATED QUALITY OF LIFE IN HAND OSTEOARTHRITIS PATIENTS IN SECONDARY CARE

was no association between the combinations of knee extensor strength and joint position sense and incident symptomatic knee OA at 30-month follow-up. Secondary analyses, also did not demonstrate a statistically significant relationship between the interaction of knee extensor strength and either the average joint position sense or the variance in joint position sense and the development of incident symptomatic knee OA (all p>.25).

012 RISK FOR SYMPTOMATIC KNEE OSTEOARTHRITIS DOES NOT VARY BY KNEE EXTENSOR STRENGTH AND KNEE JOINT POSITION SENSE

011 – Figure 1 012 RISK FOR SYMPTOMATIC KNEE OSTEOARTHRITIS DOES NOT VARY BY KNEE EXTENSOR STRENGTH AND KNEE JOINT POSITION SENSE N.A. Segal1, N.A. Glass1, D. Felson2, M. Hurley3, M. Yang2, M. Nevitt4, C.E. Lewis5, J.C. Torner1 1Univ. of Iowa, Iowa City, IA; 2Boston Univ., Boston, MA; 3King’s Coll. London, London, United Kingdom; 4Univ. of California at San Francisco, San Francisco, CA; 5Univ. of Alabama at Birmingham, Birmingham, AL Purpose: Quadriceps weakness and impaired knee joint position sense (proprioception) have been linked cross-sectionally with knee OA. While neither of these factors has been independently associated with new onset disease, it is possible that one substitutes for the other and that only when both are impaired is the joint at risk. This study investigated whether sensoriomotor dysfunction the combination of quadriceps weakness and impaired knee joint position sense precedes development of symptomatic knee OA. Methods: The Multicenter Knee Osteoarthritis (MOST) Study is a longitudinal, observational study of adults age 50-79 years with knee OA or at high risk for knee OA. MOST subjects were excluded if they had symptomatic knee OA at baseline. Those with missing data or knee pain that interfered with strength testing were also excluded. Subjects underwent bilateral, weight bearing, fixedflexion radiographs, right knee joint reposition tests, and isokinetic knee extensor strength assessments; completed the Physical Activity Scale for the Elderly (PASE) and WOMAC questionnaires; and had height, and weight measurements taken. Symptomatic knee OA was defined as the combination of knee OA (KL grade ≥2) and frequent knee pain or stiffness at follow-up. The relationship between combinations of the tertiles of sex-specific baseline peak KES and tertiles of JPS and development of incident symptomatic knee OA at 30-month follow-up was evaluated with logistic regression adjusted for age, BMI, knee injury, knee surgery, and PASE score. Secondary analyses defined joint position sense as (1) the subject-specific variance over the 10 trials and (2) the average joint position sense over the 10 trials, and also assessed the interaction of knee extensor strength and joint position sense in predicting the outcome using generalized linear models. Results: 1565 subjects (911 women and 654 men) met eligibility criteria and were included in this study. The mean±SD age was 62.1±8.0 years, BMI was 29.8±5.4kg/m2, PASE score was 182.9±88.7, and WOMAC pain subscale was 2.2±2.8. There S16 Oral Presentations was no association between the combinations of knee extensor strength and joint position sense and incident symptomatic knee OA at 30-month follow-up. Secondary analyses, also did not demonstrate a statistically significant relationship between the interaction of knee extensor strength and either the average joint position sense or the variance in joint position sense and the development of incident symptomatic knee OA (all p>.25). Relationship Between Tertiles of Strength-Proprioception and Incident Symp-

Effect of thigh strength on incident radiographic and symptomatic knee osteoarthritis in a longitudinal cohort

To assess whether knee extensor strength or hamstring:quadriceps (H:Q) ratio predicts risk for incident radiographic tibiofemoral and incident symptomatic whole knee osteoarthritis (OA) in adults ages 50-79 years. We followed 1,617 participants (2,519 knees) who, at the baseline visit of the Multicenter Osteoarthritis (MOST) Study, did not have radiographic tibiofemoral OA and 2,078 participants (3,392 knees) who did not have symptomatic whole knee OA (i.e., did not have the combination of radiographic OA and frequent knee symptoms). Isokinetic strength was measured at baseline, and participants were followed for development of incident radiographic tibiofemoral OA, or incident symptomatic whole knee OA at 30 months. Generalized estimating equations accounted for 2 knees per subject, and multivariable models adjusted for age, body mass index (BMI), hip bone mineral density, knee surgery or pain, and physical activity score. In the studies of incident radiographic and incident symptomatic knee OA, mean +/- SD ages were 62.4 +/- 8.0 years and 62.3 +/- 8.0 years, respectively, and mean +/- SD BMI scores were 30.6 +/- 5.8 kg/m(2) and 30.2 +/- 5.5 kg/m(2), respectively. Knee extensor strength and H:Q ratio at baseline significantly differed between men and women. Neither knee extensor strength nor the H:Q ratio was predictive of incident radiographic tibiofemoral OA. Compared with the lowest tertile, the highest tertile of knee extensor strength protected against development of incident symptomatic whole knee OA in both sexes (adjusted odds ratio 0.5-0.6). H:Q ratio was not predictive of incident symptomatic whole knee OA in either sex. Thigh muscle strength does not appear to predict incident radiographic OA, but does seem to predict incident symptomatic knee OA.

Level of physical activity and the risk of radiographic and symptomatic knee osteoarthritis in the elderly: the Framingham Study

PURPOSE: Because osteoarthritis may be caused by “wear and tear,” we examined the association between level of physical activity and risk of knee osteoarthritis in the elderly. SUBJECTS AND METHODS: Eligible subjects were participants in the Framingham Heart Study cohort who had radiographically normal knees at biennial exam 18 (1983–1985) and who also completed a physical activity questionnaire at exam 20 (1988–1989). Follow-up knee radiographs were obtained at biennial exam 22 (1992–1993). The study outcomes were the development of incident radiographic or symptomatic knee osteoarthritis between the baseline and follow-up exams. RESULTS: The number of hours per day of heavy physical activity was associated with the risk of incident radiographic knee osteoarthritis (odds ratio = 1.3 per hour, 95% confidence limits 1.1–1.6, P for trend = 0.006). Adjustment for age, sex, body mass index, weight loss, knee injury, health status, total calorie intake, and smoking strengthened this association (eg, odds ratio for ≥4 hours heavy physical activity/day compared with no heavy physical activity = 7.0, 95% confidence limits 2.4–20, P for trend = 0.0002). Risk was greatest among individuals in the upper tertile of body mass index (odds ratio for ≥3 hours/day of heavy physical activity = 13.0, 95% confidence limits 3.3–51). For incident symptomatic knee osteoarthritis, the results were similar, although the number of cases was small. No effects on these outcomes were observed from moderate and light physical activity, number of blocks walked, or number of flights of stairs climbed daily. CONCLUSIONS: Heavy physical activity is an important risk factor for the development of knee osteoarthritis in the elderly, especially among obese individuals. Light and moderate activities do not appear to increase risk.