Knee Joint Space Narrowing Research Articles

Severity and progression of structural hand OA is not associated with progression of structural knee OA: The IMI-APPROACH cohort

ObjectiveTo investigate whether structural hand OA or its progression is associated with structural knee OA progression after two years in a population with symptomatic knee OA. MethodsWe used baseline and two-year follow-up data from the IMI-APPROACH cohort. Symptomatic hand and knee OA were defined using ACR criteria. Radiographs of hands and knees were scored semi-quantitatively for osteophytes and joint space narrowing (JSN) following the OARSI atlas, and Kellgren-Lawrence (KL) scale. Knee images were also scored quantitatively with the Knee Image Digital Analysis (KIDA). Progression was defined as change above the minimal detectable change on patient level, except for KIDA (most affected knee compartment level). With logistic regression analyses the severity or progression of hand OA was associated with knee OA progression. ResultsIn 221 participants (mean age 66, 77% women, mean BMI 27.7, 19% hand OA), OA progression occurred in 18%–28%, and 9%–38% in hands and knees respectively, depending on features. Baseline structural hand OA features were not significantly associated with knee OA progression, except for hand osteophytes with KIDA osteophytes progression (odds ratio (OR) 1.03, 95% confidence interval (CI) 1.01–1.06). Progression of structural hand OA features was not significantly associated with knee OA progression, except for hand osteophyte or JSN progression, which was significantly associated with knee osteophyte progression (OR 0.44, 95%CI 0.22–0.84 and OR 0.43, 95%CI 0.18–0.94, respectively), and hand osteophyte progression for knee JSN (OR 2.51, 95%CI 1.15–5.48). ConclusionsIn patients with symptomatic knee OA, no consistent associations between baseline structural hand OA or hand OA progression and knee OA progression were shown.

A Framework of Faster CRNN and VGG16-Enhanced Region Proposal Network for Detection and Grade Classification of Knee RA

We developed a framework to detect and grade knee RA using digital X-radiation images and used it to demonstrate the ability of deep learning approaches to detect knee RA using a consensus-based decision (CBD) grading system. The study aimed to evaluate the efficiency with which a deep learning approach based on artificial intelligence (AI) can find and determine the severity of knee RA in digital X-radiation images. The study comprised people over 50 years with RA symptoms, such as knee joint pain, stiffness, crepitus, and functional impairments. The digitized X-radiation images of the people were obtained from the BioGPS database repository. We used 3172 digital X-radiation images of the knee joint from an anterior-posterior perspective. The trained Faster-CRNN architecture was used to identify the knee joint space narrowing (JSN) area in digital X-radiation images and extract the features using ResNet-101 with domain adaptation. In addition, we employed another well-trained model (VGG16 with domain adaptation) for knee RA severity classification. Medical experts graded the X-radiation images of the knee joint using a consensus-based decision score. We trained the enhanced-region proposal network (ERPN) using this manually extracted knee area as the test dataset image. An X-radiation image was fed into the final model, and a consensus decision was used to grade the outcome. The presented model correctly identified the marginal knee JSN region with 98.97% of accuracy, with a total knee RA intensity classification accuracy of 99.10%, with a sensitivity of 97.3%, a specificity of 98.2%, a precision of 98.1%, and a dice score of 90.1% compared with other conventional models.

Joint Space Narrowing in the Osteoarthritic Knee

Background: When patients with knee osteoarthritis (OA) are referred to an orthopaedic specialist for care, standard evaluation includes anterior-to-posterior (AP) weight-bearing (WB) radiographs to best evaluate the degree of arthritis and residual joint space, which can tailor treatment recommendations. Primary care guidelines do not require radiographs for their diagnosis; if performed, they are often non–weight-bearing (NWB). This study assessed the significance of joint space narrowing (JSN) between NWB and WB knee radiographs in patients evaluated for OA. We also compared demographic data with the measure of JSN. Methods: This was a prospective quantitative study that followed an experimental design comparing the JSN of the same AP NWB knee with WB knee radiographs. Two blinded fellowship-trained orthopaedic adult reconstruction surgeons and 1 musculoskeletal radiology fellow performed the joint space measurements. Data were analyzed using the Student t test and χ2 test as appropriate. Results: The mean JSN between WB and NWB was 1.20 mm (95% confidence interval 0.93-1.49 mm, p < 0.0001). Interrater reliability between NWB and WB measurements was 0.87 and 0.93, respectively. As body mass index (BMI) increased in our population, the amount of JSN decreased. There were significantly higher rates of JSN in those who were not obese compared with those who were. Conclusions: Weight-bearing radiographs are better able to evaluate JSN than NWB. BMI had a negative correlation with JSN in our population. Level of Evidence: II.

Effects of Weight Change on Knee and Hip Radiographic Measurements and Pain Over Four Years: Data From the Osteoarthritis Initiative.

To assess the effects of weight loss and weight gain on hip and knee radiographic changes, pain, and joint replacement over 4 years. Participants (n=2,752) from the Osteoarthritis Initiative were classified as those with weight gain (more than 5% gain), weight loss (more than -5% loss), or as controls (-3% to 3% change) over 4 years. Generalized estimating equations (adjusted for age, sex, and body mass index) were used to assess the relationship between the weight-change group and 4-year changes in knee radiographic osteoarthritis (OA) (Kellgren/Lawrence [K/L] grade), hip OA (Croft summary grade), joint space narrowing (JSN), and joint pain. For radiographic knee OA, weight loss was associated with significantly lower odds of K/L grade worsening over 4 years (odds ratio [OR] 0.69 [95% confidence interval (95% CI) 0.53-0.91], P=0.009), and weight gain was significantly associated with higher odds of medial knee JSN (OR 1.29 [95% CI 1.01-1.64], P=0.038) compared to controls. For knee pain, weight loss was significantly associated with knee pain resolution over 4 years (OR 1.40 [95% CI 1.06-1.86], P=0.019) while weight gain was associated with knee pain development (OR 1.34 [95% CI 1.08-1.67], P=0.009) compared to controls. For all hip outcomes, no significant associations (P > 0.05) were found with weight-change groups. The associations between the weight-change group and total hip or total knee replacement were not significant (P > 0.05). This large, longitudinal study (n=2,752 with 4-year follow-up) suggests that weight loss may protect against, and weight gain may exacerbate, radiographic and symptomatic knee OA, while weight change (at a 5% threshold) does not have significant effects on hip OA.

Prediction of Joint Space Narrowing Progression in Knee Osteoarthritis Patients.

Osteoarthritis is a joint disease that commonly occurs in the knee (KOA). The continuous increase in medical data regarding KOA has triggered researchers to incorporate artificial intelligence analytics for KOA prognosis or treatment. In this study, two approaches are presented to predict the progression of knee joint space narrowing (JSN) in each knee and in both knees combined. A machine learning approach is proposed with the use of multidisciplinary data from the osteoarthritis initiative database. The proposed methodology employs: (i) A clustering process to identify groups of people with progressing and non-progressing JSN; (ii) a robust feature selection (FS) process consisting of filter, wrapper, and embedded techniques that identifies the most informative risk factors; (iii) a decision making process based on the evaluation and comparison of various classification algorithms towards the selection and development of the final predictive model for JSN; and (iv) post-hoc interpretation of the features’ impact on the best performing model. The results showed that bounding the JSN progression of both knees can result to more robust prediction models with a higher accuracy (83.3%) and with fewer risk factors (29) compared to the right knee (77.7%, 88 risk factors) and the left knee (78.3%, 164 risk factors), separately.

Association between thigh muscle strength four years after partial meniscectomy and radiographic features of osteoarthritis 11\u2009years later

BackgroundMeniscus injury and meniscectomy both entail increased risk of knee osteoarthritis (OA). Thigh muscle weakness is a suggested mediator of OA but there is little evidence of its importance for knee OA development after meniscectomy. This study aimed to examine the association between thigh muscle strength after partial meniscectomy in middle-aged subjects with a non-traumatic meniscal tear and later radiographic knee OA changes.MethodsThirty-four out of 45 participants in an exercise-trial underwent testing for isokinetic thigh muscle strength 4 years after arthroscopic partial meniscectomy and had radiographic examination 11 years later (15 years post-surgery, mean age at follow-up of 57 years (range 50–61)). Outcomes were grade of joint space narrowing and osteophyte score in the medial tibiofemoral compartment of the operated knee and the contralateral knee. We tested the association between muscle strength at baseline and the radiographic outcomes at follow-up using logistic regression analyses adjusted for sex and overweight.ResultsAt follow-up, 33/34 subjects had joint space narrowing and 27/34 subjects had osteophytes in the operated knee, in the contralateral knee joint space narrowing was found in 23 subjects. In the operated knee baseline knee extensor and flexor strength were negatively associated with grade of joint space narrowing at follow-up (OR 0.972 and 0.956, p = 0.028 and 0.026, respectively) and also with osteophyte score (OR 0.968 and 0.931, p = 0.017 and 0.011, respectively). In the contralateral knee longitudinal associations between strength and radiographic OA features were similar, OR 0.949–0.972, p < 0.05.ConclusionThe finding that stronger thigh muscles 4 years after meniscectomy were associated with less severe osteoarthritic changes in the medial tibiofemoral compartment of both the operated and contralateral knee 11 years later, may suggest that strong thigh muscles can help to preserve joint integrity in middle-aged subjects at risk of knee OA.

The different influence of high levels of physical activity on the incidence of knee OA in overweight and obese men and women-a gender specific analysis

To investigate the influence of physical activity on incidence of knee osteoarthritis (OA) in overweight and obese men and women. Data were extracted from the Osteoarthritis Initiative cohort on 1,667 participants without symptomatic knee OA at baseline. We used logistic regression and marginal effect models to estimate the effect of body mass index (BMI) and reported physical activity score, together with the interaction between them, on the development of radiographic knee OA, symptomatic knee OA and joint space narrowing (JSN) after 96-months. Men in the most active quartile had almost double the likelihood of knee OA, independent of OA definition [e.g., odds ratio (OR) 2.4 (95%CI: 1.2-4.5) for radiographic knee OA]. Interaction analyses showed statistically significant interactions between physical activity and BMI on developing knee OA (i) radiographic OA interaction(P=0.039), (ii) symptomatic OA interaction(P=0.022), (iii) JSN interactionP=0.012). The margin plots in men also demonstrated that the effect of physical activity on different measures of knee OA were modified by high levels of BMI. These effects were not mirrored in women where at all BMI levels, the level of reported physical activity did not influence likelihood of knee OA independent of OA definition. In overweight and obese men, there appears to be a threshold above which increasing levels of physical activity are associated with higher risk of knee OA. This is absent in women.

Genetic exploration of osteoarthritis endophenotypes identifies new biological pathways in osteoarthritis

Purpose: Genetic studies can help to identify novel genes involved in OA and in that way elucidate OA etiological pathways. However to date, GWAS (genome-wide association studies) in OA have yielded only few loci, which is partly explained by the phenotypic and ethiological heterogeneity of OA. Therefore, we have stratified OA definitions into endophenotypes, which help to identify underlying disease etiology. We have focused on separate radiographic features of the OA process: radiographic measured joint space width (JSW), Joint space narrowing (JSN) and osteophytosis as proxies for the separate biological processes underlying OA pathology. Methods: Using the Rotterdam Study cohorts (RS1, RS2, RS3) as a discovery, we conducted GWAS on 30 OA endophenotypes based on radiographic measurements. We have used the following radiographic measurements to create (semi)-quantitative endophenotypes for the hip, knee, hand, finger and thumb joints: JSN, JSW, Osteophytes, and the quantitative KL score. GWAS were carried out under an additive model in RV-test using HRC v1.0 imputations, with adjustment for age, sex and the first 4 principle components. EasyQC was used to conduct quality control across cohorts (excluded: MAF<0.05). Cleaned results were combined in a joint meta-analysis using METAL. Functional assessed of the identified loci was done by examining if the identidied SNPs changed RNA expression in multiple tissues (GTEX), Pathway analysis (GO biological functions, reactome, KEGG, WIKIPathways), and to see if there were DNA interactions at the identified SNPs (3D genome browser). Results: In total we defined 30 different OA endophenotypes for the hip, knee, and hand joints in the Rotterdam Study cohorts. On average each GWAS performed has a relative small sample size of ∼8000 individuals. We have identified 94 different loci (100 SNPs) with a P<1E-6 of which 16 loci (20 SNPs) reached genome-wide significance (P<5E-8), We find 3 known (DOT1L , MGP and CCD91 ) and 14 novel loci to be genome-wide significantly associated to thumb, hand and knee OA endophenotypes. The most significant novel locus is located on chr1, associated to thumb OA endophynotypes, Knee JSN and (nominal significant) hip cartilage thickness. Within the same topological associated domain in this locus is WNT9A and WNT3A. WNT9A plays a central role in early synovial joint development, as ectopic expression of WNT9a in early differentiating chondrocytes induces joint formation. The other novel loci are located near DAB1, KCNK1-SLC25F3, KCND3-CTTNBP2NL, DCBLD2, COL25A1, FIP1L1-PDGFRA, ESR1, CCDC82-CNTN5, TLE3-UACA, MT1G, DYM, and MYPOP genes. Gene-function enrichment and pathway analysis using the 17 top loci shows enrichment for i.a. Regulation of growth (Padj = 4.21E-5), Female sex differentiation (Padj = 4.73E-5) and Skeletal development (Padj = 7.99E-3). Pathway enrichments is seen for i.a. differentiation Pathways ( Padj = 1.55E-3) and Wnt-signaling (Padj = 2.49E-2), in addition we also see an enrichment for height associated loci (Padj = 1.87E-5). In addition, we have examined all known OA loci in our endophenotype dataset and found striking patterns of endophenotype association. For example, the established GDF5 locus shows strong signals with all osteophytosis endophenotypes, but not with cartilage endophenotypes. Conclusions: We have identified 14 novel loci associated to different aspects of OA pathology. In addition we have identified another 80 loci with suggestive evidence for association (P<1E-6). Examination of known genetic OA loci showed striking patterns of association, and suggests that the GDF5 association is driven by bone formation pathways rather then cartilage driven pathways. Our findings highlight the potential of endophenotypes in OA genetic studies. Future analysis will consist of validation in other cohorts, and further functional assessment of the identified loci to gain etiological insight into the biological mechanism underlying the relationship between genetic variation and OA.

Functional folate receptor cell-associated inflammatory cytokines predict the progression of knee osteoarthritis

Purpose: In our prior study using 99mTc-EC20 (Etarfolatide) imaging, we observed folate receptor positive (FR+) cells in vivo in the synovium of the majority (76%) of knees of patients with osteoarthritis (OA). The quantity of these FR+ cells was associated with radiographic severity of knee joint space narrowing and osteophyte and knee pain. To identify the cells with functional folate receptors and their involvement in disease pathogenesis and progression in knee OA, we characterized the immune cell populations of OA synovium and synovial fluid by flow cytometry and evaluated the correlation of functional folate receptor positive phenotypes with cytokine production, knee OA severity and progression. Based on results from our pilot Etarfolatide study, we hypothesized that immune cells bearing functional folate receptors would be pro-inflammatory. Methods: For these analyses, we evaluated specimens from three different cohorts. Total Knee Replacement (TKR) Cohort: waste synovial tissue (SV) and matched synovial fluid (SF) obtained from knee OA patients at the time of total knee arthroplasty (n=18) at Duke University Hospital. Cell populations from SV and SF were phenotyped for cell surface markers and functional FR (FR+ detected by incubating cells with fluorescently labeled folate conjugate) using polychromatic flow cytometry. The EC20 Scan Cohort: SF from radiographic knee OA patients (Kellgren-Lawrence (KL) grade 1-4) (n=26 knees), Etarfolatide and computed tomography (CT) imaging. The Prediction of Osteoarthritis Progression (POP) Cohort: SF samples from radiographic knee OA patients (KL grade 1-3) with three-year follow-up and available SF (n=107 knees). Inflammatory cytokines were quantified in SF from all three cohorts and concentrations correlated with the immunophenotypic and imaging data. Results: Using polychromatic flow cytometry, FR+ macrophages and neutrophils were identified in both the SF and SV of the TKR cohort (Table 1). On a per cell basis, neutrophils took up significantly more folate conjugate than macrophages. Among the SF cytokines, transforming growth factor beta 1 (TGF-β1) and neutrophil elastase correlated with FR+ macrophages and FR+ neutrophils, respectively. The SF concentration of both of these cytokines were strongly correlated with the in vivo FR+ synovial phenotype by Etarfolatide uptake in the EC20 cohort (p < 0.0001). TGF-β1 and elastase were both strongly correlated with the osteophyte (OST) score (p < 0.05) in the EC20 (evaluated by CT) and POP (evaluated by radiograph) cohorts. Lastly, in the POP cohort, baseline TGF-β1 and elastase were associated with knee OA progression based on disease outcomes (no progression, radiographic features of OST, OST plus joint space narrowing (JSN) and total knee replacement (TKR) in sequence for linear trend analysis) (p<0.0001 and p=0.0014, respectively) (Fig 1A). Receiver operating characteristics (ROC) analysis of SF TGF-β1 (adjusting for age, BMI, gender, baseline OST and JSN) for the determination of any knee OA progression (either OST, JSN or TKR progression vs. non-progression) yielded an area under the curve (AUC) of 0.95 (95% CI [0.87, 0.98]) (Fig 1B). ROC analysis of elastase yielded an AUC of 0.90 (CI [0.80, 0.95]) (Fig 1B). Applying the Youden index as the cut-off value, for TGF-β1 the sensitivity was 97% (CI [89, 99]), the specificity 85% (CI [62, 97]), and the positive predictive value (PPV) 95% (CI [88, 98]). For elastase the sensitivity was 85% (CI [74, 0.92]), the specificity 86% (CI [65, 97]), and the PPV 95% (CI [86, 98]). Conclusions: We have identified activated macrophages and neutrophils as the functional folate receptor bearing cells in knee OA. The correlation of SF TGF-β1 and elastase with the EC20 imaging phenotype confirmed the pro-inflammatory nature of the FR+ cells in vivo. We further confirmed the pro-inflammatory nature of these cells based on the association of these cell markers with knee OA progression. Taken together, these results suggest that these cells could be potential therapeutic targets in OA. The promising AUC scores for these markers also suggest that SF TGF-β1 and elastase could be the novel biomarkers of risk of progression in knee OA.View Large Image Figure ViewerDownload Hi-res image Download (PPT)

Higher Bone Turnover Detected by Serum Levels of Tartrate-Resistant Acid Phosphatase 5b (TRACP-5b) Is a Risk for the Radiographic Medial Knee Joint Space Narrowing in Men in Early Forties Without Knee Pain - A Three Years Prospective Observational Study “Sportology Core Study 1”

Higher Bone Turnover Detected by Serum Levels of Tartrate-Resistant Acid Phosphatase 5b (TRACP-5b) Is a Risk for the Radiographic Medial Knee Joint Space Narrowing in Men in Early Forties Without Knee Pain - A Three Years Prospective Observational Study “Sportology Core Study 1”

Association between grip strength and hand and knee radiographic osteoarthritis in Korean adults: Data from the Dong-gu study.

ObjectivesWe assessed whether grip strength was related to various types of radiographic damage in Korean adults with osteoarthritis (OA).MethodsData from 2,251 subjects enrolled in the Dong-gu study, who had no hand joint pain, were analyzed to investigate the relationship between grip strength and OA. Hand grip strength was measured using a hand-held dynamometer, and radiographs of the hand and knee were scored according to a semi-quantitative grading system. Multiple linear regressions were used to explore associations between grip strength and radiographic features of OA.ResultsGrip strength in men and women was negatively related to hand (both p < 0.001) and knee (men, p < 0.001; women, p = 0.010) OA after adjusting for confounders. Hand (men, p < 0.001; women, p = 0.001) and knee (both p < 0.001) joint space narrowing (JSN) showed the strongest associations with low grip strength, regardless of gender. Moreover, the severity of hand osteophytes in women (p = 0.001), and subchondral cysts (men, p < 0.001) was correlated with low grip strength in both genders.ConclusionsAmong subjects without hand joint pain, low grip strength was associated significantly with hand and knee radiographic OA, regardless of gender. Among all types of OA radiographic damage, low grip strength showed the strongest association with JSN.

The lower ratio of the cartilage destruction and synthesis biomarkers is a risk for the radiographic medial knee joint space narrowing in men in early forties without knee osteoarthritis – A three years prospective observational study “sportology core study 1”

The lower ratio of the cartilage destruction and synthesis biomarkers is a risk for the radiographic medial knee joint space narrowing in men in early forties without knee osteoarthritis – A three years prospective observational study “sportology core study 1”

Sex differences in the association of skin advanced glycation endproducts with knee osteoarthritis progression

BackgroundThe accumulation of advanced glycation endproducts in articular cartilage has been suggested as an etiologic factor in the development and progression of knee osteoarthritis (KOA).MethodsWe conducted a prospective cohort study of skin advanced glycation endproducts (sAGEs) measured non-invasively by skin intrinsic fluorescence and the relationship between sAGE KOA progression in 160 men and 287 women in a sub-cohort of the Osteoarthritis Initiative at a single site. KOA progression was measured by yearly changes in Osteoarthritis Research Society International (OARSI)-defined joint space narrowing (JSN) and by yearly changes in joint space width (JSW) from baseline to 48 months. Sex-stratified repeated measures, mixed models to account for correlation between the knees within persons and adjusted for age, body mass index (BMI), Kellgren-Lawrence (KL) grade, beam angle and rim-to-rim distance were utilized.ResultsIncreasing tertiles of sAGE measured at 36 months were associated with greater JSN over 4 years in men but not in women. The percentage of knees with JSN at 48 months, by tertiles of sAGE, were 7.0%, 16.0% and 17.7% in men (p for linear trend = 0.03) and 11.4%, 14.4% and 8.4% in women (p for linear trend = 0.33). Using change in JSW as the outcome, a similar trend was found in men but it was not statistically significant in fully adjusted models and no association was found in women.ConclusionThis study provides preliminary evidence that sAGEs independent of age and BMI, are associated with knee JSN in men but not in women.

Chondroitin sulphate inhibits NF-κB activity induced by interaction of pathogenic and damage associated molecules

To evaluate the anti-inflammatory mechanism of action of Chondroitin Sulphate (CS). THP-1 macrophages were cultured with a range of sizes and concentrations of HA fragments with TLR4 (LPS in a physiologically relevant concentration determined by analyses of sera of a community clinic ascertained knee osteoarthritis (OA) cohort) or TLR2 (heat killed listeria bacteria) agonists and varying concentrations of CS in a physiologically relevant range (10-200μg/ml). We measured IL-1β release, intracellular IL-1β, proIL-1β, caspase-1 and NF-κB activity and DNA binding activity of NF-κB transcription factors from nuclear and cytoplasmic extracts. Serum LPS was significantly associated with radiographic knee joint space narrowing (JSN) (P=0.02) in the OA cohort (n=40). The priming dose of LPS used for these experiments (10ng/ml) was below the lowest serum concentration of the OA cohort (median 47.09, range 14.43-81.36ng/ml). Priming doses of LPS and HA fragments alone did not elicit an inflammatory response. However, primed with LPS, HA fragments produced large dose-dependent increases in IL-1β that were inhibitable by CS. CS did not inhibit caspase-1 activity but in physiologically achievable concentrations, attenuated NF-κB activity induced by either the TLR4 (LPS 1000ng/ml) or TLR2 agonists alone or in combination with HA fragments. LPS induced and CS significantly reduced activity of canonical NF-κB transcription factors, p65, p50, c-Rel and RelB. Subinflammatory concentrations of pathogenic (LPS, listeria) and damage associated (HA) molecules interact to induce macrophage-related inflammation. CS works upstream of the inflammasome by inhibiting activation of NF-κB transcription factors.

Both systemic and local lipopolysaccharide (LPS) burden are associated with knee OA severity and inflammation

The microbiome is recognized as a new frontier in medicine with connections to a variety of diseases. We aimed to evaluate the association of lipopolysaccharide (LPS), a key pro-inflammatory product of the microbiome, with severity of inflammation, symptoms and radiographic abnormalities of knee osteoarthritis (OA). LPS was measured using a recombinant Factor C (rFC) assay, carefully optimized for systemic and synovial fluid (SF) analyses. LPS binding protein (LBP) was tested in both serum and SF of 25 patients (31 knees) from the Etarfolatide cohort for association with OA phenotypic outcomes. Models were adjusted for age, gender and body mass index. Based on LPS spike-and-recovery, both serum and SF dilutions of 0.1% were required to achieve recovery rates of at least 75% in all test specimens. Low coefficients of variation (CVs) (<10%) were achieved with both serum and SF dilutions <0.2%. Serum LPS and LBP were associated with the abundance of activated macrophages in the knee joint capsule and synovium. SF LPS and LBP were associated with the abundance of activated macrophages in the synovium. Serum LPS, LBP and SF LPS were associated with knee osteophyte severity. SF LPS was positively associated with knee joint space narrowing (JSN) severity and total WOMAC score. SF LBP was positively associated with self-reported knee pain score. These data strongly support a role for LPS in the pathogenesis and severity of structural abnormalities and symptoms of knee OA.

Relationship between soy milk intake and radiographic knee joint space narrowing and osteophytes.

The purpose of this study was to examine the cross-sectional association between dietary soy milk intake and the prevalence of radiographic knee joint space narrowing (JSN) and osteophytes (OST). Soy milk intake was assessed using a validated semiquantitative food frequency questionnaire and classified into three categories: never, <once a day, and ≥once a day. JSN and OST were assessed individually based on the Osteoarthritis Research Society International atlas. Multivariable logistic models were used after adjusting for potentially confounding factors. A total of 5764 subjects were included. Both the models suggested a significant inverse association between soy milk intake and OST. In model 1 (adjusted for age, body mass index, and sex), the prevalence of OST decreased in "≥once a day" category (OR 0.52, 95% CI 0.28-0.98, P=0.042) and "<once a day" category (OR 0.78, 95% CI 0.66-0.93, P=0.005) comparing to "never" category of soy milk intake, and the P for trend was 0.001. The outcomes were similar in model 2 (adjusted based on model 1, with additional factors of total energy intake, activity level, smoking status, alcohol-drinking status, educational background, diabetes, hypertension, and other dairy product intake) ("≥once a day" category: OR 0.49, 95% CI 0.26-0.92, P=0.026; "<once a day" category: OR 0.79, 95% CI 0.67-0.94, P=0.009), and the P for trend was 0.001. However, the significant associations between soy milk intake and JSN in both the models were not observed. Dietary soy milk intake was found to be negatively associated with OST, but not JSN, independent of some major confounding factors.

Higher bone turnover detected by serum levels of tartrate-resistant acid phosphatase 5b (TRACP-5b) is a risk for the radiographic medial knee joint space narrowing in men in early forties without knee pain the three years prospective observational study

Higher bone turnover detected by serum levels of tartrate-resistant acid phosphatase 5b (TRACP-5b) is a risk for the radiographic medial knee joint space narrowing in men in early forties without knee pain the three years prospective observational study

Clinical predictors of medial knee osteoarthritis progression over 2 years

The overall aim of this study was to identify risk factors for knee osteoarthritis (OA) structural disease progression. More specifically, we aimed to identify what personal factors (age, sex, obesity, co-morbidity, Herberden’s nodes, history of injury, manual occupation and medication use), radiographic findings (Kellgren and Lawrence (K&L) grade, joint space width, alignment) and activity limitations (self-reported physical activity and physical function) independently predict medial knee joint space narrowing (JSN) over 2 years in people with painful medial knee OA.

Relation between phalangeal bone mineral density and radiographic knee osteoarthritis: a cross-sectional study.

BackgroundMajor reports have suggested that bone mineral density (BMD) is higher in patients with osteoarthritis (OA), while other studies do not agree. Our aim was to examine the cross-sectional association between phalangeal BMD and radiographic knee OA.MethodsA total of 2855 participants were included in this study. Radiographic knee OA was defined as Kellgren-Lawrence (K-L) Grade ≥ 2 in at least one leg. BMD scans of the middle phalanges of the second, third and fourth digits of the nondominant hand were performed with a compact radiographic absorptiometry system (Alara MetriScan®). A multivariable logistic analysis model was applied to test the relation between phalangeal BMD with radiographic knee OA, the presence of knee osteophytes (OSTs), and knee joint space narrowing (JSN) after adjusting for a number of potential confounding factors.ResultsThe multivariable-adjusted odds ratios with 95 % confidence intervals [ORs (95 % CI)] of radiographic knee OA across phalangeal BMDs were 1.08 (95 % CI 0.89–1.32) and 0.62 (95 % CI 0.45–0.86), respectively. The P for trend was 0.09. For the female population, the multivariable-adjusted ORs (95 % CI) of radiographic knee OA across phalangeal BMD were 1.01 (95 % CI 0.73–1.37) and 0.58 (95 % CI 0.38 − 0.87), respectively. The P for trend was 0.02. This positive finding, however, did not exist in the male subgroup. There was a significantly lower prevalence of OST in the osteoporosis (OP) group than in the normal group (OR = 0.59, 95 % CI 0.40–0.88; P for trend was 0.01). In contrast, the prevalence of JSN was significantly higher in the osteopenia group (OR = 1.22, 95 % CI 1.00–1.48) and the OP group (OR = 1.35, 95 % CI 1.00–1.84) than in the normal group. The P for trend was 0.02.ConclusionsThis study observed lower odds for the presence of radiographic knee OA and OST in OP patients than in normal subjects. The prevalence of JSN was higher in the osteopenia and OP groups than in normal subjects.Electronic supplementary materialThe online version of this article (doi:10.1186/s12891-016-0918-x) contains supplementary material, which is available to authorized users.

Does Chondrocalcinosis Associate With a Distinct Radiographic Phenotype of Osteoarthritis in Knees and Hips? A Case–Control Study

To examine if knee chondrocalcinosis (CC), hip CC, or CC at distant joints associates with a distinct radiographic phenotype of osteoarthritis (OA) in knees or hips. We conducted a case-control study using data from the Genetics of Osteoarthritis and Lifestyle (GOAL) study (n = 3,170). All participants of the GOAL study had radiographs of knees, hands, and pelvis, which have been scored for CC and for individual radiographic features of OA. For this study, cases had radiographic OA and CC, and controls had radiographic OA without CC at the index joint. Data for knees and hips were analyzed separately. Binary logistic regression was used to examine the association between each radiographic phenotype and CC in joints with OA. Generalized estimating equation analysis was used to account for correlated data. Knee CC, and CC at any distant joint (without knee CC), associated with attrition in knee OA (adjusted odds ratio 2.32 [95% confidence interval 1.42-3.79] and 2.42 [1.41-4.13], respectively). There was no association between knee CC and osteophytosis or joint space narrowing (JSN) in knees with OA. Hip CC associated negatively with the summated osteophyte score and minimum JSN in hip OA. However, in hips with OA, CC did not associate with cysts or sclerosis. Additionally, distant joint CC did not associate with any structural change in hip OA. This study demonstrates that knee CC and CC at distant joints associate with attrition in knee OA, and hip CC associates with a milder hip OA phenotype. There was no evidence that CC associates with a hypertrophic OA phenotype.