Knee Radiographic Knee Osteoarthritis Research Articles

Incidence and related risk factors of radiographic knee osteoarthritis: a population-based longitudinal study in China

ObjectiveTo explore the incidence and risk factors for radiographic knee osteoarthritis (ROA) in a suburban area of China.MethodsShunyi Osteoarthritis Study was a population-based, longitudinal study of knee osteoarthritis in Shunyi, a suburban area of Beijing, China. A total of 1295 residents aged over 50 years were recruited with fully informed by randomized cluster sampling and were followed up 3 years later. At the time of baseline and follow-up visits, participants completed a home interview questionnaire and received a clinical examination including height, weight, range of motion (ROM), chair stand test, 50-foot walk test, and weight-bearing posterior-anterior semi-flexed view of radiographs at tibiofemoral joints. The incident ROA for a knee was defined if its KL grade was no more than grade 1 at baseline visit and no less than grade 2 at the follow-up visit. A patient without ROA in both knees at the baseline visit and with ROA in at least one knee at the follow-up visit was viewed as an incident case of ROA in patient level. Generalized linear model and generalized estimating equation were performed to examine the association between socio-demographic factors, physical function as well as baseline knee joint condition, and incident ROA in patient and knee level.ResultsA total of 1295 residents were recruited at baseline in 2014, and 962 (74.3%) residents were followed in 2017. The annual cumulative incidence of ROA was 3.6% at knee level and 5.7% at patient level. Older age (per year, adjusted odds ratio (OR) = 1.079; 95% confidence interval (CI), 1.042-1.117), overweight (adjusted OR = 2.086; 95% CI, 1.286-3.385), female (adjusted OR = 1.756; 95% CI, 1.074-2.877), less ROM (per degree, adjusted OR = 0.952; 95% CI, 0.923-0.983) and Kellgren and Lawrence (KL) grade 1 at baseline (adjusted OR = 8.527; 95% CI, 5.489-13.246) were risk factors for incident ROA.ConclusionThe incidence of knee ROA in Chinese suburban area was high. Advanced age, female, overweight, less range of motion, and KL grade 1 at baseline were associated with an increased risk of incident ROA.

Association of Intermittent and Constant Knee Pain Patterns With Knee Pain Severity and With Radiographic Knee Osteoarthritis Duration and Severity.

To examine the relation of knee pain patterns to pain severity and to radiographic osteoarthritis (OA) severity and duration. The Multicenter Osteoarthritis Study is a longitudinal cohort of older adults with or at risk of knee OA. Participants' Intermittent and Constant Osteoarthritis Pain (ICOAP) scores were characterized as 1) no intermittent or constant pain, 2) intermittent pain only, 3) constant pain only, and 4) a combination of constant and intermittent pain. Knee pain severity was assessed using the Western Ontario andMcMaster Universities Osteoarthritis Index(WOMAC) pain subscale and a visual analog scale (VAS). Radiographic knee OA (ROA) severity was defined as Kellgren/Lawrence grade ≥2, and ROA duration was defined according to the clinic visit at which ROA was first noted. We assessed the relation of ICOAP pain patterns to knee pain severity, ROA severity, and ROA duration using regression models with generalized estimating equations. There were 2,322 participants (mean age 68.8 years, body mass index 31.0 kg/m2 , 60% female). Higher ICOAP pain patterns, i.e., a mix of constant and intermittent pain, were associated with greater WOMAC pain severity compared with those patients without either pain pattern (odds ratio [OR] 43.2 [95% confidence interval (95% CI) 26.4-61.3]). Results were similar for the VAS (OR 71.2 [95% CI 45.7-110.9]). Those patients with more severe and longer duration of ROA were more likely to have a mix of constant and intermittent pain compared with those without either pain (OR 3.7 [95% CI 3.1-4.6] and OR 2.9 [95% CI 2.5-3.5], respectively). Knee pain patterns are associated with radiographic disease stage and duration, as well as pain severity, highlighting the fact that pain patterns are important for understanding symptomatic disease progression.

Inflammatory potential of diet and risk of incident knee osteoarthritis: a prospective cohort study

BackgroundTo examine the relation between inflammatory potential of diet and incident knee osteoarthritis (OA) and the role of BMI in the association of interest.MethodsIn the Osteoarthritis Initiative, the energy-adjusted dietary inflammatory index (E-DII™) scores were calculated based on the Block Brief 2000 Food Frequency Questionnaire and categorized into sex-specific quartiles. Outcomes were incident (1) radiographic knee OA (ROA) (i.e., a KL grade ≥ 2) and (2) symptomatic knee OA (SxOA) (i.e., a combination of frequent knee pain and ROA). We fitted generalized estimating equation models to examine the association between E-DII scores and incident knee OA. We performed mediation analyses to assess the potential mediation by BMI in the DII-OA relation.ResultsOver a 48-month follow-up period, 232 and 978 knees developed ROA and SxOA, respectively. Compared with the lowest (most anti-inflammatory) E-DII quartile, the odds ratio (OR) of incident ROA for the highest (most pro-inflammatory) E-DII quartile was 1.73 (95% confidence interval (CI) 1.15 to 2.62, Ptrend = 0.007). The corresponding OR for SxOA was 1.43 (95% CI 1.16 to 1.76, Ptrend = 0.001). The DII-OA association was significantly mediated via BMI with an indirect effect of 1.08 (95% CI 1.04, 1.13) for ROA and 1.13 (95% CI 1.09, 1.16) for SxOA, accounting for 20.4% and 44.5% of the total effect, respectively.ConclusionsA higher inflammatory potential of diet increased the risk of knee OA. The association was significantly mediated via BMI. Targeting the inflammatory potential of diet may be beneficial to reduce the risk of knee OA.

Inflammatory potential of diet and risk of knee osteoarthritis: data from the osteoarthritis initiative

Purpose: Diet plays a fundamental role in prevention of many chronic diseases by regulating inflammation and body weight. The evidence of diet in OA development is accumulating. We aimed to examine the relation of inflammatory potential of diet, a modifiable risk factor, to incident knee osteoarthritis (OA) and the role of BMI in the association of interest. Methods: We used data from the Osteoarthritis Initiative. Dietary inflammatory index®(DII®) was calculated based on theBlock Brief 2000 Food Frequency Questionnaire and categorized into sex-specific quartiles. DII® is a literature-derived population-based scoring algorithm to assess the inflammatory potential of diet as a whole and was evaluated for validity and shown to predict inflammatory markers. A higher score of DII® indicates a greater inflammatory potential of diet (i.e., pro-inflammatory effect of diet). Outcomes were incident radiographic knee OA (ROA) (i.e., a KL grade ≥2) and incident symptomatic knee OA (SxOA) (i.e., a combination of a frequent knee pain and ROA). We examined the association of DII® with the risk of knee ROA (or SxOA) by comparing a higher quartile (Q2, Q3 and Q4) with the lowest quartile (Q1: reference category) using generalized estimating equations to account for the correlation between two knees for each participant. In the base model (model 1), we adjusted for age, sex (men vs. women), race (white vs. non-white) and total energy intake (kcal/day). In model 2, we further adjusted for educational attainment (below college vs college or above), annual income (<50,000 US$ vs ≥50,000 US$), tobacco use (non-smoker vs former and current smoker) and PASE score. We tested linear trends using the median value of each quartile of DII®as a continuous variable in the regression model. We conducted sensitivity analyses by including knee replacement due to knee OAduring the follow-up period as incident knee ROA or SxOA, respectively. We performed mediation analyses to assess mediation effect of BMI in DII®-OA relation. Results: We included 1786 and 2940 eligible participants in the final analyses for the association of DII®with incident knee ROA and SxOA, respectively (Figure 1). We identified 232 and 978 knees developed ROA and SxOA among eligible participants over 48-month follow-up period, respectively. Compared with the lowest quartile of DII®, odds ratio (OR) of incident ROA for the highest quartile of DII®was 1.73 (95% confidence interval (CI): 1.15 to 2.62, P for trend= 0.007) (Table 1). The corresponding OR of SxOA was 1.43 (95% CI: 1.16 to 1.76, P for trend = 0.001) (Table 1). When total knee replacement due to knee OA was counted as an incident case of either ROA or SxOA, the results did not change materially.The DII®-OA association was significantly mediated via BMI with an indirect effect of 1.05 (95% CI: 1.02,1.08) for ROA and 1.05 (95% CI: 1.05, 1.11) for SxOA, accounting for 15.6% and 36.0% of total effect, respectively (Table 2). Conclusions: A higher inflammatory potential of diet increased the risk of knee OA. The association was significantly mediated via BMI. A role of inflammatory potential in dietary strategy for OA was indicated.View Large Image Figure ViewerDownload Hi-res image Download (PPT)View Large Image Figure ViewerDownload Hi-res image Download (PPT)

Relationship of intermuscular fat volume in the thigh with knee extensor strength and physical performance in women at risk of or with knee osteoarthritis

To determine the extent to which thigh intermuscular fat (IMF) and quadriceps muscle (QM) volumes explained variance in knee extensor strength and physical performance in women with radiographic knee osteoarthritis (ROA) and without. Baseline data from 125 women (age ≥50 years) in the Osteoarthritis Initiative study, with or at risk of knee ROA were included. Knee extensor strength was measured using a fixed force transducer, normalized to body mass (N/kg). Physical performance was the time required for 5 repeated chair stands (seconds). The IMF and QM volumes, normalized to height (cm(3) /meter), were yielded from analyses of T1-weighted axial magnetic resonance images of the midthigh. Mean IMF and QM volumes, extensor strength, and physical performance were compared between women with and without ROA, controlling for age. Hierarchical multiple regressions determined whether IMF and QM volumes were related to strength and performance after controlling for age, ROA status (yes/no), alignment, and pain. Compared to subjects with ROA, the subjects without ROA were stronger and performed chair stands faster (P < 0.05). After adjusting for age, those subjects without ROA had less mean ± SD IMF (61.1 ± 20.3 cm(3) /meter) compared to mean ± SD ROA (72.0 ± 25.0 cm(3) /meter; P < 0.05). In the entire sample, 21.1% of variance in knee extensor strength was explained by alignment, pain, and IMF. A model explaining 13.4% of variance in physical performance included OA status and IMF. QM volume was unrelated to strength and physical performance. IMF volume explained a small amount of variance in knee extensor strength and physical performance among women with or at risk of knee ROA.

The effect of religious practice on the prevalence of knee osteoarthritis

The aim of this study is to evaluate the effect of religious practice on the prevalence, severity, and patterns of knee osteoarthritis (OA) in a Thai elderly population with the same ethnicity and culture but different religions. A house-to-house survey was conducted in two subdistricts of Phranakhon Sri Ayutthaya province where inhabitants are a mixture of Buddhists and Muslims. One hundred fifty-three Buddhists and 150 Muslims aged >or= 50 years were evaluated demographically, physically, and radiographically. Those suffering knee pains were questioned about severity using the Western Ontario and McMaster University Osteoarthritis Index (WOMAC) scores and examined for their range of knee motion. Radiographic knee OA (ROA) was defined as Kellgren-Lawrence radiographic grade >or=2 while symptomatic knee OA (SOA) was defined as knee symptoms of at least 1 month in a knee with ROA. Muslims had on average a higher number of daily religious practices than their Buddhist neighbors (p < 0.001). The prevalence of knee pain and ROA was significantly higher in Buddhists than in Muslims (67.11 vs. 55.80, p = 0.02 for knee pain; 85.62 vs. 70.67, p = 0.02 for ROA). For SOA, Buddhists showed a trend towards higher prevalence than Muslims (47.71 vs. 37.32, p = 0.068). No significant difference was found when the range of motion and WOMAC scores were compared between the two groups. Muslims had a lower prevalence of OA than their Buddhists counterparts with the same ethnicity but different religious practice. The Muslim way of praying since childhood, forcing the knees into deep flexion, may stretch the soft tissue surrounding the knee and decrease stiffness and contact pressure of the articular cartilage.