Prevalence Of Knee Osteoarthritis Research Articles

The dynamics of the pain system is intact in patients with knee osteoarthritis: An exploratory experimental study

Background and aimsDespite the high prevalence of knee osteoarthritis (OA) it remains one of the most frequent knee disorders without a cure. Pain and disability are prominent clinical features of knee OA. Knee OA pain is typically localized but can also be referred to the thigh or lower leg. Widespread hyperalgesia has been found in knee OA patients. In addition, patients with hyperalgesia in the OA knee joint show increased pain summation scores upon repetitive stimulation of the OA knee suggesting the involvement of facilitated central mechanisms in knee OA. The dynamics of the pain system (i.e., the adaptive responses to pain) has been widely studied, but mainly from experiments on healthy subjects, whereas less is known about the dynamics of the pain system in chronic pain patients, where the pain system has been activated for a long time. The aim of this study was to assess the dynamics of the nociceptive system quantitatively in knee osteoarthritis (OA) patients before and after induction of experimental knee pain. MethodsTen knee osteoarthritis (OA) patients participated in this randomized crossover trial. Each subject was tested on two days separated by 1 week. The most affected knee was exposed to experimental pain or control, in a randomized sequence, by injection of hypertonic saline into the infrapatellar fat pad and a control injection of isotonic saline. Pain areas were assessed by drawings on anatomical maps. Pressure pain thresholds (PPT) at the knee, thigh, lower leg, and arm were assessed before, during, and after the experimental pain and control conditions. Likewise, temporal summation of pressure pain on the knee, thigh and lower leg muscles was assessed. ResultsExperimental knee pain decreased the PPTs at the knee (P<0.01) and facilitated the temporal summation on the knee and adjacent muscles (P<0.05). No significant difference was found at the control site (the contralateral arm) (P=0.77). Further, the experimental knee pain revealed overall higher VAS scores (facilitated temporal summation of pain) at the knee (P<0.003) and adjacent muscles (P<0.0001) compared with the control condition. The experimental knee pain areas were larger compared with the OA knee pain areas before the injection. ConclusionsAcute experimental knee pain induced in patients with knee OA caused hyperalgesia and facilitated temporal summation of pain at the knee and surrounding muscles, illustrating that the pain system in individuals with knee OA can be affected even after many years of nociceptive input. This study indicates that the adaptability in the pain system is intact in patients with knee OA, which opens for opportunities to prevent development of centralized pain syndromes.

Individuals with high bone mass have an increased prevalence of radiographic knee osteoarthritis

We previously reported an association between high bone mass (HBM) and a bone-forming phenotype of radiographic hip osteoarthritis (OA). As knee and hip OA have distinct risk factors, in this study we aimed to determine (i) whether HBM is also associated with knee OA, and (ii) whether the HBM knee OA phenotype demonstrates a similar pattern of radiographic features to that observed at the hip.HBM cases (defined by DXA BMD Z-scores) from the UK-based HBM study were compared with unaffected family controls and general population controls from the Chingford and Hertfordshire cohort studies. A single blinded observer graded AP weight-bearing knee radiographs for features of OA (Kellgren–Lawrence score, osteophytes, joint space narrowing (JSN), sclerosis) using an atlas. Analyses used logistic regression, adjusting a priori for age and gender, and additionally for BMI as a potential mediator of the HBM–OA association, using Stata v12.609 HBM knees in 311 cases (mean age 60.8years, 74% female) and 1937 control knees in 991 controls (63.4years, 81% female) were analysed. The prevalence of radiographic knee OA, defined as Kellgren–Lawrence grade≥2, was increased in cases (31.5% vs. 20.9%), with age and gender adjusted OR [95% CI] 2.38 [1.81, 3.14], p<0.001. The association between HBM and osteophytosis was stronger than that for JSN, both before and after adjustment for BMI which attenuated the ORs for knee OA and osteophytes in cases vs. controls by approximately 50%.Our findings support a positive association between HBM and knee OA. This association was strongest for osteophytes, suggesting HBM confers a general predisposition to a subtype of OA characterised by increased bone formation.

Prevalence of knee pain and knee OA in southern Sweden and the proportion that seeks medical care.

The aim of this study was to estimate the prevalence of frequent knee pain in radiographic, symptomatic and clinically defined knee OA in middle-aged and elderly patients and the proportion that seeks medical care. In 2007 a random sample of 10 000 56- to 84-year-old residents of Malmö, Sweden, were questioned about knee pain. We classified subjects reporting knee pain with a duration of at least 4 weeks as having frequent knee pain. A random sample of 1300 individuals with frequent knee pain and 650 without were invited for assessment by the ACR clinical knee OA criteria and for bilateral weight-bearing knee radiography. We considered a Kellgren-Lawrence grade ≥2 as radiographic knee OA and that in combination with frequent knee pain as symptomatic knee OA. By linkage with the Skåne Healthcare Register, we determined the proportion of subjects that had consulted for knee OA or pain. The 10 000 subjects had a mean age of 70 years (s.d. 7.6), a mean BMI of 27.1 kg/m(2) and 62% were women. The prevalence of frequent knee pain was 25.1% (95% CI 24.1, 26.1), higher in women and similar across age groups. The prevalence of radiographic knee OA was 25.4% while 15.4% had either symptomatic or clinically defined knee OA. Of these, 68.9% consulted a physician for knee OA or pain during 2004-11. Fifteen per cent of middle-aged or elderly individuals have knee OA and symptoms. About one in three of those do not consult a physician. Inefficient care of OA and self-coping may be an explanation.

Trends in Prescription of Opioids From 2003–2009 in Persons With Knee Osteoarthritis

Osteoarthritis (OA) of the knee is a painful condition affecting ∼13% of persons ages >65 years. We sought to examine whether the use of opioids in older persons with OA has increased over the past decade and what patient characteristics may correlate with their use. We assembled national cohorts of individuals with knee OA using data from the 2003, 2006, and 2009 waves of the Medicare Current Beneficiary Survey. The survey data contained information on demographics, health status, and prescribed medications linked to Medicare claims. We used multivariate logistic regression to establish whether opioid use changed over time and to identify factors associated with greater opioid use. The outcome was defined as receiving ≥1 opioid prescription in the study year. The mean age and sex were similar across years (77 years and 69% women, respectively). There was a significant increase in opioid prescribing between 2003 and 2009, with 31% of patients receiving opioids in 2003, 39% in 2006, and 40% in 2009 (odds ratio [OR] 1.5, 95% confidence interval [95% CI] 1.1-2.0 for 2006 and 2009 compared with 2003). Independent correlates of opioid use across time periods included female sex (OR 1.5, 95% CI 1.2-2.0), functional limitation (OR 2.1, 95% CI 1.6-2.7), poor self-reported health status (OR 1.6, 95% CI 1.2-2.0), chronic obstructive pulmonary disease (OR 1.4, 95% CI 1.0-1.8), and musculoskeletal disease besides OA (OR 1.9, 95% CI 1.2-2.8). As the prevalence and incidence of knee OA continues to increase, the public health impact of greater opioid use should be monitored carefully.

SP0122 Biomechanical Joint Homeostasis: Mechanisms in Health, Aging and Oa

This presentation will approach the analysis of OA by considering that the maintenance of healthy cartilage homeostasis as well as cartilage breakdown is dependent on the balance of mechanical, biological...

FRI0562-HPR Effectiveness of the Introduction of Proprioceptive Training in the Exercise Programs for Knee Osteoarthritis

BackgroundRheumatic diseases are a major social and economic problem, with increasing negative impact on public health. The prevalence of Knee Osteoarthritis (KO) among older people is increasing and it seems...

OP0057 Effects of Chondroitin Sulfate on Brain Response to Painful Stimulation in Knee Osteoarthritis Patients

BackgroundKnee osteoarthritis (OA) is a degenerative joint disease causing symptoms in 12% of people over the age of 651. One of the inherent problems with efficacy assessment of pain medication...

THU0199 Comparison of the Diagnostic Value of Schuss X Ray Alone, versus Schuss and Standard AP X Rays for the Diagnosis of Knee Osteoarthritis (OA) in the Khoala Cohort

BackgroundFew data have been published about the diagnostic value of standard AP view and Schuss X rays associationObjectivesOur objective is to compare the contribution to diagnosis of the association standard...

FRI0582-HPR A Critical Review on Measurement Properties of Instruments Used to Evaluate Body Function in People with Knee Osteoarthritis

BackgroundWith the increasing prevalence of knee osteoarthritis (KOA) today1, it is imperative to use valid and reliable instruments to evaluate the effectiveness of interventions and to understand the pathology's impact...

Lower limb clinical and radiographic osteoarthritis in former elite male athletes.

To investigate the prevalence of lower extremities clinical and radiographic OA in former elite male athletes and referents from the general population and to examine its association with the participants' demographic characteristics. Two hundred and eighteen former elite male athletes (soccer, volleyball, martial arts, track and field and basketball players, and skiers) and 181 male controls that reported no systematic athletic activity were examined by means of questionnaire, clinical and radiographic evaluation. Exclusion criteria were age younger than 40 years and a positive history of lower extremity surgery, bone or soft tissue trauma and inflammatory arthropathy. Overall, the prevalence of clinical OA between former elite athletes (15.6 %) and controls (14.4 %) was similar (n.s.). The prevalence of radiographic OA was significantly higher (p = 0.03) in former elite athletes (36.6 %) compared with controls (23.9 %). All the participants with clinical OA who underwent radiographic examination also had radiographic OA. The prevalence of clinical and radiographic OA was similar (n.s.) between former athletes of different sports. Age, body mass index (BMI) and occupation variably predicted the prevalence of hip, knee and ankle OA in both study groups. In the absence of major bone and soft tissue lower limb trauma during their athletic career, former elite athletes may not be at increased risk of developing clinical OA. Radiographic signs of OA present at a significantly higher incidence and possibly precede the clinical onset of OA. Age, BMI and occupation are identified as strong predictors of the development of OA in former elite athletes.

Temporal summation of pain as a prospective predictor of clinical pain severity in adults aged 45 years and older with knee osteoarthritis: ethnic differences.

Enhanced pain facilitation is reportedly an important contributor to the clinical pain experiences of individuals with knee osteoarthritis (OA). Ethnic differences in the prevalence and severity of knee OA in addition to associated pain are also well documented. Temporal summation (TS) of pain is a widely applicable quantitative sensory testing method that invokes neural mechanisms related to pain facilitatory processes. This study tested whether TS of pain, an index of pain facilitation, differentially predicts the clinical pain experiences of African Americans and non-Hispanic whites with symptomatic knee OA. A total of 225 study participants underwent assessment of TS of mechanical and heat pain stimuli applied to their most symptomatic knee and their ipsilateral hand (mechanical) or forearm (heat). Using telephone-based surveys, participants subsequently reported their average and worst clinical pain severity across four consecutive weeks after the assessment of TS. In predicting future clinical pain, ethnicity interacted with TS of mechanical pain (but not heat pain), such that TS of mechanical pain at the knee significantly predicted greater clinical ratings of average (b = 0.02, p = .016) and worst (b = 0.02, p = .044) clinical pain for non-Hispanic whites but not African Americans (p values > .30). These results reveal the importance of considering ethnicity when examining pain facilitation and the clinical pain of individuals with symptomatic knee OA. The results of this study are discussed in terms of ethnic differences in the predictors of clinical pain experiences among African Americans and non-Hispanic whites with knee OA.

Prevalence of radiographic osteoarthritis of the knee and its relationship to self-reported pain.

Background and AimOsteoarthritis (OA) of the knee is one of the most common skeletal disorders, yet little data are available in Asian populations. We sought to assess the prevalence and pattern of radiographic OA of the knee, and its relationship to self-reported pain in a Vietnamese population.MethodsThe study was based on a sample of 170 men and 488 women aged ≥40 years who were randomly sampled from the Ho Chi Minh City (Vietnam). Radiographs of the knee were graded from 0 to 4 according to the Kellgren and Lawrence scale. Osteoarthritis was defined as being present in a knee if radiographic grades of 2 or higher were detected. Knee pain and symptoms were ascertained by direct interview using a structured questionnaire.ResultsThe point prevalence of radiographic OA of the knee was 34.2%, with women having higher rate than men (35.3% vs 31.2%). The prevalence of knee OA increased with advancing age: 8% among those aged 40–49 years, 30% in those aged 50–59 years, and 61.1% in those aged ≥60 years. Greater BMI was associated with higher risk of knee OA. Self-reported knee pain was found in 35% of men and 62% of women. There was a statistically significant association between self-reported knee pain and knee OA (prevalence ratio 3.1; 95% CI 2.0 to 4.6).ConclusionsThese data indicate that approximately a third of Vietnamese men and women have radiographic OA in the knee, and that self-reported knee pain may be used as an indicator of knee osteoarthritis.

Markers of atherosclerosis in relation to presence and progression of knee osteoarthritis: the Rotterdam study

Purpose: Several observational studies have found an association between subclinical measures of atherosclerosis and osteoarthritis (OA) of the hands and knees, predominantly among women. Different mechanisms have been suggested to explain the potential relation between atherosclerosis and OA; systemic low-grade inflammation caused by visceral adipose tissue is particularly mentioned and may consequently highlight a route to improve prevention and treatment of atherosclerosis and OA. However, the reported associations between subclinical measures of atherosclerosis and OA were modest in effect size, derived mainly from cross-sectional studies and generally attenuated after adjustment for cardiovascular risk factors. Furthermore, previous results were inconsistent for the different imaging markers of atherosclerosis. In previous work, we found no relation between peripheral measurements of atherosclerosis (including carotid intima-media-thickness or carotid plaque) and progression of knee, hand, or hip OA in a large sample of a prospective cohort study. Hence, it remains unclear whether atherosclerosis and OA are related or whether they are simply independent disorders with shared risk factors. Coronary artery calcification (CAC) is considered a late stage pathognomonic feature of coronary atherosclerosis. CD40L, VCAM-1, and VEG-f are serum biomarkers that reflect initial inflammatory stages of vascular wall damage in the ischemic cascade. In the vascular endothelium, VEG-f is a protein that stimulates angiogenesis, CD-40L and VCAM-1 are molecules that initiate coagulation and immune responses. We therefore investigated the association between these markers of early and late atherosclerosis and presence and progression of knee OA, a possible cardiometabolic phenotype of OA, in a large population-based cohort study. Methods: The analyses on prevalence of knee OA were performed in 3,465 participants from the prospective population-based Rotterdam Study (mean age 73.1 years, 61% women). Data on coronary artery calcification (CAC) were available for 1,669 participants and plasma levels of CD40L, VCAM-1, and VEG-f in 975. For the analyses on progression of knee OA, data on CAC was available for 979 participants (17% progressors), and 246 participants (20% progressors) had plasma levels of CD40L, VCAM-1, and VEG-f. We scored radiographs of the knee with the Kellgren-Lawrence (K&L) score for osteoarthritis (knee OA present with a K&L graded score greater or equal to 2) at baseline and follow-up (average follow-up time 4.5 years ( 0.5)). Overall progression of knee OA was defined as the combination of the incidence and the progression of existing OA at baseline and was considered present if the K&L score increased 1 grade between baseline and follow-up visit. After stratification by gender, multivariate logistic regression models with generalized estimated equations on knee level were used to calculate odds ratios (95% confidence intervals) for prevalence and progression of knee OA per each SD increase in marker levels. Results: Within the study population, 18% had radiographic knee OA, 11% of the men, 23% of the women. CAC and VEG-f were not associated with prevalent knee OA. Among women, CD40L (adjusted odds ratio (aOR) 1.31 (1.12 to 1.56)) and VCAM-1 (aOR 1.31 (1.08 to 1.59)) were associated with prevalent knee OA (table). No associations with progression were found in women. In men, too few progressors were available to assess associations.

Prevalence of knee osteoarthritis and impact of hyaluronic acid treatment on pain and mobility in a Canadian real-world population

Prevalence of knee osteoarthritis and impact of hyaluronic acid treatment on pain and mobility in a Canadian real-world population

Serum sclerostin is not associated with knee osteoarthritis prevalence and progression of kellgren-lawrence score in women: the ofely study

Serum sclerostin is not associated with knee osteoarthritis prevalence and progression of kellgren-lawrence score in women: the ofely study

Patterns of joint involvement in foot osteoarthritis: findings from the clinical assessment study of the foot

Patterns of joint involvement in foot osteoarthritis: findings from the clinical assessment study of the foot

Prevalence and overlap of doctor-diagnosed knee OA, frequent knee pain and radiographic knee OA in Sweden

Prevalence and overlap of doctor-diagnosed knee OA, frequent knee pain and radiographic knee OA in Sweden

The global burden of hip and knee osteoarthritis: estimates from the Global Burden of Disease 2010 study

ObjectiveTo estimate the global burden of hip and knee osteoarthritis (OA) as part of the Global Burden of Disease 2010 study and to explore how the burden of hip and...

Role of mtDNA Haplogroups in the Prevalence of Knee Osteoarthritis in a Southern Chinese Population

Mitochondrial DNA (mtDNA) has been implicated in various human degenerative diseases. However, the role of mtDNA in Osteoarthritis (OA) is less known. To investigate whether mtDNA haplogroups contribute to the prevalence of knee OA, we have carried out a comprehensive case-control study on 187 knee OA patients and 420 geographically matched controls in southern China. OA patients were classified on the Kellgren/Lawrence scale from two to four for the disease severity study and the data were analyzed by adjusting for age and sex. We found that patients with haplogroup G (OR = 3.834; 95% CI 1.139, 12.908; p = 0.03) and T16362C (OR = 1.715; 95% CI 1.174, 2.506; p = 0.005) exhibited an increased risk of OA occurrence. Furthermore, patients carrying haplogroup G had a higher severity progression of knee OA (OR = 10.870; 95% CI 1.307, 90.909; p = 0.007). On the other hand, people with haplogroup B/B4 (OR = 0.503; 95% CI 0.283, 0.893; p = 0.019)/(OR = 0.483; 95% CI 0.245, 0.954; p = 0.036) were less susceptible for OA occurrence. Interestingly, we found OA patients also exhibited a general increase in mtDNA content. Our study indicates that the mtDNA haplogroup plays a role in modulating OA development.

Definición, etiopatogenia, clasificación y formas de presentación

Osteoarthritis is defined as a degenerative process affecting the joints as a result of mechanical and biological disorders that destabilize the balance between the synthesis and degradation of joint cartilage, stimulating the growth of subchondral bone; chronic synovitis is also present. Currently, the joint is considered as a functional unit that includes distinct tissues, mainly cartilage, the synovial membrane, and subchondral bone, all of which are involved in the pathogenesis of the disease.Distinct risk factors for the development of osteoarthritis have been described: general, unmodifiable risk factors (age, sex, and genetic makeup), general, modifiable risk factors (obesity and hormonal factors) and local risk factors (prior joint anomalies and joint overload). Notable among the main factors related to disease progression are joint alignment defects and generalized osteoarthritis.Several classifications of osteoarthritis have been proposed but none is particularly important for the primary care management of the disease. These classifications include etiological (primary or idiopathic forms and secondary forms) and topographical (typical and atypical localizations) classifications, the Kellgren and Lawrence classification (radiological repercussions) and that of the American College of Rheumatology for osteoarthritis of the hand, hip and knee.The prevalence of knee osteoarthritis is 10.2% in Spain and shows a marked discrepancy between clinical and radiological findings. Hand osteoarthritis, with a prevalence of symptomatic involvement of around 6.2%, has several forms of presentation (nodal osteoarthritis, generalized osteoarthritis, rhizarthrosis, and erosive osteoarthritis). Symptomatic osteoarthritis of the hip affects between 3.5% and 5.6% of persons older than 50 years and has different radiological patterns depending on femoral head migration.