Association of clinical findings with pre–radiographic and radiographic knee osteoarthritis in a population-based study

Authors

  • Jolanda Cibere,

    Corresponding author
    1. University of British Columbia and Arthritis Research Centre of Canada, Vancouver, British Columbia, Canada
    • Arthritis Research Centre of Canada, 895 West 10th Avenue, Vancouver, British Columbia, Canada, V5Z 1L7
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    • Dr. Cibere has received consultant fees, speaking fees, and/or honoraria (less than $10,000 each) from Amgen Inc. and Centocor Research & Development, Inc.

  • Hongbin Zhang,

    1. University of British Columbia and Canadian HIV Trials Network, Vancouver, British Columbia, Canada
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  • Anona Thorne,

    1. University of British Columbia and Canadian HIV Trials Network, Vancouver, British Columbia, Canada
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  • Hubert Wong,

    1. University of British Columbia and Canadian HIV Trials Network, Vancouver, British Columbia, Canada
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  • Joel Singer,

    1. University of British Columbia and Centre for Health Evaluation and Outcome Sciences, Vancouver, British Columbia, Canada
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    • Dr. Singer has received consultant fees, speaking fees, and/or honoraria (less than $10,000 each) from Bristol-Myers Squibb, the Canadian Centre for Functional Medicine, and Astellas Pharma, and receives royalties from McMaster University for the Inflammatory Bowel Disease Questionnaire.

  • Jacek A. Kopec,

    1. University of British Columbia and Arthritis Research Centre of Canada, Vancouver, British Columbia, Canada
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  • Ali Guermazi,

    1. Boston University Medical Center, Boston, Massachusetts
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    • Dr. Guermazi has received consultant fees, speaking fees, and/or honoraria (less than $10,000 each) from Genzyme, Novartis, and Facet Solutions, and (more than $10,000 each) from Merck Sorono and Stryker; owns stock and/or holds stock options in Synarc Inc.; and is the President of Boston Imaging Core Lab, LLC.

  • Charles Peterfy,

    1. Spire Sciences LLC, San Francisco, California
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    • Dr. Peterfy owns stock and/or holds stock options in Spire Sciences LLC and CCBR-Synarc, Inc.

  • Savvakis Nicolaou,

    1. Spire Sciences LLC, San Francisco, California
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  • Peter L. Munk,

    1. University of British Columbia and Vancouver General Hospital, Vancouver, British Columbia, Canada
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    • Dr. Munk has received speaking fees (less than $10,000 each) from Cook Group Inc. and Boston Scientific Inc.

  • John M. Esdaile

    1. University of British Columbia and Arthritis Research Centre of Canada, Vancouver, British Columbia, Canada
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Abstract

Objective

To determine the prevalence of pre–radiographic osteoarthritis (ROA) and ROA of the knee in a symptomatic population-based cohort, and to evaluate the clinical correlates of pre-ROA and ROA.

Methods

Subjects ages 40–79 years with knee pain were recruited as a random population sample and classified using magnetic resonance cartilage (MRC) scores (range 0–4) and Kellgren/Lawrence (K/L) scale grades (range 0–4) as no OA (MRC score <2, K/L grade <2), pre-ROA (MRC score ≥2, K/L grade <2), and ROA (MRC score ≥2, K/L grade ≥2). Logistic regression was used to evaluate the association of clinical variables with cartilage defects, comparing subjects with any cartilage defects (pre-ROA/ROA) with those without, and to determine associations with individual OA subgroups.

Results

Of 255 symptomatic subjects, no OA, pre-ROA, and ROA were seen in 13%, 49%, and 38%, respectively. The prevalence of pre-ROA/ROA compared with no OA was associated with age (odds ratio [OR] 2.89, 95% confidence interval [95% CI] 1.59–5.26), sports activity (OR 1.35, 95% CI 1.07–1.70), abnormal gait (OR 10.86, 95% CI 1.46–1,388.4), effusion (OR 16.58, 95% CI 2.22–2,120.5), and flexion contracture (OR 2.37, 95% CI 1.50–3.73). The prevalence of ROA versus no OA was significantly associated with age, body mass index, pain frequency, pain duration, severe knee injury, sports activity, gait, effusion, bony swelling, crepitus, flexion contracture, and flexion. The prevalence of pre-ROA versus no OA was increased with age, sports activity, effusion, and flexion contracture, and reduced with valgus malalignment.

Conclusion

Cartilage defects were highly prevalent in this symptomatic population-based cohort, with 49% of subjects having pre-ROA and 38% having ROA. Prevalent cartilage defects were significantly associated with age, sports activity, abnormal gait, effusion, and flexion contracture.

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