The Impact of Systemic Comorbidities on the Radiographic Severity of Knee Osteoarthritis: A Cross-Sectional Analysis

Abstract

Background and Aim: Knee osteoarthritis (KOA) is a highly prevalent musculoskeletal disorder associated with systemic comorbidities. However, the relationship between the radiographic severity of KOA and comorbidities remains poorly understood. This study aimed to investigate the association between common systemic comorbidities and the radiographic severity of KOA. Materials and Methods: A total of 181 patients with KOA were included in this cross-sectional study. Demographic characteristics, body mass index (BMI), and comorbidities, including hypertension (HT), diabetes mellitus (DM), thyroid disease, and other systemic comorbidities, were recorded according to the Charlson Comorbidity Index (CCI). Radiographic severity was assessed using the Kellgren–Lawrence (KL) grading system. Associations between comorbidities and KL grade were evaluated using chi-square tests. Ordinal logistic regression analyses were adjusted for age, sex, and BMI. Results: The mean age of the participants was 68.7±9.1 years, and the mean BMI was 29.4±4.5 kg/m². HT was present in 56.4% of patients with KOA, DM in 23.2%, and thyroid disease in 21.5%. Patients with HT demonstrated greater radiographic severity, with 44.1% classified as KL grades 3–4, compared with 16.5% of patients without HT (χ²=16.18, p=0.001). In the adjusted ordinal logistic regression analysis, HT remained independently associated with higher KL grades (p=0.004). No significant associations were observed between KL grade and DM, thyroid disease, other comorbidities, or CCI. Conclusion: HT was independently associated with greater radiographic severity of KOA, whereas the other evaluated comorbidities showed no significant associations. These findings support a potential role for vascular and systemic mechanisms in KOA progression and highlight the importance of cardiovascular health in patients with KOA.