Associations of Knee Symptomatic, Radiographic, and Structural Abnormalities With Contralateral Knee Osteoarthritis Progression.
TL;DR
Ass associations of symptomatic, radiographic, and structural knee indicators with radiographic osteoarthritis (OA) progression in the contralateral knee among individuals with or at risk of OA are investigated, suggesting contralateral knee condition should be considered in OA evaluation.
Abstract
Aim
To investigate associations of symptomatic, radiographic, and structural knee indicators with radiographic osteoarthritis (OA) progression in the contralateral knee among individuals with or at risk of OA.
Methods
Data were obtained from the Osteoarthritis Initiative Database (accessed on December 21, 2022), with knees as the unit of analysis. Baseline exposures included symptomatic measures (Western Ontario and McMaster Universities Osteoarthritis Index [WOMAC], Knee injury and Osteoarthritis Outcome Score), radiographic features (radiographic OA status, Kellgren-Lawrence [KL] grades, joint space width [JSW], and alignment), and magnetic resonance imaging (MRI)-based structural abnormalities (MRI Osteoarthritis Knee Score [MOAKS]-assessed lesions including cartilage defects, bone marrow lesions, meniscal morphology, Hoffa-synovitis, and effusion-synovitis). Outcomes were 4-year contralateral KL grades and 4-year JSW change. Generalized estimating equation models were used.
Results
Each 1-point increase in WOMAC total score was associated with increased contralateral KL grades (β = 0.002, 95% confidence interval [CI], 0.001 to 0.003) and greater medial JSW narrowing (β = -0.005 mm, 95% CI, -0.007 to -0.003 mm). Radiographic OA status was associated with higher KL grades (β = 0.112, 95% CI, 0.088 to 0.136) and reduced medial JSW (β = -0.179 mm, 95% CI, -0.236 to -0.122 mm) and lateral JSW (β = -0.168 mm, 95% CI, -0.257 to -0.079 mm). MRI-based analyses showed that MOAKS-defined structural damage was associated with greater contralateral JSW loss, with compartment-specific patterns. Each 1-point increase in medial tibiofemoral (TF) joint bone marrow lesion (BML) size was associated with a 0.045 mm decrease in contralateral medial JSW (95% CI, -0.065 to -0.025 mm), while each 1-point increase lateral TF joint BML size was associated with a 0.048 mm decrease in contralateral lateral JSW (95% CI, -0.084 to -0.012 mm).
Conclusions
Worse symptomatic, radiographic, and structural knee status is associated with contralateral radiographic OA progression, suggesting contralateral knee condition should be considered in OA evaluation.