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“[Knees] can progress from normal appearance to end-stage disease within four years, and many of these knees can experience these changes in less than 12 months,” writes lead author Jeffrey Driban, PhD, ATC, CSCS, of the Division of Rheumatology at Tufts Medical Center in Boston in an e-mail to The Rheumatologist. “So far, we know very little about this possible subset of osteoarthritis.”
The study, published October 2014 in Arthritis Care & Research, followed participants in the Osteoarthritis Initiative study and assessed whether knee injuries were associated with the outcome of accelerated knee OA or common knee OA progression over 48 months. Authors reported that a knee injury during the total observation period was associated with accelerated knee OA progression (n=54; odds ratio [OR] 3.14), but not common knee OA progression (n=187; OR 1.08). A more recent knee injury (within a year of the outcome) was associated with both accelerated (OR 8.46) and common knee OA progression (OR 3.12).
Dr. Driban believes connecting knee injuries with accelerated knee OA could improve clinical trials if researchers could selectively recruit participants at risk for faster progression.
“If we can understand which injuries lead to accelerated knee osteoarthritis then this could help us identify new treatment strategies to prevent it,” Dr. Driban writes. “We are still trying to figure out which injuries initiate or coincide with accelerated knee osteoarthritis. For now, these results remind us that we should be cautious and closely monitor older adults who report an injury.”
Dr. Driban notes it is concerning that certain as-yet-unknown injuries may predispose a knee to a rapid cascade toward joint failure in less than a year.
“Imagine the implications of a patient who had no knee osteoarthritis, but reports a recent knee injury, and then less than 12 months later presents with end-stage osteoarthritis,” he writes. “In less than a year, they developed a chronic condition. Going forward, we’ll need to determine which injuries are risk factors.” (posted 12/5/14)
Richard Quinn is a freelance writer in New Jersey.
1. Driban JB, Eaton CB, Lo GH, et al. Association of knee injuries with accelerated knee osteoarthritis progression: Data from the osteoarthritis initiative. 2014. Arthritis Care Res (Hoboken). Nov;66(11):1673–1679.