ACR Meeting Abstracts

ACR Meeting Abstracts

Abstract Number: 431

Early Pre-Radiographic Structural Pathology Precedes the Onset of Accelerated Knee Osteoarthritis: Data from the Osteoarthritis Initiative

Matthew Harkey1, Julie Davis2, Bing Lu3, Lori Lyn Price4,5, Robert J. Ward6, James MacKay7, Charles B. Eaton8, Grace H. Lo9, Mary Barbe10, Ming Zhang11, Jincheng Pang12, Alina Stout1, Timothy E. McAlindon13 and Jeffrey B. Driban14, 1Rheumatology, Tufts Medical Center, Boston, MA, 2Rheumatology, Tufts Medical Center, BOSTON, MA, 3Brigham & Women's Hospital and Harvard Medical School, Boston, MA, 4Institute for Clinical Research and Health Policy Studies, Tufts Medical Center, Boston, MA, 5Tufts Clinical and Translational Science Institute, Tufts University, Boston, MA, 6Radiology, Tufts Medical Center, Boston, MA, 7Radiology, University of Cambridge School of Clinical Medicine, Cambridge, United Kingdom, 8Family Medicine and Community Health( Epidemiology), Alpert Medical School of Brown University, Pawtucket, RI, 9Michael E. DeBakey Veterans Affairs Medical Center / Baylor College of Medicine, Houston, TX, 10Temple University School of Medicine, Philadelphia, PA, 11Tufts Medical Center, Boston, MA, 12Electrical Engineering, Tufts University, Medford, MA, 13Division of Rheumatology, Tufts Medical Center, Boston, MA, 14Medicine, Division of Rheumatology, Tufts Medical Center, Boston, MA

Meeting: 2018 ACR/ARHP Annual Meeting

Keywords: , ,

Session Information

Date: Sunday, October 21, 2018

Title: Osteoarthritis – Clinical Poster I

Session Type: ACR Poster Session A

Session Time: 9:00AM-11:00AM

Background/Purpose: Individuals that develop accelerated knee osteoarthritis (AKOA) have more frequent knee pain, decreased physical function, and are more likely to receive a knee replacement when compared to adults with a gradual onset of knee osteoarthritis (OA). Therefore, developing prognostic tools that provide earlier signs of individuals at risk for the development of AKOA are needed to lessen the burden of this disease. The purpose of this analysis was to determine which pre-radiographic structural pathologies precede the development of AKOA. 

Methods: The sample comprised participants from the Osteoarthritis Initiative (OAI) who had at least one radiographically normal knee at baseline (Kellgren-Lawrence [KL] grade ≤1). Participants were classified into 2 groups based on radiographic disease progression from baseline to 48 months: AKOA (KL grade change from ≤1 to ≥3) and No AKOA. Magnetic resonance images were assessed for the presence of 9 semi-quantitative structural pathologies and separated into tertiles for 3 quantitative pathologies at the OAI baseline (Table). For the quantitative pathologies, we converted the tertiles to a dichotomous variable to compare the worst tertile (i.e. largest bone marrow lesion and effusion, smallest cartilage damage index) to the combination of the other two tertiles. Logistic regressions were used to determine which pre-radiographic structural pathologies were more likely to antedate the development of AKOA compared to individuals not developing AKOA.

Results: Overall the groups were predominantly female (63%), overweight, and 33% reported frequent knee pain within a year of baseline. At the OAI baseline visit, degenerative cruciate ligaments (odds ratio [OR]=2.2, 95% confidence interval [CI]=1.3,3.5), infrapatellar synovitis (OR=2.0, 95%CI=1.2,3.2), medial meniscal pathology (OR=2.1, 95%CI=1.3,3.4), lateral meniscal pathology (OR=2.4, 95%CI=1.5,3.8) and larger quantitative knee effusion (OR=2.2, 95%CI=1.4,3.4) were more likely to antedate the development of AKOA when compared to those that did not develop AKOA (Table).

Conclusion: The presence of early ligamentous degeneration, synovitis, meniscal pathology, and large effusion precedes the onset of AKOA and may be prognostic biomarkers.

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Disclosure: M. Harkey, None; J. Davis, None; B. Lu, None; L. L. Price, None; R. J. Ward, None; J. MacKay, None; C. B. Eaton, None; G. H. Lo, None; M. Barbe, None; M. Zhang, None; J. Pang, None; A. Stout, None; T. E. McAlindon, None; J. B. Driban, None.

To cite this abstract in AMA style:

Harkey M, Davis J, Lu B, Price LL, Ward RJ, MacKay J, Eaton CB, Lo GH, Barbe M, Zhang M, Pang J, Stout A, McAlindon TE, Driban JB. Early Pre-Radiographic Structural Pathology Precedes the Onset of Accelerated Knee Osteoarthritis: Data from the Osteoarthritis Initiative [abstract]. Arthritis Rheumatol. 2018; 70 (suppl 9). https://acrabstracts.org/abstract/early-pre-radiographic-structural-pathology-precedes-the-onset-of-accelerated-knee-osteoarthritis-data-from-the-osteoarthritis-initiative/. Accessed .

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