Predictors of and Longitudinal Factors Associated with Change in Pain, Stiffness and Physical Function over 8 Years in a Midlife Cohort with a Low Prevalence of Knee Osteoarthritis

Hussain Ijaz Khan¹, Andrew McBride², Louisa Chou³, Dawn Aitken⁴, Leigh Blizzard⁵, Changhai Ding⁶, Jean-Pierre Pelletier⁷, Johanne Martel-Pelletier⁸, Flavia Cicuttini⁹ and Graeme Jones⁶, ¹Musculoskeletal Unit, Menzies Institute of Medical Research, Hobart, Australia, ²Musculoskeletal Unit, Menzies Institute of Medical Research, Hobart, 7000, Australia, ³Menzies Institute of Medical Research, University of Tasmania, Hobart, 7000, Australia, ⁴Muscyloskeletal Unit, Menzies Institute of Medical Research, Hobart, Australia, ⁵Biostatistics, Menzies Institute of Medical Research, Hobart, Australia, ⁶Musculoskeletal Unit, Menzies Institute for Medical Research, University of Tasmania, Hobart, Australia, ⁷Rheumatology, Institut de recherche en rhumatologie de Montréal (IRRM), Montréal, QC, Canada, ⁸Pharmacology, Osteoarthritis Research Unit, University of Montreal Hospital Research Centre (CRCHUM), Notre-Dame Hospital, Montreal, QC, Canada, ⁹Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, Australia

Meeting: 2015 ACR/ARHP Annual Meeting

Date of first publication: September 29, 2015

Keywords: functional status, Knee, MRI, osteoarthritis and pain

Session Information

Date: Tuesday, November 10, 2015

Title: Osteoarthritis - Clinical Aspects Poster II: Biomarkers, Biomechanics and Health Services Research

Session Type: ACR Poster Session C

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

Background/Purpose:

Knee Osteoarthritis (OA) is the most common musculoskeletal
condition affecting quality of life and was one of the leading causes of the years
lived with disability in the global burden of disease 2010 study by the World
Health Organisation. Knee OA can result in pain and stiffness leading to
impairment in routine daily activities. The aim of this study was to examine
the demographic, structural and non-structural factors predicting and
associated with change in knee pain, stiffness and physical function in a
midlife cohort, with a low prevalence of radiographic OA, over 8 years.

Methods:

220 participants [mean age 47 (28-63); 57% female] were
studied at baseline and eight years. Approximately half were the adult
offspring of subjects who had a knee replacement performed for knee OA and the
remaining were randomly selected controls. Western Ontario and McMaster
Universities Osteoarthritis Index (WOMAC) was used to assess pain, stiffness
and physical function at both baseline and follow up visits. Pain, stiffness
and physical function scores were combined to get a complete WOMAC Index (WI)
score representing overall morbidity. Cartilage volume/defects, bone marrow
lesions (BMLs), meniscal tears/extrusion and effusion were assessed on MRI and joint
space narrowing and osteophytes on radiographs. BMI was classified as
normal=18.5-24.9, overweight=25-29.9 and obese=≥30.

Results:

At the baseline visit, higher BMI (prevalence
ratio (PR) for WI= +1.5 (+1.1 , +2.2), p= 0.02), history of knee injury (PR
for WI= +1.9 (+1.1, +3.2), p=0.01) and patellar BMLs (PR for WI= +1.5 (+1.1,+1.9),
p=<0.01) showed an independent cross-sectional association with the complete
WI as well as each individual sub-scale. Total tibiofemoral BMLs (PR=+1.82
(+1.2, +2.7), p=<0.01) showed an independent association with knee
stiffness only.

Baseline patellar cartilage defects (β for
WI= +6.4 (+1.0,+12.0), p=0.02) and total (medial + lateral) body meniscal
tears (β for WI= +16.1 (+4.0. +28.0), p=0.01) independently
predicted change in WI as well as each sub-scale over 8 years. Total knee
meniscal tears (β= +1.1 (+0.2, +1.9), p=0.01) independently
predicted change in stiffness only.

Change in total knee meniscal tears (β for
WI= +6.1 (+0.2, +12.0), p=0.045) and extrusion (β for WI= +7.6
(+0.9, +14.3), p=0.026) showed an independent deleterious association with
change in WI and each individual sub-scale over 8 years. In unadjusted analysis
change in both medial and lateral radiographic OA scores were associated with
change in WI but in the fully adjusted model, only change in lateral
radiographic OA (β for WI= +7.9 (+2.8, +13.0), p=<0.01) was
independently associated with WI and each sub-scale. Change in meniscal tears
and extrusion explained most of the changes in the medial compartment on
radiographs.

Conclusion:

In this midlife cohort higher BMI, history of knee
injury and BMLs are associated with prevalent disability. Patellar cartilage
defects and meniscal tears predicted worsening morbidity over 8 years. Change
in meniscal tears/extrusion and lateral compartment radiographic OA were
independently associated with worsening pain, stiffness and physical function.

Disclosure: H. I. Khan, None; A. McBride, None; L. Chou, None; D. Aitken, None; L. Blizzard, None; C. Ding, None; J. P. Pelletier, None; J. Martel-Pelletier, Artrotec Inc, 1; F. Cicuttini, None; G. Jones, None.

To cite this abstract in AMA style:

Khan HI, McBride A, Chou L, Aitken D, Blizzard L, Ding C, Pelletier JP, Martel-Pelletier J, Cicuttini F, Jones G. Predictors of and Longitudinal Factors Associated with Change in Pain, Stiffness and Physical Function over 8 Years in a Midlife Cohort with a Low Prevalence of Knee Osteoarthritis [abstract]. Arthritis Rheumatol. 2015; 67 (suppl 10). https://acrabstracts.org/abstract/predictors-of-and-longitudinal-factors-associated-with-change-in-pain-stiffness-and-physical-function-over-8-years-in-a-midlife-cohort-with-a-low-prevalence-of-knee-osteoarthritis/. Accessed .

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