title: Identification of factors associated with the development of knee osteoarthritis in a young to middle-aged cohort of patients with knee complaints.
abstract: The objective of this study was to identify risk factors for knee osteoarthritis (OA) development in a young to middle-aged population with sub-acute knee complaints. This, in order to define high risk patients who may benefit from early preventive or future disease modifying therapies. Knee OA development visible on radiographs and MR in 319 patients (mean age 41.5 years) 10 years after sub-acute knee complaints and subjective knee function (KOOS score) was studied. Associations between OA development and age, gender, activity level, BMI, meniscal or anterior cruciate ligament (ACL) lesions, OA in first-degree relatives and radiographic hand OA were determined using multivariable logistic regression analysis. OA on radiographs and MR in the TFC is associated with increased age (OR: 1.10, 95 % 1.04-1.16 and OR: 1.07, 95 % 1.02-1.13). TFC OA on radiographs only is associated with ACL and/or meniscal lesions (OR: 5.01, 95 % 2.14-11.73), presence of hand OA (OR: 4.69, 95 % 1.35-16.32) and higher Tegner activity scores at baseline before the complaints (OR: 1.20, 95 % 1.01-1.43). The presence of OA in the TFC diagnosed only on MRI is associated with a family history of OA (OR: 2.44, 95 % 1.18-5.06) and a higher BMI (OR: 1.13, 95 % 1.04-1.23). OA in the PFC diagnosed on both radiographs and MR is associated with an increased age (OR: 1.06, 95 % 1.02-1.12 and OR: 1.05, 95 % 1.00-1.09). PFC OA diagnosed on radiographs only is associated with a higher BMI (OR: 1.12, 95 % 1.02-1.22). The presence of OA in the PFC diagnosed on MR only is associated with the presence of hand OA (OR: 3.39, 95 % 1.10-10.50). Compared to normal reference values, the study population had significantly lower KOOS scores in the different subscales. These results show that knee OA development in young to middle aged patients with a history of sub-acute knee complaints is associated with the presence of known risk factors for knee OA. OA is already visible on radiographs and MRI after 10 years. These high risk patients may benefit from adequate OA management early in life.
authors.affiliation: Department of Orthopedics, Leiden University Medical Center, P.O. Box 9600, 2300 RC, Leiden, The Netherlands. k.huetink@lumc.nl.
authors.forename: Kasper
authors.initials: K
authors.lastname: Huétink
authors.affiliation: Department of Radiology, Leiden University Medical Center, Albinusdreef 2, 2333 ZA Leiden, Roomnumber C2-S, Leiden, The Netherlands.
authors.forename: Berend C
authors.initials: BC
authors.lastname: Stoel
authors.affiliation: Department of Radiology, Leiden University Medical Center, Albinusdreef 2, 2333 ZA Leiden, Roomnumber C2-S, Leiden, The Netherlands.
authors.forename: Iain
authors.initials: I
authors.lastname: Watt
authors.affiliation: Department of Rheumatology, Leiden University Medical Center, Albinusdreef 2, 2333 ZA Leiden, Roomnumber C1-R, Leiden, The Netherlands.
authors.forename: Margreet
authors.initials: M
authors.lastname: Kloppenburg
authors.affiliation: Department of Radiology, Leiden University Medical Center, Albinusdreef 2, 2333 ZA Leiden, Roomnumber C2-S, Leiden, The Netherlands.
authors.forename: Johan L
authors.initials: JL
authors.lastname: Bloem
authors.affiliation: Department of Endocrinology, Leiden University Medical Center, Albinusdreef 2, 2333 ZA Leiden, Roomnumber C2-S, Leiden, The Netherlands.
authors.forename: Steve H
authors.initials: SH
authors.lastname: Malm
authors.affiliation: Department of Radiology, Leiden University Medical Center, Albinusdreef 2, 2333 ZA Leiden, Roomnumber C2-S, Leiden, The Netherlands.
authors.forename: Ronald
authors.initials: R
authors.lastname: Van't Klooster
authors.affiliation: Department of Orthopedics, Leiden University Medical Center, P.O. Box 9600, 2300 RC, Leiden, The Netherlands.
authors.forename: Rob G H H
authors.initials: RG
authors.lastname: Nelissen
mesh_terms: D000328:Adult; D000367:Age Factors; D016118:Anterior Cruciate Ligament / Q000000981:diagnostic imaging / Q000473:pathology; D005192:Family Health; D005260:Female; D006225:Hand / Q000000981:diagnostic imaging / Q000473:pathology; D006801:Humans; D007717:Knee / Q000000981:diagnostic imaging / Q000473:pathology; D007719:Knee Joint / Q000000981:diagnostic imaging / Q000473:pathology; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D020370:Osteoarthritis, Knee / Q000000981:diagnostic imaging* / Q000473:pathology* / Q000628:therapy*; D011446:Prospective Studies; D011859:Radiography; D012307:Risk Factors
keywords: Associated factors; Knee complaints; Knee osteoarthritis; Young population