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. 2020 Jan 31;21(1):60.
doi: 10.1186/s12891-020-3073-3.

The incidence and characteristics of accelerated knee osteoarthritis among women: the Chingford cohort

Jeffrey B Driban  1 , Raveendhara R Bannuru  2 , Charles B Eaton  3 , Tim D Spector  4 , Deborah J Hart  4 , Timothy E McAlindon  2 , Bing Lu  5 , Grace H Lo  6   7 , Nigel K Arden  8
Affiliations

The incidence and characteristics of accelerated knee osteoarthritis among women: the Chingford cohort

Jeffrey B Driban et al. BMC Musculoskelet Disord. .

Abstract

Background: Prior research on accelerated knee osteoarthritis (AKOA) was primarily confined to the Osteoarthritis Initiative, which was enriched with people with risk factors for knee osteoarthritis (KOA). It is unclear how often AKOA develops in a community-based cohort and whether we can replicate prior findings from the Osteoarthritis Initiative in another cohort. Hence, we determined the incidence and characteristics of AKOA among women in the Chingford Study, which is a prospective community-based cohort.

Methods: The Chingford Study had 1003 women with quinquennial knee radiographs over 15 years. We divided the 15-year observation period into three consecutive 5-year phases. Within each 5-year phase, we selected 3 groups of participants among women who started a phase without KOA (Kellgren-Lawrence [KL] < 2): 1) incident AKOA developed KL grade ≥ 3, 2) typical KOA increased radiographic scoring (excluding AKOA), and 3) no KOA had the same KL grade over time. Study staff recorded each participant's age, body mass index (BMI), and blood pressure at baseline, 5-year, and 10-year study visits. We used multinomial logistic regression models to test the association between groups (outcome) and age, BMI, and blood pressure at the start of each phase. The cumulative incidences and odds ratios (OR) from each phase were pooled using a fixed-effect meta-analysis model.

Results: The person-based cumulative incidence of AKOA was 3.9% over 5 years (pooled estimate across the three 5-year phases). Among incident cases of KOA, AKOA represented ~ 15% of women with incident KOA. Women with AKOA were older than those with typical (OR = 1.56, 95%CI = 1.16-2.11) or no KOA (OR = 1.84, 95%CI = 1.40-2.43). Women with AKOA had a greater BMI than those without KOA (OR = 1.52, 95%CI = 1.17-1.97). We observed no association between group and blood pressure.

Conclusions: In a community-based cohort, > 1 in 7 women with incident KOA had AKOA. Like the Osteoarthritis Initiative, people with AKOA were more likely to have greater age and BMI.

Keywords: Epidemiology; Phenotype; Total knee replacement.

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Conflict of interest statement

Jeffrey B. Driban is a member of the Editorial Board of BMC Musculoskeletal Disorders. Charles B. Eaton and Jeffrey B. Driban reported grants with money paid to their institutions from the National Institutes of Health. Jeffrey B. Driban also reported payment for lectures from Pfizer, Inc. and consultancy from Pfizer/Lily. Nigel Arden reported payment for consultancy from Merck, Pfizer/Lily, Flexion, and Regeneron and payment to his institution from Merck.

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References

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