Open AccessDenuded subchondral bone and knee pain in persons with knee osteoarthritis
Author(s) -
Moisio Kirsten,
Eckstein Felix,
Chmiel Joan S.,
Guermazi Ali,
Prasad Pottumarthi,
Almagor Orit,
Song Jing,
Dunlop Dorothy,
Hudelmaier Martin,
Kothari Ami,
Sharma Leena
Publication year - 2009
Publication title -
arthritis & rheumatism
Language(s) - English
Resource type - Journals
eISSN - 1529-0131
pISSN - 0004-3591
DOI - 10.1002/art.25014
Subject(s) - medicine , knee pain , osteoarthritis , patella , magnetic resonance imaging , confidence interval , odds ratio , cartilage , knee joint , visual analogue scale , surgery , anatomy , radiology , pathology , alternative medicine
Objective It is unclear how articular cartilage loss contributes to pain in patients with knee osteoarthritis (OA). Full‐thickness cartilage defects expose the subchondral bone plate. The relationship between denuded bone and pain has not been examined. The aim of this study was to investigate whether the percent of denuded bone is associated with moderate‐to‐severe knee pain or frequent knee pain and longitudinally with frequent knee pain 2 years after the baseline evaluation. Methods We studied 182 persons with knee OA (305 knees). Applying specialized magnetic resonance imaging techniques, manual segmentation was used to compute cartilage‐covered and denuded bone areas for each surface. Moderate‐to‐severe knee pain was defined as a score of ≥40 mm on a knee‐specific 100‐mm visual analog scale, and frequent knee pain was defined as pain on most days during the past month. Logistic regression and generalized estimating equations were used in analyses, adjusting for age, sex, body mass index, and bone marrow lesions. Results Cross‐sectional analyses revealed that moderate‐to‐severe knee pain was associated with percent denuded bone in the medial compartment (adjusted odds ratio [OR] 3.90, 95% confidence interval [95% CI] 1.33–11.47), in the medial and patellar surfaces together, and in the lateral and patellar surfaces. Frequent knee pain was associated with percent denuded bone in the patellar surface (adjusted OR 3.11, 95% CI 1.24–7.81), in the medial and patellar surfaces, and in the lateral and patellar surfaces. Longitudinal analyses (in 168 knees without frequent knee pain at baseline) revealed that percent denuded bone in the medial and patellar surfaces was associated with frequent incident knee pain (adjusted OR 4.19, 95% CI 1.56–11.22). Conclusion These results support a relationship between subchondral bone plate exposure and prevalent and incident knee pain in patients with knee OA.