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Contralateral advanced radiographic knee osteoarthritis predicts radiographic progression and future arthroplasty in ipsilateral knee with early-stage osteoarthritis

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Abstract

Purpose

To explore whether the severity of contralateral knee osteoarthritis (OA) is associated with OA progression in ipsilateral knee with early OA.

Methods

Knees in early OA (Kellgren-Lawrence grade (KLG):1–2) with intact baseline demographic and clinical data were retrieved from OAI database and defined as target knees. The target knees were divided into the exposure group (contralateral knees KLG 3 to 4) and the control group (contralateral knees KLG 0 to 2). Both groups underwent propensity score matching (PSM) concerning demographic data, as well as radiographic and clinical outcomes at the baseline. The primary outcome was the upgrade of KLG in the target knee in the first 12 and 24 months. The secondary outcome was the incidence of knee arthroplasty in ipsilateral knee during the first 108 months.

Results

One thousand seven hundred fifty-two knees were included, with 449 in the exposure cohort and 1276 in the control cohort. Four hundred thirty-four knees in each group were matched after PSM. Target knees in the exposure cohort showed a significantly higher rate of radiographic progression in the first 12 months (12.9% vs. 5.1%, P < 0.001) and 24 months (19.6% vs. 8.1%, P < 0.001). As for the risk of future arthroplasty, a significant difference was also found between the two groups (7.8% vs. 4.0%, P = 0.02). Kaplan–Meier analysis showed that the 108-month accumulated knee survival rate was significantly lower in the exposure group (P = 0.01).

Conclusion

The ipsilateral knee with early-stage OA is prone to have worse early to mid-, and long-term prognosis in the circumstance of contralateral radiographic advanced knee OA.

Key Points

•Identifying early knee osteoarthritis (OA) with a high risk of radiographic progression and future arthroplasty enables early personalized intervention.

•This is a novel study to investigate the relationship between the risk of future arthroplasty and contralateral knee status.

•Propensity score matching holds promise to minimize selection bias in observational studies.

•Knees with early OA are prone to have a high risk of radiographic progression and future arthroplasty in the circumstance of contralateral advanced knee OA.

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Acknowledgements

The OAI is a public-private partnership comprised of five contracts (N01-AR-2-2258; N01-AR-2-2259; N01-AR-2-2260; N01-AR-2-2261; N01-AR-2-2262) funded by the National Institutes of Health, a branch of the Department of Health and Human Services, and conducted by the OAI Study Investigators. Private funding partners include Merck Research Laboratories; Novartis Pharmaceuticals Corporation, GlaxoSmithKline; and Pfizer, Inc. Private sector funding for the OAI is managed by the Foundation for the National Institutes of Health. This manuscript was prepared using an OAI public use data set and does not necessarily reflect the opinions or views of the OAI investigators, the NIH or the private funding partners.

Funding

This work was supported by the Guangdong Basic and Applied Basic Research Foundation (2022A1515011103), (2020A1515110511) and (2021A1515110458), NSFC Incubation Program of GDPH (KY012021163), and Science and Technology Program of Guangzhou (202102020050) and (202102020427) and the Program of Administration of Traditional Chinese Medicine of Guangdong Province (20212033).

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Author notes

  1. Rongjie Wu, Guangtao Fu and Mengyuan Li contributed equally to this work.

Authors and Affiliations

  1. Department of Orthopedics, Guangdong Province, Guangdong Provincial People’s Hospital, Guangdong Academy of Medical Sciences, Guangzhou, People’s Republic of China

    Rongjie Wu, Guangtao Fu, Mengyuan Li, Yuanchen Ma, Qingtian Li, Zhantao Deng & Qiujian Zheng

  2. Guangdong Province, Shantou University Medical College, Shantou, People’s Republic of China

    Rongjie Wu

  3. The Second School of Clinical Medicine, Guangdong Province, Southern Medical University, Guangzhou, People’s Republic of China

    Qiujian Zheng

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  1. Rongjie Wu
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Correspondence to Qiujian Zheng.

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Wu, R., Fu, G., Li, M. et al. Contralateral advanced radiographic knee osteoarthritis predicts radiographic progression and future arthroplasty in ipsilateral knee with early-stage osteoarthritis. Clin Rheumatol 41, 3151–3157 (2022). https://doi.org/10.1007/s10067-022-06235-7

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  • DOI: https://doi.org/10.1007/s10067-022-06235-7

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