Objective To enable interventions aimed at preventing onset of frequent knee osteoarthritis (OA) symptoms and their sequelae, effective screening methods are required. Conventional radiographs are accessible and inexpensive; consequently, they have the potential to identify those at high risk of developing symptoms. Thus, we aimed to determine whether radiographic severity is prognostic of frequent symptoms at 12-and 48-month follow-up visits. Methods We studied knees from participants of the Osteoarthritis Initiative without frequent symptoms at the baseline visit. Posteroanterior semi-flexed knee radiographs were obtained at the baseline visit and scored for Kellgren-Lawrence (KL) grade (0-4). Frequent knee symptoms were defined by self-report at baseline, month 12, and month 48 follow-up visits. We used knee-based logistic regression, using generalized estimating equations to account for correlation between knees within person, to assess if baseline KL grade was associated with incident frequent symptoms (at 12 and 48 months). Results The study included 5,653 knees (3,407 participants). The incidence of frequent symptoms at 12 months by baseline KL grades were: 12.4% (KL0), 15.6% (KL1), 18.6% (KL2), 24.7% (KL3), and 37.2% (KL4). Relative to KL0, the odds (and 95% confidence interval) of frequent knee symptoms at 12 months were elevated for KL1 (OR=1.30, (1.05–1.61)), KL2 (OR=1.61, (1.32–1.96)), KL3 (OR=2.31, (1.82–2.92)), and KL4 (OR=4.18, (2.69–6.48)). 48-month results were similar. Conclusion s: Radiographic OA severity should be considered a potential prognostic biomarker to identify individuals at high risk of developing knee symptoms.
Lo et al. (Fri,) studied this question.