Knee Pain and a Prior Injury Are Associated with Increased Risk of a New Knee Injury: Data from the Osteoarthritis Initiative

Abstract

Objectives We explored if knee pain or a history of knee injury was associated with a knee injury in the following 12 months. Methods We conducted longitudinal knee-based analyses among knees in the Osteoarthritis Initiative. We included both knees of all participants who had at least one follow-up visit with complete data. Our first sets of exposures were knee pain (chronic knee symptoms and severity) at baseline, 12-month, 24-month, and 36-month visits. Another exposure was a history of injury, which we defined as a self-reported injury at any time prior to baseline, 12-month, 24-month, or 36-month visits. The outcome was self-reported knee injury during the past year at 12-month, 24-month, 36-month, and 48-month visits. We evaluated the association between ipsilateral and contralateral knee pain or history of injury and a new knee injury within 12 months of the exposure using generalized linear mixed model for repeated binary outcomes. Results A knee with reported chronic knee symptoms or ipsilateral or contralateral history of an injury was more likely to experience a new knee injury in the following 12 months than a knee without chronic knee symptoms (odds ratio [OR]=1.84, 95% confidence interval [CI]=1.57, 2.16) or prior injury (prior ipsilateral knee injury OR=1.81, 95% CI=1.56, 2.09; prior contralateral knee injury OR=1.43, 95% CI=1.23, 1.66). Conclusion Knee pain and a history of injury are associated with new knee injuries. It may be beneficial for individuals with knee pain or a history of injury to participate in injury prevention programs.

Knee symptoms among adults at risk for accelerated knee osteoarthritis: data from the Osteoarthritis Initiative

“…These two findings may indicate that the onset of frequent knee pain developed within a few weeks or months prior to the index visit. The presence of frequent knee pain and more severe knee symptoms are concerning because these clinical findings are associated with faster cartilage loss and radiographic progression [13,14,6] and may predispose them to a new knee injury, which is a risk factor for accelerated KOA [15]. Hence, clinicians should be concerned about adults over 45 years of age without radiographic KOA who report frequent symptoms or severe knee symptoms with both high and low demanding activities because it may be an early sign of individuals at risk for incident accelerated KOA or with early-stage accelerated KOA.…”

“…Early recognition of these frequent or severe symptoms may enable clinicians to implement early interventions before the joint develops advance-stage disease, which may be more challenging to treat nonoperatively. Referring a patient for physical rehabilitation to actively address functional limitations and symptoms will improve the patient’s symptoms, quality of life, and function as well as reduce the risk of knee injury, which may be a catalyst for accelerated KOA [15]. …”

A single recent injury is a potent risk factor for the development of accelerated knee osteoarthritis: data from the osteoarthritis initiative

“…It remains unclear which injuries may trigger the incidence of AKOA (e.g., which structures are injured, how severe was the injury, how the injury was treated). Furthermore, future studies are needed to rule out the possibility that the sudden onset of AKOA, which is associated with pain and dysfunction [6], may cause a person to experience a new injury [8]. This also raises the concern that there may be a vicious cycle in which an injury triggers the onset of AKOA, which predisposes the person to a new injury, and another wave of accelerated progression.…”

“…The incidence of AKOA is characterized by a knee that progresses from normal appearance to advance-stage disease within four years and often in less than 12 months [3,2,4–6,1,7]. We previously found that risk factors such as greater age, greater body mass index (BMI), and prior injury are associated with the development of AKOA [8,3,1] using the data from the first four years of the OAI compared to adults with a gradual onset of KOA or no KOA. In recent years, the OAI has released clinical data and radiographic readings from the 48-, 72- and 96-months visits.…”

Worker compensation status increases the risk for presence of pain in the contralateral knee at final follow-up after arthroscopic knee surgery

“…Driban et al evaluated the association between ipsilateral and contralateral knee pain and the risk of a sustaining a new knee injury. Subjects who reported chronic knee symptoms in the contralateral knee were almost two times more likely to experience a new knee injury within the 12 months after surgery 12. Riddle and Stratford found that patients who have pain in both knees have lower self-reported pain and functional scores than those with unilateral knee pain 13.…”