The Early Osteoarthritic Knee

Classification Criteria For Early Knee Osteoarthritis: A Review Article

“…The arthroscopic evaluation, included in Luyten et al 2012’s criteria, was discarded in their 2018 review of the criteria. The arthroscopic evaluation remains the gold standard for assessing cartilage defects and their reparability, but it cannot determine the cause of the lesion, and is not generally useful in primary care because of its invasive nature 12 16 19 .…”

“…Experts agree that pain is the primary criteria for the classification of symptomatic EKOA [10,[15][16][17], despite pain and radiographic severity are not synonymous as there are subsets of OA patients with severe pain and mild radiographic changes, and those with mild or no pain despite severe radiographic changes [18,19]. Joint line tenderness and crepitus are clinical features easy to examine, in clinical practice as well as for research purposes, and they might be associated with the development of OA in the future, even in the absence of radiological findings of OA [15][16][17][18].Effusion has also been considered by some authors, based on a study of the OAI cohort showing the association of joint effusion at baseline with future cartilage volume loss, progression of radiographic OA, and risk of total knee replacement over 4 years [16][17][18].…”

“…The arthroscopic evaluation, included in Luyten et al 2012's criteria, was discarded in their 2018 review of the criteria. The arthroscopic evaluation remains the gold standard for assessing cartilage defects and their reparability, but it cannot determine the cause of the lesion, and is not generally useful in primary care because of its invasive nature [12,16,19]. In the light of the above analysis of the current criteria, further efforts on the classification of EKOA are still needed, and maybe it should be considered if the classification in this early stage is even possible, given its nature of pre-radiographic stage and the heterogeneity and intermittence of symptoms.…”

Catabolism of Fibromodulin in Developmental Rudiment and Pathologic Articular Cartilage Demonstrates Novel Roles for MMP-13 and ADAMTS-4 in C-terminal Processing of SLRPs

“…Historically, the degeneration of articular cartilage has been a major focus of studies on the etiopathogenesis of OA. However, with the appreciation of OA as a multifactorial global disorder and that degenerative changes in cartilage are affected by the synovium, subchondral bone, infra-patellar fat pad, meniscus, ligaments and tendons [40,41,42,43,44,45,46,47,48,49,50], there is now a greater appreciation of the contributions and feedback from and between all these joint tissues in the achievement of optimal knee functional properties [51,52,53,54]. A potential pathway exists whereby joint tissues may interact and contribute to the onset and progression of OA through the generation of a variety of damage-associated molecular pattern molecules (DAMPs) which act through multiple pathways [55].…”

Serum lipid biomarkers and inflammatory cytokines associated with onset and clinical status of patients with early knee osteoarthritis

“…Multifactorial causes of OA, and the combination of mechanical and metabolic variables, determine that the structural findings of the disease are a late phenomenon ( 17 , 18 ) This process has a negative impact on patients, since non-surgical interventions normally have limited efficacy, since they are applied at an advanced stage of the pathology with severe joint and functional involvement ( 19 , 20 ) In addition, the lack of control over the triggering factors translates into inaccurate forecasts, loss of functional independence and high costs for health services ( 21 ). It is for this reason that research has begun to focus on the concept of “early osteoarthritis” (EOA), with the aim of providing the patient a treatment in the early stages of the disease, which can prevent progression and structural changes in the joint, associated with later stages of OA ( 22 , 23 ).…”