Knee Osteoarthritis
Osteoarthritis (OA) is a common musculoskeletal disorder which affects joints – typically the knees, hips, hands, feet, or spine. Healthy joints have a layer of hard tissue called cartilage over the ends of the bones which permits the joint surfaces to glide across each other smoothly. In osteoarthritis, this cartilage thins and the bone underneath becomes thicker, changes shape and sometimes begins to grow outwards, forming bony spurs; these changes are unfortunately associated with pain and poor joint function. These changes were examined in Hertfordshire using x-rays of the knees and hips; in addition, cohort members’ hands were examined for swellings typical of osteoarthritis.
Our research has shown that people with osteoarthritis at the hip and knee are more likely to walk and rise from a chair more slowly and are more likely to have difficulties with balancing (1).
We have also explored the different ways in which osteoarthritis is identified in clinical practice. It can be diagnosed by a healthcare professional using a combination of symptoms and clinical signs on examination. Diagnosis is also made on the basis of characteristic appearances of the joint which are seen on an x-ray. However, the overlap and agreement between the different ways of diagnosing osteoarthritis is poorly understood. Our Hertfordshire research has shown that there is modest agreement between knee osteoarthritis diagnosed using an x-ray, and knee osteoarthritis diagnosed by a healthcare professional by examination (2). This is relevant to clinical practice because it will help healthcare professionals to better understand the relationship between the clinical findings that they identify on examination of a patient and the images they see on x-ray.
Although osteoarthritis affects approximately 10% of the world’s population aged 60 years and older, its risk factors are not fully understood. Our research has found that influences acting before birth and in infancy affect risk of osteoarthritis in later life. People who were born small were more likely to have bony spurs in their hip joint in later life than people who were bigger at birth, and people who were small at one year were more likely to have bony spurs in their hip or knee, and also more likely to have symptoms of osteoarthritis in their hand (3). This research shows that there are risk factors for osteoarthritis which act across the lifecourse.
Reference List
Bevilacqua G, Laskou F, Patel HP, Westbury LD, Fuggle NR, Cooper C, Dennison EM. What impact does osteoarthritis have on ability to self-care and receipt of care in older adults? Findings from the Hertfordshire Cohort Study. Osteoarthr Cartil Open. 2022 Sep 9;4(4):100310. doi: 10.1016/j.ocarto.2022.100310. PMID: 36474798; PMCID: PMC9718070.
Clynes MA, Parsons C, Edwards MH, Tobias JH, Deere K, Cooper C, Dennison EM. A diagnosis of knee osteoarthritis does not predict physical activity 2 years later in older adults: findings from the Hertfordshire Cohort Study. Rheumatol Int. 2019 Aug;39(8):1405-1411. doi: 10.1007/s00296-019-04309-5. Epub 2019 Apr 29. PMID: 31037363.
Clynes MA, Jameson KA, Edwards MH, Cooper C, Dennison EM. Impact of osteoarthritis on activities of daily living: does joint site matter? Aging Clin Exp Res. 2019 Aug;31(8):1049-1056. doi: 10.1007/s40520-019-01163-0. Epub 2019 Mar 21. PMID: 30903599; PMCID: PMC6661019.
Timmermans EJ, de Koning EJ, van Schoor NM, van der Pas S, Denkinger MD, Dennison EM, Maggi S, Pedersen NL, Otero Á, Peter R, Cooper C, Siviero P, Castell MV, Herbolsheimer F, Edwards M, Limongi F, Deeg DJH, Schaap LA. Within-person pain variability and physical activity in older adults with osteoarthritis from six European countries. BMC Musculoskelet Disord. 2019 Jan 5;20(1):12. doi: 10.1186/s12891-018-2392-0. PMID: 30611248; PMCID: PMC6320627.
Parsons C, Fuggle NR, Edwards MH, Goulston L, Litwic AE, Jagannath D, van der Pas S, Cooper C, Dennison EM; EPOSA Research Group. Concordance between clinical and radiographic evaluations of knee osteoarthritis. Aging Clin Exp Res. 2018 Jan;30(1):17-25. doi: 10.1007/s40520-017-0847-z. Epub 2017 Nov 3. PMID: 29101670; PMCID: PMC5785611.
Timmermans EJ, van der Pas S, Schaap LA, Cooper C, Edwards MH, Gale CR, Deeg DJ, Dennison EM. Associations between perceived neighbourhood problems and quality of life in older adults with and without osteoarthritis: Results from the Hertfordshire Cohort Study. Health Place. 2017 Jan;43:144-150. doi: 10.1016/j.healthplace.2016.11.013. Epub 2017 Jan 3. PMID: 28061391; PMCID: PMC5289497.
Timmermans EJ, van der Pas S, Cooper C, Schaap LA, Edwards MH, Deeg DJ, Gale CR, Dennison EM. The neighbourhood environment and use of neighbourhood resources in older adults with and without lower limb osteoarthritis: results from the Hertfordshire Cohort Study. Clin Rheumatol. 2016 Nov;35(11):2797-2805. doi: 10.1007/s10067-016-3388-5. Epub 2016 Aug 27. PMID: 27567628; PMCID: PMC5063902.
Parsons C, Clynes M, Syddall H, Jagannath D, Litwic A, van der Pas S, Cooper C, Dennison EM, Edwards MH; EPOSA research group. How well do radiographic, clinical and self-reported diagnoses of knee osteoarthritis agree? Findings from the Hertfordshire cohort study. Springerplus. 2015 Apr 15;4:177. doi: 10.1186/s40064-015-0949-z. PMID: 25932366; PMCID: PMC4408304.
Clynes MA, Parsons C, Edwards MH, Jameson KA, Harvey NC, Sayer AA, Cooper C, Dennison EM. Further evidence of the developmental origins of osteoarthritis: results from the Hertfordshire Cohort Study. J Dev Orig Health Dis. 2014 Dec;5(6):453-8. doi: 10.1017/S2040174414000373. Epub 2014 Aug 26. PMID: 25154411; PMCID: PMC4521289.
Muraki S, Dennison E, Jameson K, Boucher BJ, Akune T, Yoshimura N, Judge A, Arden NK, Javaid K, Cooper C. Association of vitamin D status with knee pain and radiographic knee osteoarthritis. Osteoarthritis Cartilage. 2011 Nov;19(11):1301-6. doi: 10.1016/j.joca.2011.07.017. Epub 2011 Aug 16. PMID: 21884812.