Is the association between knee injury and knee osteoarthritis modified by the presence of general joint hypermobility?

Kristin Y. Shiue; Rebecca J. Cleveland; Todd A. Schwartz; Amanda E. Nelson; Virginia B. Kraus; Marian T. Hannan; Howard J. Hillstrom; Adam P. Goode; Portia P.E. Flowers; Jordan B. Renner; Joanne M. Jordan; Yvonne M. Golightly

Osteoarthritis and Cartilage Open (Jun 2020)

Is the association between knee injury and knee osteoarthritis modified by the presence of general joint hypermobility?

Kristin Y. Shiue,
Rebecca J. Cleveland,
Todd A. Schwartz,
Amanda E. Nelson,
Virginia B. Kraus,
Marian T. Hannan,
Howard J. Hillstrom,
Adam P. Goode,
Portia P.E. Flowers,
Jordan B. Renner,
Joanne M. Jordan,
Yvonne M. Golightly

Affiliations

Kristin Y. Shiue: Department of Epidemiology, University of North Carolina, Chapel Hill, NC, USA; Injury Prevention Research Center, University of North Carolina, Chapel Hill, NC, USA
Rebecca J. Cleveland: Thurston Arthritis Research Center, University of North Carolina, Chapel Hill, NC, USA
Todd A. Schwartz: Thurston Arthritis Research Center, University of North Carolina, Chapel Hill, NC, USA; Department of Biostatistics, University of North Carolina, Chapel Hill, NC, USA
Amanda E. Nelson: Thurston Arthritis Research Center, University of North Carolina, Chapel Hill, NC, USA; Department of Medicine, University of North Carolina, Chapel Hill, NC, USA
Virginia B. Kraus: Duke Molecular Physiology Institute and Department of Medicine, Duke University School of Medicine, Durham, NC, USA
Marian T. Hannan: Institute for Aging Research, Hebrew Senior Life, Boston, MA, USA; Harvard Medical School, Boston, MA, USA
Howard J. Hillstrom: Hospital for Special Surgery, New York, NY, USA
Adam P. Goode: Department of Orthopedic Surgery, Duke University School of Medicine, Durham, NC, USA; Duke Clinical Research Institute, Duke University, Durham, NC, USA; Duke Department of Population Health Sciences, Durham, NC, USA
Portia P.E. Flowers: Thurston Arthritis Research Center, University of North Carolina, Chapel Hill, NC, USA
Jordan B. Renner: Thurston Arthritis Research Center, University of North Carolina, Chapel Hill, NC, USA; Department of Radiology, University of North Carolina, Chapel Hill, NC, USA
Joanne M. Jordan: Department of Epidemiology, University of North Carolina, Chapel Hill, NC, USA; Thurston Arthritis Research Center, University of North Carolina, Chapel Hill, NC, USA; Department of Medicine, University of North Carolina, Chapel Hill, NC, USA; Department of Orthopedics, University of North Carolina, Chapel Hill, NC, USA
Yvonne M. Golightly: Department of Epidemiology, University of North Carolina, Chapel Hill, NC, USA; Injury Prevention Research Center, University of North Carolina, Chapel Hill, NC, USA; Thurston Arthritis Research Center, University of North Carolina, Chapel Hill, NC, USA; Division of Physical Therapy, University of North Carolina, Chapel Hill, NC, USA; Corresponding author. Thurston Arthritis Research Center, University of North Carolina, 3300 Thurston Building, Campus Box #7280, Chapel Hill, NC, 27599-7280, USA.

Journal volume & issue: Vol. 2, no. 2
p. 100045

Abstract

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Summary: Objective: To evaluate whether joint hypermobility modifies the association between knee joint injury and knee osteoarthritis (OA) among adults. Methods: Data were from three studies: Genetics of Generalized Osteoarthritis (GOGO; N = 2341), Genetics of Osteoarthritis (GO; N = 1872), and the population-based Johnston County Osteoarthritis Project (JoCoOA; N = 1937). Knee injury was defined as a self-report of prior fracture or severe injury to either knee. OA was defined using three variables: knee pain (pain, aching, or stiffness of the knee on most days), radiographic OA (rOA; Kellgren-Lawrence grade 2–4), and symptomatic OA (sxOA; knee rOA with knee pain). Joint hypermobility was defined as Beighton score ≥4. For each study, separate logistic regression models, stratified by joint hypermobility, were used to estimate the association of knee injury with knee pain, rOA, and sxOA, adjusting for age, sex, body mass index, and race (JoCoOA only); statistical interactions between injury and hypermobility were assessed (p-value<0.10). Results: In all three studies, knee injury was associated with OA variables of knee pain, rOA, and sxOA (adjusted odds ratios [aOR] range 1.83–3.75). The association of knee injury with rOA and sxOA was magnified among individuals with vs. without joint hypermobility in GOGO: rOA aOR 11.0, 95% confidence interval [CI] 4.0–30.1 vs. 2.7, 95% CI 2.0–3.6, p = 0.009; sxOA aOR 9.2, 95% CI 3.5–24.3 vs. 3.3, 95% CI 2.4–4.4, p = 0.032. Interactions were not statistically significant in GO or JoCoOA. Conclusions: In a general adult population, the presence of joint hypermobility may not modify the strong association between knee injury and OA.

Published in Osteoarthritis and Cartilage Open

ISSN: 2665-9131 (Online)
Publisher: Elsevier
Country of publisher: United Kingdom
LCC subjects: Medicine: Internal medicine: Specialties of internal medicine: Diseases of the musculoskeletal system
Website: https://www.journals.elsevier.com/osteoarthritis-and-cartilage-open/

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