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 Among thousands of people with no knee pain who were followed for
three years, one quarter had noisy knees yet they made up three
quarters of the cases of symptomatic knee arthritis that emerged by
the end of the study period, researchers found.
“Many people who have signs of osteoarthritis on X-rays do not
necessarily complain about pain. Presently, there are no known
strategies for preventing the development of pain in this group,”
said lead study author Grace Lo of Baylor College of Medicine in
Houston, Texas.
Especially when people have joint space loss or other
arthritis-related changes visible on X-rays, their also having noisy
knees can be considered a sign of higher risk for developing pain
within the next year, she said.
Osteoarthritis is the most common form of arthritis, affecting more
than 30 million adults in the United States, Lo and colleagues write
in Arthritis Care and Research. Symptomatic knee osteoarthritis,
which means X-ray evidence of arthritis plus pain or stiffness,
affects about 16 percent of adults older than 60, they note.
Lo and colleagues analyzed data from 3,495 participants ranging in
age from about 50 to 70 in a long-term study conducted in hospitals
in Rhode Island, Ohio, Pennsylvania and Maryland. None had
symptomatic knee arthritis at the start.
The researchers looked at how often people experienced knee pain,
stiffness and “crepitus,” or noises and scraping feelings in their
knees.
During clinic visits, people were asked questions like, “Do you feel
grinding, hear clicking or any other type of noise when your right
knee moves?” and “During the past 12 months, have you had pain,
aching or stiffness in or around your right knee on most days for at
least one month?” The patients were evaluated at the beginning of
the study and again at 12, 24 and 36 months. X-rays were also taken
once a year.
At the start, 65 percent of participants said they had no crepitus,
11 percent experienced it “rarely,” 15 percent had it “sometimes”
and 9 percent had it “often” or “always.”
Overall, 635 participants, 18 percent, developed symptomatic
arthritis of the knee during the study period.
Even after adjusting for weight and other factors, researchers found
that odds of developing symptomatic arthritis rose along with the
frequency of crepitus. Those who reported it “rarely” had 50 percent
higher risk than those who never had it, and those with crepitus
“sometimes” or “often” had about double the odds.
People with crepitus “always” were three times more likely to
develop arthritis over four years than those who never had it.
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Older age and having crepitus also increased the likelihood of
developing arthritis, and men with crepitus were more likely than
women with noisy knees to go on to develop arthritis.
“Differences across genders is interesting and unexplained. This may
tell us about differences in symptom reporting or the biology of
osteoarthritis,” said Daniel Solomon, the chair of arthritis and
population health at Harvard Medical School in Boston.
“Knowing how to predict who will develop symptomatic osteoarthritis
may give patients and providers clues to who should receive earlier
treatment or even prevention,” Solomon, who wasn’t involved in the
study, told Reuters Health by email.
“It would be helpful to look at the MRIs of the people who had X-ray
evidence, no pain and always had crepitus to understand what is
happening in their knees,” Lo said. “This could help identify ways
to decrease the risk for developing knee pain.”
Since MRI scans are more sensitive than X-rays, Lo added,
researchers for future studies may be able to see osteophyte
formations or other symptoms around the knee that they can’t usually
see.
“Not all noises coming from a knee are a bad sign,” she said. “It
might be helpful to ask your doctor for an X-ray to see if you have
evidence of osteoarthritis and then take precautions from there.”
SOURCE: http://bit.ly/2pBKkUE Arthritis Care and Research, online
May 4, 2017.
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