Kristin Y Shiue1,2, Rebecca J Cleveland3, Todd A Schwartz3,4, Amanda E Nelson3,5, Virginia B Kraus6, Marian T Hannan7,8, Howard J Hillstrom9, Adam P Goode10,11,12, Portia P E Flowers3, Jordan B Renner3,13, Joanne M Jordan1,3,5,14, Yvonne M Golightly1,2,3,15. 1. Department of Epidemiology, University of North Carolina, Chapel Hill, NC, USA. 2. Injury Prevention Research Center, University of North Carolina, Chapel Hill, NC, USA. 3. Thurston Arthritis Research Center, University of North Carolina, Chapel Hill, NC, USA. 4. Department of Biostatistics, University of North Carolina, Chapel Hill, NC, USA. 5. Department of Medicine, University of North Carolina, Chapel Hill, NC, USA. 6. Duke Molecular Physiology Institute and Department of Medicine, Duke University School of Medicine, Durham, North Carolina, USA. 7. Institute for Aging Research, Hebrew Senior Life, Boston, MA, USA. 8. Harvard Medical School, Boston, MA, USA. 9. Hospital for Special Surgery, New York, New York, USA. 10. Department of Orthopedic Surgery, Duke University School of Medicine, Durham, NC USA. 11. Duke Clinical Research Institute, Duke University, Durham, NC USA. 12. Duke Department of Population Health Sciences, Durham, NC USA. 13. Department of Radiology, University of North Carolina, Chapel Hill, NC, USA. 14. Department of Orthopedics, University of North Carolina, Chapel Hill, NC, USA. 15. Division of Physical Therapy, University of North Carolina, Chapel Hill, NC, USA.
Abstract
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=2,341), Genetics of Osteoarthritis (GO; N=1,872), and the population-based Johnston County Osteoarthritis Project (JoCoOA; N=1,937). 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.
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=2,341), Genetics of Osteoarthritis (GO; N=1,872), and the population-based Johnston County Osteoarthritis Project (JoCoOA; N=1,937). 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.
Authors: Jennifer M Hootman; Charles G Helmick; Kamil E Barbour; Kristina A Theis; Michael A Boring Journal: Arthritis Rheumatol Date: 2016-07 Impact factor: 10.995
Authors: V B Kraus; Y-J Li; E R Martin; J M Jordan; J B Renner; M Doherty; A G Wilson; R Moskowitz; M Hochberg; R Loeser; M Hooper; Scott Sundseth Journal: Arthritis Rheum Date: 2004-07
Authors: Portia P E Flowers; Rebecca J Cleveland; Todd A Schwartz; Amanda E Nelson; Virginia B Kraus; Howard J Hillstrom; Adam P Goode; Marian T Hannan; Jordan B Renner; Joanne M Jordan; Yvonne M Golightly Journal: Arthritis Res Ther Date: 2018-04-18 Impact factor: 5.156