Early Changes in Knee Osteoarthritis (ECKO)
Principal Investigator: Leena Sharma, MD, Northwestern University
Co-Investigator: C. Kent Kwoh, MD
Funding: NIAMS, NIH R01AR065473
A major barrier to development of disease-modifying therapy for knee osteoarthritis (OA) is the nature of disease progression, a downward spiral involving many tissues. The potential for changing disease course may be highest before this process is in motion. The literature documents cartilage, bone, and meniscal lesions by MRI in knees of some older individuals without radiographic OA, but does not reveal whether they represent early OA.
This study will advance knowledge of early events in knee OA development and identify an earlier disease onset window; enable future identification of risk factors for clinically important early lesions and prevention strategies that could be introduced earlier in the lifespan; and identify which lesions represent early disease and potential targets of disease-modifying intervention at a point when success may be more realizable.
The specific aims are to evaluate the association between each lesion—cartilage damage, bone marrow lesion, meniscal tear, meniscal extrusion—by MRI at baseline and risk of incident knee OA by radiographic and by MRI criteria; to evaluate the association between each lesion by MRI at baseline and risk of incident clinical features of knee OA; and to explore the association between each lesion by MRI at baseline and baseline-to-120-month physical function decline by performance and self-report measures of function.
The Osteoarthritis Initiative (OAI) is a longitudinal observational cohort study that enrolled 4800 participants with or at risk of developing knee osteoarthritis at four clinical centers (i.e., University of Pittsburgh, Ohio State University, University of Maryland, and Memorial Hospital in Rhode Island). The proposed study will focus on OAI participants that had no evidence of arthritis in either knee at study enrollment and will add a 120-month follow-up for these individuals.