Do Knee-Straining Activities Influence the Subchondral Bone Microarchitecture and Accelerate Knee Osteoarthritis Progression?

BACKGROUND

Knee overload was detrimental to knee osteoarthritis subjects. We aim to analyze the association between the subchondral bone microarchitecture sclerosis and typical knee-straining activities.

METHODS

The frequency of experiencing squatting, kneeling, lifting, and climbing of 481 knee osteoarthritis subjects was investigated. Subchondral bone microarchitecture (bone volume fraction, trabecular thickness, trabecular separation, and trabecular number) was measured by the fast imaging with steady-state free precession magnetic resonance imaging applying trabecular sequencing, at baseline and 12-mo follow-up. Logistic regression was conducted to investigate the relationship between microarchitecture change and each knee-straining activity, adjusted by age, sex, weight, and Kellgren-Lawrence grade. All data were from the Osteoarthritis Initiative.

RESULTS

Long kneeling was associated with increased bone volume fraction (adjusted odds ratio = 1.16, confidence interval = 1.01-1.33) and trabecular number (adjusted odds ratio = 1.16, confidence interval = 1.02-1.33). Long squatting was associated with a lower risk of increased trabecular separation (adjusted odds ratio = 0.84, confidence interval = 0.71-0.98) and a higher risk of increased trabecular thickness (adjusted odds ratio = 1.29, confidence interval = 1.06-1.55). Long squatting also increased the medial compartment joint width narrowing (-0.21 in squatting group vs -0.03 in no squatting group, P < 0.05).

CONCLUSIONS

Knee osteoarthritis patients should avoid long squatting and kneeling, and subchondral bone microarchitecture possesses excellent potential as a monitoring indicator in subjects who kneel or squat for long.