Researchers at the University of Arizona Health Sciences are hoping to determine if changes in knee structure can predict clinical outcomes and treatments in people with osteoarthritis in a new study funded by a $2.1 million grant from the National Institutes of Health (NIH).

According to the Centers for Disease Control and Prevention, more than 32 million people in the U.S. have osteoarthritis, with the knee being one of the most commonly affected areas. No treatments are available to prevent the disease or halt its progression, due in part to challenges in identifying knees at highest risk for structural progression, such as loss of joint space width. 

C. Kent Kwoh, MD, is the director of the UArizona Arthritis Center and chief of the Division of Rheumatology in the UArizona College of Medicine – Tucson. He will lead the three-year study, “Healthy knee aging vs. osteoarthritis in three large diverse cohorts: What is the clinical relevance of structural changes seen on radiographs?” with funding from the National Institute of Arthritis and Musculoskeletal and Skin Diseases, a division of the NIH.

Researchers hope to establish healthy ranges of knee structure in men and women between the ages of 45 and 90. They will evaluate if changes in knee structure can predict pain, functional limitations and the need for future knee replacements.

To do so, Dr. Kwoh and his team will examine 76,000 X-rays and clinical data from 10,500 participants in three of the largest and most diverse studies of osteoarthritis in the world: the Johnston County Osteoarthritis Project, the Multicenter Osteoarthritis study and the Osteoarthritis Initiative.

“The distinction between normal age-related decline in knee function and joint space width loss typical of progressive knee osteoarthritis is not known and represents an important knowledge gap,” said Dr. Kwoh, who also is affiliated with the UArizona Health Sciences Comprehensive Pain and Addiction Center. “The study will examine the clinical relevance of changes in joint space width in terms of pain and function and perform an evaluation of risk factors.”

The findings could eventually lead to new treatments for osteoarthritis. Knee structure assessment is a critical component in the evaluation of potential treatments for osteoarthritis, including pharmacologic approaches regulated by the FDA and nonpharmacologic approaches.

Dr. Kwoh will lead a multidisciplinary research team that includes Edward J. Bedrick, PhD, a professor of biostatistics in the UArizona Mel and Enid Zuckerman College of Public Health and a member of the BIO5 Institute, Zong-Ming Li, PhD, associate director of the UArizona Arthritis Center, a professor of orthopaedic surgery and member of the BIO5 Institute, and Xiaoxiao Sun, PhD, an assistant professor of biostatistics in the Zuckerman College of Public Health and BIO5 Institute member, as well as collaborators with expertise in medical imaging, rheumatology and epidemiology at Harvard Medical School, the University of North Carolina and Boston University.

This research is supported by the National Institute of Arthritis and Musculoskeletal and Skin Diseases, a division of the National Institutes of Health (1R01AR078187-01).