Knee Popping and Cracking May Signal Future OA

Subjective crepitus, or grating, cracking, or popping sounds in and around a joint, often predicts incident symptomatic osteoarthritis (OA) in those who currently do not have OA, according to a recent study.

For their study, the researchers evaluated 3495 participants in the Osteoarthritis Initiative (OAI) cohort without baseline symptomatic OA. Mean patient age was 61.1 years, and 42.2% of participants were men.
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A question from the Knee Injury and Osteoarthritis Outcome Score was used to determine crepitus frequency at baseline and at 12, 24, and 36 months, and frequent knee pain and radiographs were evaluated at baseline and at annual visits up to 48 months.

The researchers defined radiographic OA as a tibiofemoral Kellgren/Lawrence grade of at least 2, and symptomatic OA as a knee with frequent symptoms and radiographic OA. A repeated-measures analysis was performed, and results were adjusted for various factors.

Results of the study showed that patients with greater frequency of crepitus had a higher risk for incident symptomatic OA, with adjusted odds ratios of 1.5 (rarely), 1.8 (sometimes), 2.2 (often), and 3.0 (always). The researchers noted that 26% of the observations and more than 75% of incident symptomatic OA cases were contributed by the group with radiographic OA at OAI baseline.

“In those without symptomatic OA, subjective knee crepitus predicts incident symptomatic OA longitudinally, with most cases occurring in those with preexisting tibiofemoral radiographic OA but without frequent knee pain,” the researchers concluded. “However, an important limitation is that patellofemoral OA was not systematically evaluated within the OAI. Subjective crepitus offers utility for the identification of at-risk individuals, predictive modeling, and future research.

—Christina Vogt

Reference:

Lo GH, Strayhorn MT, Driban JB, Price LL, Eaton CB, Mcalindon TE. Subjective crepitus as a risk factor for incident symptomatic knee osteoarthritis: data from the osteoarthritis initiative. Arthritis Care Res. 2018;70(1):53-60. doi:10.1002/acr.23246.