Jeffrey B. Driban, PhD, on Knee OA Incidence
In a new study1, Jeffrey B. Driban, PhD, ATC, CSCS, an assistant professor in the division of rheumatology at Tufts University School of Medicine, and colleagues sought to determine if infrapatellar fat pad (IFP) signal intensity alteration and greater effusion-synovitis volume can differentiate adults who develop accelerated knee osteoarthritis from those who develop a gradual onset of disease or no disease at all.
Results showed that beginning 2 years before disease onset, individuals who developed accelerated knee osteoarthritis had greater effusion-synovitis volume and increased likelihood of having IFP signal intensity alteration than those with no knee osteoarthritis.
Rheumatology Consultant caught up with Dr Driban about the research.
Rheumatology Consultant: What prompted you to conduct this study?
Jeffrey Driban: Clinicians and researchers have known for years that people with osteoarthritis progress at different rates. However, it was unclear if individuals who quickly develop osteoarthritis were simply progressing faster than everyone else or if there was something unique about them. If unique traits could be identified in those individuals, then it could influence how we test new therapies and highlight the need for better screening.
RHEUM CON: Were you surprised by the study findings?
JD: We were most surprised to see differences between adults with accelerated knee osteoarthritis as early as 2 years before someone developed evidence of accelerated knee osteoarthritis on x-ray. We were also surprised by how much effusion and synovitis these individuals had compared with those with typical or no knee osteoarthritis.
RHEUM CON: How do you think a rheumatologist can approach an individual with IFP signal intensity alteration and/or greater effusion-synovitis volume?
JD: The evidence of local inflammation may indicate that accelerated knee osteoarthritis is different from the typical gradual onset. Clinicians should be aware that adults with greater effusion-synovitis or IFP signal intensity alteration in the absence of knee osteoarthritis on x-rays may be at high-risk for accelerated knee osteoarthritis. Clinicians should consider scheduling these patients to be reassessed more frequently. It may also be advantageous to send them to physical rehabilitation.
RHEUM CON: What are the next steps of your research?
JD: We will continue to characterize accelerated knee osteoarthritis to help us better understand possible interventions and screening strategies.
Reference:
- Davis JE, Ward RJ, MacKay JW, et al. Effusion-synovitis and infrapatellar fat pad signal intensity alteration differentiate accelerated knee osteoarthritis. Rheumatology. 2019;58(3):418–426. https://doi.org/10.1093/rheumatology/key305.