NEW YORK (Reuters Health) - The association between radiographic hand osteoarthritis and post-meniscectomy radiographic knee osteoarthritis suggests an interaction between hereditary and environmental factors for osteoarthritis, according to a report in the February issue of Arthritis & Rheumatism.
Radiographic hand osteoarthritis has a marked heredity component, the authors explain, and meniscectomy of the knee is associated with a high risk of radiographic knee osteoarthritis and knee disability at long-term follow-up.
To examine the possible interaction between heredity and environment in causing osteoarthritis, Dr. Martin Englund from Lund University Hospital, Lund, Sweden and colleagues examined 170 patients who had undergone isolated meniscectomy of the knee an average of 20 years earlier.
Fifty-seven patients (34%) had radiographic hand osteoarthritis, the authors report, and 105 (62%) had radiographic knee osteoarthritis (55% in the operated knee and 28% in the contralateral knee).
Patients with radiographic hand osteoarthritis were significantly more likely to have radiographic knee osteoarthritis than were those with normal hands, the results indicate, and bilateral radiographic knee osteoarthritis was more likely than unilateral knee osteoarthritis to be associated with hand osteoarthritis.
Radiographic hand osteoarthritis was associated with radiographic knee osteoarthritis in the operated knee after adjustment for all related variables, the researchers note, but its association with arthritis in the nonoperated contralateral knee did not reach the level of statistical significance.
In patients younger than 50 years (but not in older age groups), the report indicates, radiographic hand osteoarthritis was associated with more severe radiographic changes in the operated knee than in patients without hand osteoarthritis.
“We emphasize that there is an interaction between hereditary and environmental risk factors in the development of knee osteoarthritis (OA), not solely one or the other,” Dr. Englund told Reuters Health. “Our finding that having hand OA is associated with knee OA after a meniscus injury is a good example of an interaction between genes and environment for a common disease, something that is increasingly recognized as important also for other common diseases.”
“A degenerative meniscal lesion may represent early-stage knee OA, a disease involving degenerative changes also in the menisci and other joint tissues, not only joint cartilage,” Dr. Englund explained. “The meniscal tear, due to a weakened meniscal structure through the OA disease process, may thus be an early ‘signal’ feature of the disorder.”
“At the moment we are planning to make another clinical and radiographic assessment of the patient cohort involved in this study,” Dr. Englund added. “The primary objective will be to study the disease progression since last assessment, and to evaluate candidate risk factors for progression and incident knee OA, respectively. Hand radiographs will be included as a marker for the hereditary risk factor.”
Source: Arthritis Rheum 2004;50:469-475. [ Google search on this article ]
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