What is it about?
A great deal of research is investigating the possible causes of painful knee osteoarthritis. Using MRI technology, phenomena called bone marrow lesions (BMLs) can often be seen inside the knees of people with painful osteoarthritis; and other research studies have linked them to knee pain. BMLs appear to be regions inside the bone that are close to the joint where inflammatory cells have infiltrated. In this study, we looked at whether the forces that transfer through the knees might be causing pain by stimulating BMLs. We used data from a large study in the USA, called the Osteoarthritis Initiative (OAI) which has collected data from people at risk of knee osteoarthritis for many years and has made the data available to researchers from all countries. MRI images of the knees had been examined by the OAI researchers and the location of any BMLs had been recorded. Detailed scoring of pain and painful activities were also recorded for the 1000+ study participants that we analysed. We looked at whether movements and activities might feel more painful when there was a BML in the load-bearing region of the bone. We also tried to make sure that our findings were not influenced by BMLs in other regions of the bone and were not confounded by pain felt while people were resting. We found that walking, standing and climbing stairs were all associated with a worse pain score when there was a BML in a weight-bearing region. Across a 2 year time period, we also saw that changes in the size of BMLs within the weight-bearing regions corresponded to changes in the pain scores of activities.
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Why is it important?
Our findings support the idea that BMLs could be a cause of pain in knee osteoarthritis. New treatments that could stop or suppress BMLs forming would be worth investigating further as possible treatments for osteoarthritis pain.
Perspectives
The exact causes of knee pain are not well known. This work should help researchers define a pathway towards targets for future therapies.
Dr Daniel McWilliams
University of Nottingham
Read the Original
This page is a summary of: Association of subchondral bone marrow lesion localization with weight-bearing pain in people with knee osteoarthritis: data from the Osteoarthritis Initiative, January 2021, Springer Science + Business Media,
DOI: 10.1186/s13075-021-02422-0.
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