Open Access Highly Accessed Research article

Does moderate or severe nonspecific knee injury affect radiographic osteoarthritis incidence and progression?

Eric C Sayre1*, Joel Singer2, Anona Thorne2, Hubert Wong2, Jacek A Kopec12, John M Esdaile134, Ali Guermazi5, Savvas Nicolaou6 and Jolanda Cibere13

Author Affiliations

1 Arthritis Research Centre of Canada, 5591 No. 3 Rd, Richmond, BC, V6X 2C7, Canada

2 School of Population & Public Health, University of British Columbia (UBC), Vancouver, Canada

3 Medicine, UBC, Vancouver, Canada

4 Medicine, University of Calgary, Calgary, Canada

5 Radiology, Boston University School of Medicine, Boston, USA

6 Radiology, UBC, Vancouver, Canada

For all author emails, please log on.

BMC Musculoskeletal Disorders 2013, 14:309  doi:10.1186/1471-2474-14-309

Published: 28 October 2013



Knee injuries can lead to radiographic osteoarthritis (ROA). Injuries may be “specific” (SI) including ligament or meniscal tears or patellar trauma, or “nonspecific” (NSI). Our objective is to understand the effect of knee NSI on ROA incidence and progression.


163 people (sample-weighted for population representativeness) aged 40+ with history of knee pain had radiographs assessed on Kellgren Lawrence (KL) grade (0/1 collapsed) at baseline and follow-up (median 3.2 years apart). Progression was an increase in KL score. SIs and NSIs were labeled “severe” (walking aid for ≥1 week) or “moderate”. One model treated SI and NSI as dichotomous (yes/no), and another as trichotomous (none/moderate/severe). Models were adjusted for age, sex, BMI, KL grade and follow-up time.


SI/NSI history was none, moderate (7.8/24.4%) or severe (11.0/10.8%). Duration at baseline since SI/NSI ranged from <1 year to several decades (SI/NSI mean 4.6/6.5 years). SI was significantly associated with ROA incidence and progression (odds ratio (OR) = 2.90; 95% CI = 1.04, 8.09), but NSI showed no significant effect (OR = 1.36; 95% CI = 0.61, 3.02). In the trichotomous model, severe SI was significant (OR = 4.35, 95% CI = 1.26, 15.02), while moderate SI was not (OR = 1.51, 95% CI = 0.33, 6.84). NSI showed no effect: moderate OR = 1.51, 95% CI = 0.61, 3.74; severe OR = 0.90, 95% CI = 0.24, 3.40. This study had 80% power to detect an NSI OR of 2.9.


We find no evidence that history of NSI affects knee ROA incidence and progression in a population with knee pain, adjusting for SI, age, sex, BMI, KL grade and follow-up time.