Peripheral arterial occlusive disease tied to knee OA
Peripheral arterial occlusive disease (PAOD) may be associated with knee osteoarthritis (OA), according to data presented at the 7th Association of South-East Asian Pain Societies (ASEAPS) Congress 2017, held in Yangon, Myanmar.
“Our results support a bidirectional temporal association between PAOD and [total knee replacement] for knee OA,” said researchers led by Dr Shu-Yih Wu, from the Physical Medicine & Rehabilitation Department of Mackay Memorial Hospital, Taipei, Taiwan.
Using data from the Taiwan NHIRD*, researchers conducted a bidirectional longitudinal study to determine total knee replacement [TKR] risks for knee OA after PAOD (study 1) and the risk of PAOD after TKR for knee OA (study 2). Participants were randomly matched for age and sex with controls (study 1, 32,933 vs 131,732 and study 2, 4,534 vs 18,136). [ASEAPS 2017 meeting, abstract 24]
In study 1 (mean age, 58.8 years, 54.67 percent women), 2.74 percent (n=903) of PAOD patients and 2.05 percent (n=2,695) of the control population required TKR. In study 2 (mean age, 67.94 years, 75.52 percent women), 14.18 percent (n=643) of TKR patients and 10.83 percent (n=1,964) of the control population eventually developed PAOD.
After adjusting for demographic characteristics and certain comorbidities, PAOD patients in study 1 had an increased risk of subsequent TKR for knee OA (adjusted hazard ratio [adjHR], 1.21, 95 percent confidence interval [CI], 1.12–1.30). In study 2, TKR patients had an increased risk of developing PAOD (adjHR, 1.22, 95 percent CI, 1.11–1.33).
Given that knee OA has been associated with cardiovascular-related conditions in previous studies, PAOD might be a potential OA risk, noted the researchers. [Curr Opin Rheumatol 2010;22:512-519; Int J Rheum Dis 2014;17:299-303]
Furthermore, the distal claudication in PAOD and subchondral bone remodelling and bone marrow oedema in OA were both attributed to ischemia, which could account for the bidirectional relationship between PAOD and TKR for OA, according to the researchers. Frequent use of NSAIDs in OA treatment was also tied to the potential development of atherosclerotic lesions that could progress to PAOD, they added.