Bone marrow lesion coexisted with subchondral bone attrition and/or subchondral bone cyst is associated with knee pain in knee osteoarthritis regardless of cartilage lesion: the Bunkyo health study.

ABSTRACT:

Background

Subchondral bone changes, which include bone marrow lesion (BML), subchondral bone attrition (SBA) and subchondral bone cyst (SBC) by magnetic resonance imaging (MRI) analysis, are reportedly implicated for knee pain in knee osteoarthritis (OA). However, the relationship between these subchondral bone changes and OA knee pain and the effect of articular cartilage lesion on the pain remain elusive.

Methods

Elderly subjects (1,145 subjects, 72.9 years old on average) in the Bunkyo Health Study, 71.5% of whom had knee OA with ≥ Kellgren-Lawrence grade 2, were enrolled. Knee pain in daily life over the past few days was measured using Visual Analogue Scale (VAS) in the Japanese Knee Osteoarthritis Measure. The subjects without or with pain were defined if they indicated a pain VAS score of 0 or a pain VAS score of ≥ 1. The association was examined between knee pain and MRI-detected OA structural changes which were determined according to the Whole Organ Magnetic Resonance Imaging Score.

Results

While 62.2% of the subjects were free from knee pain, 37.8% of the subjects had knee pain. Knee pain was not related with cartilage lesion without subchondral bone changes (odds ratio [OR]: 1.10 [95% confidence interval [CI]: 0.83-1.46]) or BML alone (OR: 1.32 [95% CI: 0.95-1.83]). However, knee pain was significantly associated with BML coexistent with SBA (OR: 2.22 [95% CI: 1.25-3.97]), SBC (OR: 1.79 [95% CI: 1.28-2.51]), or both SBA and SBC (OR: 2.18 [95% CI: 1.35-3.53]). Similar positive relationships between knee pain and coexisted subchondral bone changes were obtained regardless of the presence or absence of cartilage lesion present above the BML region. When BML was not coexistent with either SBA or SBC regardless of cartilage lesion above the subchondral bone changes, BML was not associated with knee pain (OR: 1.26 [95% CI: 0.90-1.77]) or (OR: 2.16 [95% CI: 0.89-5.23]).

Conclusions

BML coexistent with SBA and/or SBC, but not BML without the coexistence, was associated with knee pain in the elderly with knee OA regardless of the presence or absence of cartilage lesion.

SUBMITTER: Tomura J 

PROVIDER: S-EPMC12465792 | biostudies-literature | 2025 Sep

REPOSITORIES: biostudies-literature