Association of Periarticular Subchondral Bone Mineral Density With the Presence and Progression of Knee Pain: Data From the Osteoarthritis Initiative
Authors' conclusion
Higher medial-to-lateral sBMD ratio was associated with both the presence and progression of knee pain, suggesting that relative subchondral bone distribution may better capture biomechanical loading imbalance related to symptomatic OA than absolute sBMD alone.
Study context
- Population
- Participants from the Osteoarthritis Initiative (OAI); mean age 64.1 years; 50.5% male1,137 knees
- Participants
- 594 participants
- Exposure
- Periarticular subchondral BMD and knee pain
- Outcome
- Presence of knee pain (WOMAC pain ≥ 5 at baseline) and pain progression (increase in WOMAC pain score of ≥ 2 in at least 3 of the 6 follow-up visits)
- Follow-up
- Through month 108
Methodological detailslogistic regression with generalized estimating equations, per SD increase in subchondral bone mineral density (sBMD)
- Logistic regression with generalized estimating equations
- Per SD increase in sBMD
Main finding
As reported in the abstract
Progression of knee pain (WOMAC pain increase ≥ 2 in at least 3 of 6 follow-up visits)
Odds ratio (95% CI)P value
Higher medial sBMD
1.50(1.25–1.81)
P < 0.001Higher medial-to-lateral ratio
1.29(1.11–1.49)
P = 0.001Per SD increase, as printed
- Knees with pain progression during follow-up
- 37.4%
Observational data: associations, not effects.
Further findings
| Outcome | OR (95% CI) | P value | |
|---|---|---|---|
| Presence of knee pain (WOMAC pain ≥ 5 at baseline)Per SD increase | 1.21 (1.05–1.40) | P = 0.01 | |
| 0.512Odds ratio (log scale) |
- Presence of knee pain (WOMAC pain ≥ 5 at baseline) — Knees with higher pain at baseline
- 31.6%
Original publication
Association of Periarticular Subchondral Bone Mineral Density With the Presence and Progression of Knee Pain: Data From the Osteoarthritis Initiative. J Rheumatol. Published 15 May 2026. doi:10.
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