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
Authors' conclusion
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.
Study context
- Population
- Elderly subjects in the Bunkyo Health Study (mean age 72.9 years), 71.5% with knee osteoarthritis (OA) (Kellgren-Lawrence grade ≥2)
- Participants
- 1,145 subjects
- Exposure
- Magnetic resonance imaging (MRI)-detected subchondral bone changes vs none, in relation to knee pain
- Outcome
- Knee pain (Visual Analogue Scale (VAS) ≥1 vs 0, Japanese Knee OA Measure) associated with MRI-detected OA structural changes
Methodological detailspopulation-based cohort (Bunkyo Health Study), MRI (WORMS)
- Population-based cohort (Bunkyo Health Study)
- MRI (WORMS)
Main finding
As reported in the abstract
Knee pain by MRI subchondral bone change
- Cartilage lesion without subchondral bone changes, OR
- 1.10 (0.83-1.46) (95% CI)
- Bone marrow lesion (BML) alone, OR
- 1.32 (0.95-1.83) (95% CI)
- BML coexistent with subchondral bone attrition (SBA), OR
- 2.22 (1.25-3.97) (95% CI)
- BML coexistent with subchondral bone cyst (SBC), OR
- 1.79 (1.28-2.51) (95% CI)
- BML coexistent with both SBA and SBC, OR
- 2.18 (1.35-3.53) (95% CI)
Observational data: associations, not effects.
Further findings
Knee pain prevalence
- Free from knee pain
- 62.2%
- Knee pain
- 37.8%
BML without SBA or SBC, regardless of overlying cartilage lesion
- Not associated with knee pain, OR
- 1.26 (0.90-1.77) (95% CI)
- Not associated with knee pain, OR
- 2.16 (0.89-5.23) (95% CI)
- Similar positive relationships for coexisting subchondral bone changes regardless of cartilage lesion above the BML region
Original publication
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. Arthritis Res Ther. Published 26 September 2025. doi:10.
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