Influence of major trauma and lower limb loss on radiographic progression and incidence of knee osteoarthritis and pain: a comparative and predictive analysis from the ADVANCE study
Authors' conclusion
Our results are consistent with a short post-injury window of increased rOA incidence, followed by a plateau.
Study context
- Population
- UK male military personnel deployed in Afghanistan (2003–2014); assessed 8- and 11-years post-injury
- Participants
- 579 vs 565
- Exposure
- Combat-injured vs uninjured UK male military personnel
- Combat-injuryn = 579
- Uninjuredn = 565reference
- Outcome
- Incidence and progression of knee rOA and knee pain (KP)
- Follow-up
- 8- and 11-years post-injury
Methodological detailslongitudinal, frequency-matched for age, rank, role, service, and deployment
- Longitudinal
- Frequency-matched for age, rank, role, service, and deployment
Main finding
As reported in the abstract
Knee rOA and KP incidence and progression · Follow-up (11 years post-injury)
Each group vs uninjuredIncidence rate ratio (95% CI)
Specific knee injuryKP progression
2.53(1.08–5.92)
Lower-limb lossrOA incidence
1.98(1.21–2.95)
Trauma-exposed, no limb-loss or knee injuryKP incidence
1.45(1.05–2.01)
Observational data: associations, not effects.
Further findings
Prediction of radiographic OA (rOA) or KP incidence or progression (twenty potential predictors)
- No predictive model explained a large proportion of variance
Original publication
Influence of major trauma and lower limb loss on radiographic progression and incidence of knee osteoarthritis and pain: a comparative and predictive analysis from the ADVANCE study. Arthritis Res Ther. Published 26 January 2026. doi:10.
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