Cookies on this website

We use cookies to ensure that we give you the best experience on our website. If you click 'Accept all cookies' we'll assume that you are happy to receive all cookies and you won't see this message again. If you click 'Reject all non-essential cookies' only necessary cookies providing core functionality such as security, network management, and accessibility will be enabled. Click 'Find out more' for information on how to change your cookie settings.

A new study published in The Lancet Rheumatology shows potential ways to predict how likely someone is to develop osteoarthritis after a knee injury.

Patient having knee examined

Osteoarthritis (OA) is the most common form of arthritis, affecting approximately 8.5 million people in the UK. It is by far the most frequent reason for costly joint replacement.

It has been shown that joint injury can cause OA in some people, but it is not currently possible to predict who will develop problems after injury and who won't.

Dr Fiona Watt, from the Kennedy Institute of Rheumatology at NDORMS took a closer look at this well-known association and the results have been published in The Lancet Rheumatology.


Supported by funding from Versus Arthritis, Fiona and a team of researchers hoped to understand whether there was anything happening at the time of injury, which might explain whether somebody was more likely to develop osteoarthritis in the future.

Fiona said: "Joint injury is an important opportunity for us to understand risk factors and processes occurring early on in osteoarthritis development. This may allow us to identify people at higher risk and aim to prevent later disease. We set up this study because our laboratory work had told us that the trauma to joint tissues at the time of a joint injury causes inflammation. We wanted to understand if the level of this response in a joint at the time of injury was an important factor in an individual's risk of developing osteoarthritis in the future".

They recruited 150 people between the ages of 16 and 50 who had experienced an acute knee injury within the last eight weeks.

At the start of the study, close to the time of injury, the research team measured markers of inflammation in both the blood and synovial fluid (the lubricating fluid inside the joint) of the injured knee.

Then two years on from the initial injury the team looked at:

  • Patient reported symptoms such as knee pain
  • and structural changes to the knee joint on X-ray.

The team found that large numbers of people from the study were experiencing ongoing knee pain or issues with knee functioning at two years. The researchers also saw that around 15-20% of people who took part in the study were showing signs of knee osteoarthritis two years after injury. This is substantial, given that most of the people who took part in the study were a young age.

There were three key factors measured in clinic that affected the outcome for people who had experienced a knee injury:

  • How bad knee symptoms were at the time of injury
  • Presence of large amounts of blood in the joint at the time of injury
  • Swelling in the knee joint (which can also be caused by blood in the joint, or just extra knee fluid)

This is the first time it has been found that measuring how much blood is present in the joint can be a useful risk factor for future knee osteoarthritis symptoms across a range of knee injuries.

The levels of two inflammatory markers measured in synovial fluid at the time of injury (rather than the blood) added to the ability to predict knee symptoms at two years.

Interestingly, the team also saw that what was seen on X-ray (ie structural differences to the knee after two years) often did not match up with the knee symptoms that people were actually self-reporting, for example, someone experiencing large amounts of pain, but with little change seen on X-ray or vice versa.

This research shows that there are potentially ways to measure and predict how likely somebody is to develop osteoarthritis after knee injury. With further research it may be possible to develop ways to intervene at the time of injury or introduce potential preventative measures to stop the onset of osteoarthritis.

Similar stories

Adalimumab is found to be a cost-effective treatment for early-stage Dupuytren’s disease

Researchers at the Kennedy Institute of Rheumatology and Oxford Population Health’s Health Economics Research Centre have found that anti-TNF treatment (adalimumab) is likely to be a cost-effective treatment for people affected by early-stage Dupuytren’s disease.

Patients like me

What can patients learn from the experiences of people like them who’ve already had a hip replacement? A new tool called ‘Patients like me’ helps answer some of the questions about pain, complications and how long the prosthesis might last.

Study reveals new evidence on rare blood-clotting condition after covid-19 vaccination

Researchers from NDORMS at the University of Oxford have investigated claims that some adenovirus-based COVID-19 vaccines increase the risk of rare blood clots compared to their mRNA-based counterparts.

NDORMS contributes to new UK research to tackle monkeypox outbreak

The UK’s efforts to tackle the monkeypox outbreak will receive a huge boost with the creation of a new research consortium and a new study to study vaccine effectiveness.

World Osteoporosis Day 2022

A bone-healthy lifestyle is vital for strong bones and a mobile, fracture-free future. On World Osteoporosis Day, we are sharing advice from the International Osteoporosis Foundation (IOF), on putting your bone health first.

Mathematician boosts data science research at the Kennedy Institute

Welcome to Yang Luo who has joined the Kennedy Institute as the Principal Investigator of the Luo Group. Her lab is leading the investigation into how genetic variations contribute to diseases of the immune system.