Association of serum biomarkers with radiographic knee osteoarthritis, knee pain and function in a young, male, trauma-exposed population – Findings from the ADVANCE study

O'Sullivan, Oliver; Stocks, Joanne; Schofield, Susie; Bilzon, James; Boos, Christopher J.; Bull, Anthony M.J.; Fear, Nicola T.; Watt, Fiona E.; Bennett, Alexander N.; Kluzek, Stefan; Valdes, Ana M.

Abstract

Objective: The ArmeD SerVices TrAuma RehabilitatioN OutComE (ADVANCE) study is investigating long-term combat-injury outcomes; this sub-study aims to understand the association of osteoarthritis (OA) biomarkers with knee radiographic OA (rOA), pain and function in this high-risk population for post-traumatic OA. Design: ADVANCE compares combat-injured participants with age, rank, deployment and job-role frequency-matched uninjured participants. Post-injury immunoassay-measured serum biomarkers, knee radiographs, Knee Injury and Osteoarthritis Outcome Scale, and six-minute walk tests are reported. The primary analysis, adjusted for age, body mass, socioeconomic status, and ethnicity, was to determine any differences in biomarkers between those with/without combat injury, rOA and pain. Secondary analyses were performed to compare post-traumatic/idiopathic OA, painful/painfree rOA and injury patterns. Results: A total of 1145 male participants were recruited, aged 34.1 ± 5.4, 8.9 ± 2.2 years post-injury (n = 579 trauma-exposed, of which, traumatic-amputation n = 161) or deployment (n = 566 matched). Cartilage oligomeric matrix protein (COMP) was significantly higher in the combat-injured group compared to uninjured (p = 0.01). Notably, COMP was significantly lower in the traumatic-amputation group compared to non-amputees (p < 0.001), decreasing relative to number of amputations (p < 0.001). Leptin was higher (p = 0.005) and adiponectin lower (p = 0.017) in those with v without knee pain, associated with an increased risk of 22% and 17% for pain, and 46% and 34% for painful rOA, respectively. There were no significant differences between trauma-exposed and unexposed participants with rOA. Conclusions: The most notable findings of this large, unique study are the similarities between those with rOA regardless of trauma-exposure, the injury-pattern and traumatic-amputation-associated differences in COMP, and the relationship between adipokines and pain.

Citation

O'Sullivan, O., Stocks, J., Schofield, S., Bilzon, J., Boos, C. J., Bull, A. M., Fear, N. T., Watt, F. E., Bennett, A. N., Kluzek, S., & Valdes, A. M. (2024). Association of serum biomarkers with radiographic knee osteoarthritis, knee pain and function in a young, male, trauma-exposed population – Findings from the ADVANCE study. Osteoarthritis and Cartilage, 32(12), 1636-1646. https://doi.org/10.1016/j.joca.2024.07.016

• Journal Article Type: Article
• Acceptance Date: Jul 30, 2024
• Online Publication Date: Aug 2, 2024
• Publication Date: 2024-12
• Deposit Date: Aug 5, 2024
• Publicly Available Date: Sep 30, 2024
• Journal: Osteoarthritis and Cartilage
• Print ISSN: 1063-4584
• Electronic ISSN: 1522-9653
• Publisher: Elsevier
• Peer Reviewed: Peer Reviewed
• Volume: 32
• Issue: 12
• Pages: 1636-1646
• DOI: https://doi.org/10.1016/j.joca.2024.07.016
• Keywords: Post-traumatic osteoarthritis; Trauma; Serum biomarkers; Pain; ADVANCE
• Public URL: https://nottingham-repository.worktribe.com/output/38105098
• Publisher URL: https://www.sciencedirect.com/science/article/pii/S1063458424013219