Chondrocalcinosis and incident knee osteoarthritis: findings from 2 large prospective cohorts with 20 years of follow-up.

Abstract

Chondrocalcinosis, a radiographic feature of calcium crystal deposition, is frequently observed alongside osteoarthritis. Although cross-sectional studies suggest an association, it remains unclear whether chondrocalcinosis is a consequence or a contributing factor in osteoarthritis development. This study investigates its role as a potential risk factor for incident knee osteoarthritis and knee pain in 2 large longitudinal cohorts: the Rotterdam Study (RS) and the Multicenter Osteoarthritis Study (MOST). This prospective cohort study analysed 20-year follow-up data from 3737 participants in RS and 7-year follow-up data from 2750 in MOST. We examined the association of baseline knee chondrocalcinosis with (1) incident radiographic knee osteoarthritis and (2) incident knee pain in participants with Kellgren and Lawrence grade (KLG) 0 or 1, including a subgroup restricted to KLG = 0. Logistic regression models were adjusted for age, sex, and body mass index, with results pooled using meta-analysis. Chondrocalcinosis was present in 5% of osteoarthritis-free participants at baseline. It was significantly associated with incident knee osteoarthritis in both cohorts (pooled odds ratio [OR]: 1.75, 95% CI: 1.35-2.27, P < .001), with significance maintained in KLG = 0 participants (pooled OR: 1.77, 95% CI: 1.04-3.01, P = .035). No consistent association with incident knee pain was observed. Chondrocalcinosis was associated with an increased risk of incident knee osteoarthritis in 2 large cohorts. These findings suggest that chondrocalcinosis may contribute to osteoarthritis incidence and represent a distinct disease subgroup. Future research is needed to explore potential targeted prevention and treatment strategies.