Nodes provide a clue to osteoarthritis outcomes

Patients with nodal and non-nodal forms of severe hip osteoarthritis (OA) have different risk factor profiles and differ in the likelihood of total hip replacement (THR) being required. Those with nodal and non-nodal OA who underwent total knee replacement (TKR) also have different risk profiles, but only with respect to age, sex, and body mass index (BMI).

Valdes and associates examined genetic, radiographic, and risk factor data from 3800 patients who underwent total joint replacement (TJR). Heberden and Bouchard nodes were determined by clinical inspection and palpation.

Numerous differences were found in the association of risk factors (age, sex, height, BMI, GDF5 polymorphism) with TJR for nodal and non-nodal OA. For example, GDF5 polymorphism was significantly associated with THR in persons with nodal OA. In persons with non-nodal OA, tall stature was a risk factor for THR and being female protected against the need for TKR. Conversely, women with nodal OA were more likely to need TKR. Persons with the nodal phenotype were more likely to need THR, TKR, or bilateral TKR but less likely to need bilateral THR.

The authors suggested that noting the presence of nodes when considering a treatment plan for persons with OA appears worthwhile.