Radiographic Severity and Clinical Implications of Knee Osteoarthritis in Adults Under 55: Incidence and Insight Into...

Knee osteoarthritis (OA) increasingly affects adults well before traditional "older-age" brackets, raising questions about joint-preserving options. We evaluated radiographic OA severity among patients <55 years and considered the potential role of geniculate artery embolisation (GAE) for symptomatic management.

This was a retrospective cross-sectional study of consecutive outpatients (<55 years) referred to a Northern Ireland hospital with suspected knee OA. Anteroposterior radiographs were graded according to the Kellgren-Lawrence (KL) scale. Outcomes were the proportion with radiographic OA (KL≥2) and with moderate-to-severe OA (KL≥3).

A total of 89 patients (mean age 47.5 years; range 35-54) were included in the study. The distribution of KL grades was as follows: grade 0 in 40.4%, grade 1 in 5.6%, grade 2 in 20.2%, grade 3 in 29.2%, and grade 4 in 4.5% of patients. Overall, 53.9% had radiographic osteoarthritis (KL ≥2), while 33.7% had moderate-to-severe disease (KL ≥3).

Over half of symptomatic outpatients under 55 had definite radiographic OA, and one-third had moderate-to-severe disease, highlighting a substantial disease burden in "younger" adults. Given joint-replacement deferral in this age group, GAE warrants evaluation within research pathways for persistent, treatment-refractory pain. The National Institute for Health and Care Excellence (NICE) currently recommends GAE only in research settings.