Identification of phenotypes with different clinical outcomes in knee osteoarthritis: data from the Osteoarthritis Initiative

Jesper Knoop, Marike van der Leeden, Carina A Thorstensson, Leo D Roorda, Willem F Lems, Dirk L Knol, Martijn P M Steultjens, Joost Dekker

Research output: Contribution to JournalArticleAcademicpeer-review


OBJECTIVE: To identify subgroups or phenotypes of knee osteoarthritis (OA) patients based on similarities of clinically relevant patient characteristics, and to compare clinical outcomes of these phenotypes.

METHODS: Data from 842 knee OA patients of the Osteoarthritis Initiative were used. A cluster analysis method was performed, in which clusters were formed based on similarities in 4 clinically relevant, easily available variables: severity of radiographic OA, lower extremity muscle strength, body mass index, and depression. Univariable and multivariable regression analyses were used to compare phenotypes on clinical outcomes (pain and activity limitations), taking into account possible confounders.

RESULTS: Five phenotypes of knee OA patients were identified: "minimal joint disease phenotype," "strong muscle phenotype," "nonobese and weak muscle phenotype," "obese and weak muscle phenotype," and "depressive phenotype." The "depressive phenotype" and "obese and weak muscle phenotype" showed higher pain levels and more severe activity limitations than the other 3 phenotypes.

CONCLUSION: Five phenotypes based on clinically relevant patient characteristics can be identified in the heterogeneous population of knee OA patients. These phenotypes showed different clinical outcomes. Interventions may need to be tailored to these clinical phenotypes.

Original languageEnglish
Pages (from-to)1535-1542
Number of pages8
JournalArthritis Care & Research
Issue number11
Early online date27 Sept 2011
Publication statusPublished - Nov 2011


  • Aged
  • Body Mass Index
  • Cluster Analysis
  • Depression/diagnosis
  • Disability Evaluation
  • Exercise Test
  • Female
  • Humans
  • Knee Joint/diagnostic imaging
  • Linear Models
  • Male
  • Middle Aged
  • Muscle Strength
  • Muscle Weakness/diagnosis
  • Netherlands
  • Obesity/diagnosis
  • Osteoarthritis, Knee/classification
  • Pain/diagnosis
  • Pain Measurement
  • Phenotype
  • Prognosis
  • Radiography
  • Severity of Illness Index


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