Association between statins and progression of osteoarthritis features on magnetic resonance imaging in a predominantly pre-radiographic cohort: the Vancouver Longitudinal Study of Early Knee Osteoarthritis (VALSEKO): a cohort study

BMC Musculoskelet Disord. 2022 Oct 28;23(1):937. doi: 10.1186/s12891-022-05900-x.


Background: To evaluate the effect of statin use on osteoarthritis (OA) incidence/progression using magnetic resonance imaging (MRI) in a population-based cohort with predominantly pre-radiographic knee OA.

Methods: A cohort aged 40-79 years with knee pain was recruited using random population sampling and followed for 7 years. Baseline exclusions were inflammatory arthritis, recent knee surgery/injury, and inability to undergo MRI. At baseline, current statin use was ascertained. Baseline and follow-up MRIs were read semi-quantitatively for cartilage damage (grade 0-4, 0/1 collapsed, 6 regions), osteophytes (grade 0-3, 8 regions), bone marrow lesions (BML) (grade 0-3, 6 regions) and effusion (grade 0-3). The primary outcome was cartilage damage incidence/progression, while secondary outcomes were incidence/progression of osteophytes, BML, and effusion, each defined as an increase by ≥1 grade at any region. To ensure population representative samples, sample weights were used. Logistic regression was used to assess the association of statin use at baseline with incidence/progression of MRI outcomes. Analyses were adjusted for sex, age, BMI, and multiple comorbidities requiring statin therapy.

Results: Of 255 participants evaluated at baseline, 122 completed the 7-year follow-up. Statin use was not significantly associated with progression of cartilage damage (OR 0.82; 95% CI 0.17, 4.06), osteophytes (OR 3.48; 95% CI 0.40, 30.31), BML (OR 0.61; 95% CI 0.12, 3.02), or effusion (OR 2.38; 95% CI 0.42, 13.63), after adjusting for confounders.

Conclusion: In this population-based cohort of predominantly pre-radiographic knee OA, statins did not affect MRI incidence/progression of cartilage damage, BML, osteophytes or effusion. Therefore, statin use does not appear to affect people with pre-radiographic stages of knee OA.

Keywords: Cartilage; Diagnostic imaging; Magnetic resonance imaging; Osteoarthritis; Statins.

MeSH terms

  • Cartilage, Articular* / diagnostic imaging
  • Cartilage, Articular* / pathology
  • Cohort Studies
  • Disease Progression
  • Humans
  • Hydroxymethylglutaryl-CoA Reductase Inhibitors* / therapeutic use
  • Knee Joint / diagnostic imaging
  • Knee Joint / pathology
  • Longitudinal Studies
  • Magnetic Resonance Imaging / methods
  • Osteoarthritis, Knee* / diagnostic imaging
  • Osteoarthritis, Knee* / drug therapy
  • Osteoarthritis, Knee* / pathology
  • Osteophyte* / pathology


  • Hydroxymethylglutaryl-CoA Reductase Inhibitors