While osteoarthritis (OA) is generally perceived as a noninflammatory disease, recent studies suggest that local inflammation may play a prominent role in its pathogenesis. This meta-analysis reviewed literature concerning the association between C-reactive protein and OA.

Literature was reviewed for the years 1992 through 2012 from multiple databases. The authors identified studies which involved patients with OA, and included serum high sensitivity C-reactive protein (hsCRP). The data were reviewed to determine the relationship between circulating levels of CRP and OA phenotypes.

The literature review produced 32 studies, including 10 case controlled, 15 cross-sectional, four longitudinal and three clinical trials. Overall, hsCRP was modestly elevated in the population with OA (P<0.001) as compared to controls. In addition, serum hsCRP was associated with symptoms of OA, including pain (P<0.001) and loss of physical function (P<0.001). Serum hsCRP was not, however, significantly associated with joint space narrowing nor Kellgren Lawrence scores. The findings revealed no evidence of a predictive value of hsCRP for the progression of OA.

This literature review and meta-analysis found that low-grade systemic inflammation may play a role in symptoms related to OA, but not radiographic changes associated with OA.