Davis JE, et al. - Three sex-matched groups among Osteoarthritis Initiative participants who had a knee without radiographic knee osteoarthritis (KOA) were recognized by the experts in order to assess if adults with incident accelerated KOA were more likely to have degenerative knee ligaments or tendons in comparison to individuals with typical or no KOA. Adults with accelerated KOA two times more likely to have degenerative cruciate ligaments than no KOA, starting at least 2 years prior to the onset. For adults with accelerated vs typical KOA, a weaker correlation was discovered. In contrast to no KOA individuals, adults with accelerated or typical KOA were two times more likely to have a degenerative extensor mechanism, regardless of the time. Also, no other structural features were statistically important. Hence, the radiographic onset of accelerated KOA was antedated by the degenerative cruciate ligaments or extensor mechanism. Furthermore, knee instability could lead to accelerated KOA, which could help recognize patients at high-risk for accelerated KOA and novel prevention strategies.