Composite quantitative knee structure metrics predict the development of accelerated knee osteoarthritis: data from the osteoarthritis initiative

BMC Musculoskeletal Disorders

Charles B. Eaton¹  Mary F. Barbe²  Julie E. Davis³  Robert J. Ward⁴  Timothy E. McAlindon⁵  Ming Zhang⁵  Jeffrey B. Driban⁵  Matthew S. Harkey⁵  Bing Lu⁶  Grace H. Lo⁷  James W. MacKay⁸  Jincheng Pang⁹  Alina C. Stout^1,10  Lori Lyn Price^1,11 

[1] Center for Primary Care and Prevention, Alpert Medical School of Brown University;Department of Anatomy and Cell Biology, Temple University School of Medicine;Department of Global Health in the Milken Institute of Public Health, George Washington University;Department of Radiology, Tufts Medical Center;Division of Rheumatology, Allergy, & Immunology, Tufts Medical Center;Division of Rheumatology, Immunology & Allergy, Brigham & Women’s Hospital and Harvard Medical School;Medical Care Line and Research Care Line, Houston Health Services Research and Development Center of Excellence Michael E. DeBakey VAMC;Norwich Medical School, University of East Anglia;Pfizer Inc.;Public Health Institute, Northeastern University;The Institute for Clinical Research and Health Policy Studies, Tufts Medical Center;

关键词: Magnetic resonance imaging;    Cartilage;    Bone marrow lesions;    Effusion;    Synovitis;   

DOI  :  10.1186/s12891-020-03338-7

来源: DOAJ

【 摘 要 】

Abstract Background We aimed to determine if composite structural measures of knee osteoarthritis (KOA) progression on magnetic resonance (MR) imaging can predict the radiographic onset of accelerated knee osteoarthritis. Methods We used data from a nested case-control study among participants from the Osteoarthritis Initiative without radiographic KOA at baseline. Participants were separated into three groups based on radiographic disease progression over 4 years: 1) accelerated (Kellgren-Lawrence grades [KL] 0/1 to 3/4), 2) typical (increase in KL, excluding accelerated osteoarthritis), or 3) no KOA (no change in KL). We assessed tibiofemoral cartilage damage (four regions: medial/lateral tibia/femur), bone marrow lesion (BML) volume (four regions: medial/lateral tibia/femur), and whole knee effusion-synovitis volume on 3 T MR images with semi-automated programs. We calculated two MR-based composite scores. Cumulative damage was the sum of standardized cartilage damage. Disease activity was the sum of standardized volumes of effusion-synovitis and BMLs. We focused on annual images from 2 years before to 2 years after radiographic onset (or a matched time for those without knee osteoarthritis). To determine between group differences in the composite metrics at all time points, we used generalized linear mixed models with group (3 levels) and time (up to 5 levels). For our prognostic analysis, we used multinomial logistic regression models to determine if one-year worsening in each composite metric change associated with future accelerated knee osteoarthritis (odds ratios [OR] based on units of 1 standard deviation of change). Results Prior to disease onset, the accelerated KOA group had greater average disease activity compared to the typical and no KOA groups and this persisted up to 2 years after disease onset. During a pre-radiographic disease period, the odds of developing accelerated KOA were greater in people with worsening disease activity [versus typical KOA OR (95% confidence interval [CI]): 1.58 (1.08 to 2.33); versus no KOA: 2.39 (1.55 to 3.71)] or cumulative damage [versus typical KOA: 1.69 (1.14 to 2.51); versus no KOA: 2.11 (1.41 to 3.16)]. Conclusions MR-based disease activity and cumulative damage metrics may be prognostic markers to help identify people at risk for accelerated onset and progression of knee osteoarthritis.

【 授权许可】

Unknown