Cleveland Clinic Lerner College of Medicine, 9500 Euclid Ave, NA-21, Cleveland, OH 44195, USA.
Osteoarthritis Cartilage. 2013 Sep;21(9):1185-90. doi: 10.1016/j.joca.2013.06.024.
To evaluate if quantitative joint space width (JSW) measurements from radiographs correlate with 4-year Knee injury and Osteoarthritis Outcome Scores (KOOS) and clinical performance measures.
The study group consisted of 942 patients with symptomatic knee osteoarthritis (OA). 4-year outcomes for six measures (KOOS Pain, Symptom, Quality of Life, and Function scores, 20-m walk pace, and chair stand time) were used to create six multiple linear regression models. Primary predictors were baseline minimum JSW and 4-year change in JSW measured from fixed flexion radiographs. Age, gender, body mass index (BMI), race, knee alignment, and baseline measures of the outcomes of interest were covariates.
Lower baseline minimum JSW and a greater decrease in 4-year JSW significantly correlated with worse 4-year KOOS Pain, Symptom, and Quality of Life. With all other factors constant, a 4.1, 4.8, and 5.6 mm lower baseline JSW correlated with a clinically significant eight-point drop in 4-year KOOS Pain, Symptom, and Quality of Life scores respectively. Additionally, a 3.5, 3.1, and 4.0 mm loss of JSW over 4 years correlated with a clinically significant eight-point drop in 4-year KOOS Pain, Symptom, and Quality of Life scores respectively.
Our results indicate quantitative radiographic JSW measurements correlate with 4-year clinical outcomes. Since patients with narrower JSW at the onset of study had lower KOOS scores at 4 years even after controlling for 4-year change in JSW and baseline KOOS scores, clinical outcomes in knee OA may be predetermined once the disease process begins. These findings suggest early treatment with disease modifying therapies may be necessary to influence outcomes.
评估来自 X 光片的定量关节间隙宽度（JSW）测量值与 4 年膝关节损伤和骨关节炎结局评分（KOOS）以及临床表现测量值是否相关。
研究组包括 942 例有症状膝关节骨关节炎（OA）患者。使用六个指标（KOOS 疼痛、症状、生活质量和功能评分、20 米步行速度和坐站时间）的 4 年结果创建了六个多元线性回归模型。主要预测指标是基线最小 JSW 和从固定屈曲 X 光片测量的 4 年 JSW 变化。年龄、性别、体重指数（BMI）、种族、膝关节对线和基线感兴趣结局的测量值为协变量。
较低的基线最小 JSW 和 4 年内 JSW 下降较大与 4 年 KOOS 疼痛、症状和生活质量较差显著相关。在所有其他因素保持不变的情况下，基线 JSW 低 4.1、4.8 和 5.6 毫米与 4 年 KOOS 疼痛、症状和生活质量评分分别降低 8 分具有临床意义相关。此外，4 年内 JSW 损失 3.5、3.1 和 4.0 毫米与 4 年 KOOS 疼痛、症状和生活质量评分分别降低 8 分具有临床意义相关。
我们的结果表明定量放射学 JSW 测量值与 4 年临床结局相关。由于在控制 4 年 JSW 变化和基线 KOOS 评分后，研究开始时 JSW 较窄的患者在 4 年内的 KOOS 评分较低，因此膝关节 OA 的临床结局可能在疾病过程开始时就已预先确定。这些发现表明，可能需要早期采用疾病修正疗法来影响结局。
