Liu Lizu, Ishijima Muneaki, Kaneko Haruka, Sadatsuki Ryo, Hada Shinnosuke, Kinoshita Mayuko, Aoki Takako, Futami Ippei, Yusup Anwarjan, Arita Hitoshi, Shiozawa Jun, Takazawa Yuji, Ikeda Hiroshi, Kaneko Kazuo
a Department of Medicine for Orthopaedics and Motor Organ , Juntendo University Graduate School of Medicine , Tokyo , Japan.
b Sportology Center, Juntendo University Graduate School of Medicine , Tokyo , Japan , and.
Mod Rheumatol. 2017 Mar;27(2):332-338. doi: 10.1080/14397595.2016.1206509. Epub 2016 Jul 18.
The aim of this prospective cohort study was to examine whether MRI-detected osteoarthritis (OA)-structural changes at baseline could predict knee OA patients who would undergo total knee arthroplasty (TKA).
In total, 128 end-stage medial-type knee OA patients were enrolled and followed up for 6 months. MRI using the whole-organ MRI scoring (WORMS) method, radiographic findings, visual analog scale (VAS) for pain and a patient-oriented outcome measure, and the Japanese Knee Osteoarthritis Measure (JKOM) were recorded at baseline. The area under the curve (AUC) was estimated to determine the discriminative value of the prediction models.
While 74 patients (57.8%) did not undergo TKA, the remaining 54 patients (42.2%) underwent TKA during this period. The AUCs of the receiver operating characteristic (ROC) curve for the activities of daily living (ADL) score evaluated by the JKOM ADL score [0.70 (95% CI: 0.60-0.79)] and osteophyte score [0.72 (0.64-0.81)] were 0.70 or greater. The JKOM ADL score (17/40) and the osteophyte score (30/98) showed relative risks (RR) of 2.61 (1.32-5.15) and 3.01 (1.39-6.52) for undergoing TKA, respectively.
The osteophyte score detected by MRI, in addition to ADL score, was found to be an important factor in determining whether the patient should undergo TKA.
这项前瞻性队列研究的目的是检查基线时磁共振成像（MRI）检测到的骨关节炎（OA）结构变化是否能预测接受全膝关节置换术（TKA）的膝骨关节炎患者。
总共纳入128例终末期内侧型膝骨关节炎患者，并随访6个月。在基线时记录使用全器官MRI评分（WORMS）方法的MRI、影像学检查结果、疼痛视觉模拟量表（VAS）和以患者为导向的结局指标以及日本膝关节骨关节炎测量量表（JKOM）。估计曲线下面积（AUC）以确定预测模型的判别价值。
在此期间，74例患者（57.8%）未接受TKA，其余54例患者（42.2%）接受了TKA。JKOM评估的日常生活活动（ADL）评分[0.70（95%CI：0.60-0.79）]和骨赘评分[0.72（0.64-0.81）]的受试者工作特征（ROC）曲线的AUC均为0.70或更高。JKOM ADL评分（17/40）和骨赘评分（30/98）接受TKA的相对风险（RR）分别为2.61（1.32-5.15）和3.01（1.39-6.52）。
除ADL评分外，MRI检测到的骨赘评分是决定患者是否应接受TKA的一个重要因素。
