Institute of Anatomy, Paracelsus Medical University Salzburg & Nuremberg, Salzburg, Austria & Chondrometrics GmbH, Ainring, Germany.
Rheumatology Department, Royal North Shore Hospital and Institute of Bone and Joint Research, Kolling Institute, University of Sydney, Sydney, NSW, Australia.
Osteoarthritis Cartilage. 2017 Dec;25(12):2063-2071. doi: 10.1016/j.joca.2017.08.005. Epub 2017 Aug 31.
To investigate the predictive and concurrent validity of magnetic resonance imaging (MRI)-based cartilage thickness change between baseline (BL) and year-two (Y2) follow-up (predictive validity) and between Y2 and Y4 follow-up (concurrent validity) for symptomatic and radiographic knee osteoarthritis (OA) progression during Y2→Y4.
777 knees from 777 Osteoarthritis Initiative (OAI) participants (age: 61.3 ± 9.0 years, BMI: 30.1 ± 4.8 kg/m) with Kellgren Lawrence (KL) grade 1-3 at Y2 (visit before progression interval) had cartilage thickness measurements from 3T MRI at BL, Y2 (n = 777), and Y4 (n = 708). Analysis of covariance and logistic regression were used to assess the association of pain progression (≥9 WOMAC units [scale 0-100], n = 205/572 with/without progression) and radiographic progression (≥0.7 mm minimum joint space width (mJSW) loss, n = 166/611 with/without progression) between Y2 and Y4 with preceding (BL→Y2) and concurrent (Y2→Y4) change in central medial femorotibial (cMFTC) compartment cartilage thickness.
Symptomatic progression was associated with concurrent (Y2→Y4: -305 ± 470 μm vs -155 ± 346 μm, Odds ratios (OR) = 1.5 [1.2, 1.7]) but not with preceding cartilage thickness loss in cMFTC (-150 ± 276 μm vs -151 ± 299 μm, OR = 0.9 95% CI: [0.8, 1.1]). Radiographic progression, in contrast, was significantly associated with both concurrent (-542 ± 550 μm vs -98 ± 255 μm, OR = 3.4 [2.6, 4.3]) and preceding cMFTC thickness loss (-229 ± 355 μm vs -130 ± 270 μm, OR = 1.3 [1.1, 1.5]).
These results extend previous reports that did not discern predictive vs concurrent associations of cartilage thickness loss with OA progression. The observed predictive and concurrent validity of cartilage thickness loss for radiographic progression and observed concurrent validity for symptomatic progression provide an important step in qualifying cartilage thickness loss as a biomarker of knee OA progression. CLINICALTRIALS.
NCT00080171.
探究基线（BL）至第 2 年（Y2）随访（预测性有效性）和 Y2 至第 4 年（Y4）随访（同时有效性）之间基于磁共振成像（MRI）的软骨厚度变化对 Y2→Y4 期间膝关节骨关节炎（OA）进展的症状和放射学进展的预测和同时有效性。
777 名来自 777 名骨关节炎倡议（OAI）参与者（年龄：61.3±9.0 岁，BMI：30.1±4.8 kg/m2），在 Y2（进展间隔前的访问）时 KL 分级为 1-3，在 BL、Y2（n=777）和 Y4（n=708）时进行了 3T MRI 的软骨厚度测量。协方差分析和逻辑回归用于评估疼痛进展（≥9 个 WOMAC 单位[范围 0-100]，n=205/572 有/无进展）和放射学进展（≥0.7mm 最小关节间隙宽度[mJSW]丢失，n=166/611 有/无进展）与 Y2 至 Y4 之间的中央内侧股胫关节（cMFTC）软骨厚度的关系。
症状进展与同时（Y2→Y4：-305±470μm 与-155±346μm，比值比（OR）=1.5[1.2, 1.7]）而不是 cMFTC 中先前的软骨厚度损失相关（-150±276μm 与-151±299μm，OR=0.995%CI：[0.8, 1.1]）。相比之下，放射学进展与同时（-542±550μm 与-98±255μm，OR=3.4[2.6, 4.3]）和之前的 cMFTC 厚度损失显著相关（-229±355μm 与-130±270μm，OR=1.3[1.1, 1.5]）。
这些结果扩展了先前的报告，这些报告没有区分软骨厚度损失与 OA 进展的预测性和同时性关联。观察到的软骨厚度损失对放射学进展的预测性和同时有效性以及对症状进展的同时有效性为将软骨厚度损失作为膝关节 OA 进展的生物标志物提供了重要步骤。
临床试验。
NCT00080171。
