Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia.
Osteoarthritis Research Unit, University of Montreal Hospital Research Centre (CRCHUM), Montreal, Quebec, Canada.
Rheumatology (Oxford). 2019 Feb 1;58(2):246-253. doi: 10.1093/rheumatology/key274.
To examine whether baseline knee joint effusion volume and the change in effusion volume over 1 year are associated with cartilage volume loss, progression of radiographic OA (ROA) over 4 years and risk of total knee replacement over 6 years.
This study included 4115 Osteoarthritis Initiative participants with knee joint effusion volume quantified by MRI at baseline. The change in effusion volume over 1 year was assessed. Cartilage volume loss and progression of ROA over 4 years were assessed using MRI and X-ray and total knee replacement over 6 years was assessed. Multiple linear regression and binary logistic regression were used for data analyses.
Baseline knee effusion volume (per 5 ml) was positively associated with a loss of medial and lateral cartilage volume [regression coefficient 0.13%/year (95% CI 0.10, 0.17) and 0.13%/year (95% CI 0.10, 0.16), respectively, both P < 0.001], progression of ROA [odds ratio (OR) 1.28 (95% CI 1.20, 1.37), P < 0.001], and risk of knee replacement [OR 1.12 (95% CI 1.05, 1.20), P = 0.001]. A 5 ml increase in knee effusion volume over 1 year was positively associated with medial cartilage volume loss [regression coefficient 0.09%/year (95% CI 0.04, 0.15), P = 0.001], progression of ROA [OR 1.21 (95% CI 1.11, 1.33), P < 0.001] and risk of knee replacement [OR 1.24 (95% CI 1.12, 1.37), P < 0.001].
Knee joint effusion volume assessed from MRI provides a continuous and sensitive measure that was associated with cartilage volume loss, progression of ROA and risk of total knee replacement. It may provide a method to identify individuals with an inflammatory OA phenotype who are at higher risk of disease progression.
探讨基线膝关节积液量和 1 年内积液量的变化与软骨体积丢失、4 年内放射学骨关节炎（ROA）进展以及 6 年内全膝关节置换的风险之间的关系。
本研究纳入了 4115 名接受 MRI 检查的 Osteoarthritis Initiative 参与者，基线时对膝关节积液量进行了定量评估。评估了 1 年内积液量的变化。使用 MRI 和 X 射线评估了 4 年内软骨体积丢失和 ROA 的进展情况，并评估了 6 年内全膝关节置换的情况。采用多元线性回归和二项逻辑回归进行数据分析。
基线膝关节积液量（每 5ml）与内侧和外侧软骨体积丢失呈正相关[回归系数分别为 0.13%/年（95%CI 0.10，0.17）和 0.13%/年（95%CI 0.10，0.16），均 P<0.001]、ROA 进展[比值比（OR）1.28（95%CI 1.20，1.37），P<0.001]和膝关节置换的风险[OR 1.12（95%CI 1.05，1.20），P=0.001]。1 年内膝关节积液量增加 5ml 与内侧软骨体积丢失呈正相关[回归系数 0.09%/年（95%CI 0.04，0.15），P=0.001]、ROA 进展[OR 1.21（95%CI 1.11，1.33），P<0.001]和膝关节置换的风险[OR 1.24（95%CI 1.12，1.37），P<0.001]。
MRI 评估的膝关节积液量提供了一种连续、敏感的测量方法，与软骨体积丢失、ROA 进展和全膝关节置换的风险相关。它可能为识别具有炎症性 OA 表型的个体提供一种方法，这些个体疾病进展的风险更高。
