The Parker Institute, Copenhagen University Hospital, Bispebjerg and Frederiksberg, Nordre Fasanvej 57, 2000 Frederiksberg, Copenhagen, Denmark.
The Parker Institute, Copenhagen University Hospital, Bispebjerg and Frederiksberg, Nordre Fasanvej 57, 2000 Frederiksberg, Copenhagen, Denmark; Department of Radiology, Copenhagen University Hospital, Bispebjerg and Frederiksberg, Bispebjerg Bakke 23, 2400 Copenhagen, Denmark.
Knee. 2021 Jan;28:256-265. doi: 10.1016/j.knee.2020.12.022. Epub 2021 Jan 13.
This study investigated the effect of exercise therapy on inflammatory activity in synovitis and bone marrow lesions (BMLs) assessed by magnetic resonance imaging (MRI) in patients with knee OA.
60 patients with knee OA were randomized 1:1 to 12 weeks of supervised exercise therapy 3 times/week (ET) or a no-attention control group (CG). Synovitis and BMLs were assessed with static MRI with and without contrast and with dynamic contrast enhanced MRI (DCE-MRI). DCE-MRI data was quantified using pixel-by-pixel methodology based on analysis of signal intensity curves. Pain was assessed by the Knee Injury and Osteoarthritis Outcome Score (KOOS). Analyses of covariance were used assessing group differences in changes from baseline to week 12.
33 patients adhered to the protocol and had valid MRI and KOOS data (ET, n = 16, CG, n = 17). Statistically significant and clinically relevant group difference in favour of ET was seen in KOOS pain change (-11.7 points, 95%CI: -20.1 to -3.4). There were statistically significant group differences in DCE-MRI assessed synovitis in the anterior synovium with unchanged inflammatory activity in the ET group compared to the CG. There were no group differences in BMLs and static MRI.
Inflammatory activity was unchanged, and pain was reduced in patients with knee OA adhering to 12 weeks of exercise therapy compared to a no-attention control group. The reduction in pain was not explained by changes in inflammatory activity. Overall, the results suggest that exercise is not harmful in knee OA. ClinicalTrials.gov number: NCT01545258.
本研究旨在通过磁共振成像（MRI）评估，研究运动疗法对膝骨关节炎患者滑膜炎和骨髓病变（BML）炎症活动的影响。
60 例膝骨关节炎患者按 1:1 随机分为 12 周每周 3 次监督运动治疗（ET）组或无关注对照组（CG）。滑膜炎和 BML 通过静息 MRI（有无对比剂）和动态对比增强 MRI（DCE-MRI）评估。DCE-MRI 数据采用基于信号强度曲线分析的逐像素方法进行量化。疼痛采用膝关节损伤和骨关节炎结果评分（KOOS）评估。协方差分析用于评估从基线到第 12 周的组间差异。
33 例患者坚持方案并具有有效 MRI 和 KOOS 数据（ET 组 n=16，CG 组 n=17）。与 CG 组相比，ET 组在 KOOS 疼痛变化方面具有统计学显著和临床相关的优势（-11.7 分，95%CI：-20.1 至-3.4）。在 DCE-MRI 评估的前滑膜滑膜炎方面，ET 组与 CG 组相比，炎症活动无统计学显著差异。BML 和静息 MRI 无组间差异。
与无关注对照组相比，坚持 12 周运动治疗的膝骨关节炎患者炎症活动无变化，疼痛减轻。疼痛减轻不能用炎症活动的变化来解释。总的来说，结果表明运动对膝骨关节炎没有危害。临床试验注册号：NCT01545258。
