Department of Orthopedics, Guangdong Province, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, People's Republic of China.
Guangdong Province, Shantou University Medical College, Shantou, People's Republic of China.
Clin Rheumatol. 2022 Oct;41(10):3151-3157. doi: 10.1007/s10067-022-06235-7. Epub 2022 Jun 10.
To explore whether the severity of contralateral knee osteoarthritis (OA) is associated with OA progression in ipsilateral knee with early OA.
Knees in early OA (Kellgren-Lawrence grade (KLG):1-2) with intact baseline demographic and clinical data were retrieved from OAI database and defined as target knees. The target knees were divided into the exposure group (contralateral knees KLG 3 to 4) and the control group (contralateral knees KLG 0 to 2). Both groups underwent propensity score matching (PSM) concerning demographic data, as well as radiographic and clinical outcomes at the baseline. The primary outcome was the upgrade of KLG in the target knee in the first 12 and 24 months. The secondary outcome was the incidence of knee arthroplasty in ipsilateral knee during the first 108 months.
One thousand seven hundred fifty-two knees were included, with 449 in the exposure cohort and 1276 in the control cohort. Four hundred thirty-four knees in each group were matched after PSM. Target knees in the exposure cohort showed a significantly higher rate of radiographic progression in the first 12 months (12.9% vs. 5.1%, P < 0.001) and 24 months (19.6% vs. 8.1%, P < 0.001). As for the risk of future arthroplasty, a significant difference was also found between the two groups (7.8% vs. 4.0%, P = 0.02). Kaplan-Meier analysis showed that the 108-month accumulated knee survival rate was significantly lower in the exposure group (P = 0.01).
The ipsilateral knee with early-stage OA is prone to have worse early to mid-, and long-term prognosis in the circumstance of contralateral radiographic advanced knee OA. Key Points •Identifying early knee osteoarthritis (OA) with a high risk of radiographic progression and future arthroplasty enables early personalized intervention. •This is a novel study to investigate the relationship between the risk of future arthroplasty and contralateral knee status. •Propensity score matching holds promise to minimize selection bias in observational studies. •Knees with early OA are prone to have a high risk of radiographic progression and future arthroplasty in the circumstance of contralateral advanced knee OA.
探讨早期膝关节骨关节炎（OA）对侧膝关节 OA 严重程度是否与同侧膝关节 OA 进展相关。
从 OAI 数据库中检索到基线人口统计学和临床数据完整的早期 OA（Kellgren-Lawrence 分级（KLG）：1-2）膝关节，将其定义为目标膝关节。将目标膝关节分为暴露组（对侧膝关节 KLG3-4）和对照组（对侧膝关节 KLG0-2）。两组均进行倾向评分匹配（PSM），比较基线时的人口统计学数据、影像学和临床结果。主要结局为目标膝关节在第 12 和 24 个月时 KLG 的升级。次要结局为 108 个月内同侧膝关节关节置换术的发生率。
共纳入 1752 例膝关节，其中暴露组 449 例，对照组 1276 例。PSM 后每组匹配 434 例膝关节。暴露组目标膝关节在第 12 个月（12.9%比 5.1%，P<0.001）和第 24 个月（19.6%比 8.1%，P<0.001）的影像学进展率明显更高。对于未来关节置换术的风险，两组也存在显著差异（7.8%比 4.0%，P=0.02）。Kaplan-Meier 分析显示，暴露组 108 个月的累计膝关节生存率明显较低（P=0.01）。
在对侧膝关节影像学进展性 OA 的情况下，早期 OA 的同侧膝关节在早中期和长期预后较差。关键点 •识别具有影像学进展和未来关节置换高风险的早期膝关节骨关节炎（OA），以便进行早期个体化干预。 •这是一项研究对侧膝关节状态与未来关节置换风险关系的新研究。 •倾向评分匹配有望减少观察性研究中的选择偏倚。 •在对侧膝关节严重 OA 的情况下，早期 OA 的膝关节有较高的影像学进展和未来关节置换风险。
