Alexander Louie C, Huebner Janet L, Cicconetti Greg, Jordan Joanne M, Renner Jordan B, Doherty Michael, Wilson Anthony G, Hochberg Marc C, Loeser Richard, Kraus Virginia Byers
Duke Molecular Physiology Institute, USA.
AbbVie, North Chicago, IL, USA.
Osteoarthr Cartil Open. 2022 Sep;4(3). doi: 10.1016/j.ocarto.2022.100288. Epub 2022 Jun 18.
To evaluate the degree of symmetry of knee osteoarthritis (OA) structural severity and progression of participants with a mean follow-up time of 3.8 years.
Participants from the Genetics of Generalized Osteoarthritis (GOGO) study (n = 705) were selected on the basis of radiographic evidence of OA in at least 1 knee, availability of radiographs at baseline and follow-up, and no history of prior knee injury or surgery. Incidence and progression of osteoarthritis were determined by radiographic Kellgren-Lawrence (KL) grade; compartmental OA progression was determined by change in joint space width of lateral and medial tibiofemoral compartments. Total OA progression was the sum of change in KL grade of both knees.
Compared with left knees, right knees had more severe KL grades at baseline (p = 0.0002) and follow-up (p = 0.0004), McNemar's χ = 34.16 and 26.08, respectively; however, both knees progressed similarly (p = 0.121, McNemar's χ = 10.09). Compartmental changes were symmetric across knees: medial r = 0.287, p = 0.0002; lateral r = 0.593, p = 0.0002. Change in joint space width in the medial compartment was negatively correlated with change in the lateral compartment of the same knee (left knees: r = -0.293, p = 0.021; right knees: r = -0.195, p = 0.0002).
Although right knees tended to have more severe OA at both baseline and follow-up, radiographic progression did not differ by knee and compartmental progression correlated across knees. Given this trend in generalized OA, the risk of progression for both knees should be considered, even if only one knee has radiographic OA at baseline.
评估平均随访时间为3.8年的膝关节骨关节炎(OA)患者结构严重程度和进展的对称程度。
从广义骨关节炎遗传学(GOGO)研究中选取参与者(n = 705),入选标准为至少一侧膝关节有OA的影像学证据、基线和随访时有X线片,且无既往膝关节损伤或手术史。骨关节炎的发病率和进展通过影像学Kellgren-Lawrence(KL)分级确定;关节间OA进展通过外侧和内侧胫股关节间隙宽度的变化来确定。总OA进展为双膝KL分级变化之和。
与左膝相比,右膝在基线时(p = 0.0002)和随访时(p = 0.0004)的KL分级更严重,McNemar's χ分别为34.16和26.08;然而,双膝进展相似(p = 0.121,McNemar's χ = 10.09)。膝关节间的节段性变化是对称的:内侧r = 0.287,p = 0.0002;外侧r = 0.593,p = 0.0002。内侧关节间隙宽度的变化与同一膝关节外侧间隙的变化呈负相关(左膝:r = -0.293,p = 0.021;右膝:r = -0.195,p = 0.0002)。
虽然右膝在基线和随访时往往有更严重的OA,但影像学进展在双膝之间并无差异,且膝关节间的节段性进展是相关的。鉴于广义OA的这种趋势,即使基线时只有一侧膝关节有影像学OA,也应考虑双膝进展的风险。