Joint space narrowing and Kellgren–Lawrence progression in knee osteoarthritis: an analytic literature synthesis

Emrani, Parastu S.; Katz, Jeffrey N.; Kessler, Courtenay L.; Reichmann, William M.; Wright, Elizabeth A.; McAlindon, Timothy E.; Losina, Elena

doi:10.1016/j.joca.2007.12.004

Cited by 151 publications

(125 citation statements)

References 41 publications

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“…In particular, BMI is usually considered a risk factor of incident OA. However, the association between mean BMI and JSL was not found in a recent review (26). Our results are in contrast with studies showing a positive association between increased urinary CTX-II levels and progression of knee (33) or hip (34) OA, but are consistent with a study by Mazzuca et al, who found no relationship between urinary CTX-II and JSL (35).…”

Section: Knee Joint Space Study In Womensupporting

confidence: 76%

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Radiologic assessment of age‐related knee joint space changes in women: A 4‐year longitudinal study

Gensburger

Arlot

Sornay‐Rendu

et al. 2009

Arthritis & Rheumatism

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Objective. To analyze a population-based cohort of women in order to establish normal values of joint space width (JSW) and to evaluate the existence of age-related joint space loss (JSL). Methods. Knee radiographs were performed 4 years apart in women from the OFELY (Os des Femmes de Lyon) Cohort. Posteroanterior radiographs of both knees were taken in semiflexion with a standardized fluoroscopically assisted protocol. Radiographs were qualitatively evaluated using a scoring system based on the Altman score that assessed joint space narrowing, osteophytes, and sclerosis for each tibiofemoral compartment and each side. For quantitative assessment, radiographs were digitized using a video camera, and specific software was used to measure JSW in every compartment. Results. We evaluated the radiographs of 606 women (ages 39 -90 years, mean 62 years) and found that in all subjects, JSW significantly decreased with age in every compartment (r ‫؍‬ ؊0.12 to ؊0.16, P < 0.001), including in 358 subjects without any radiographic abnormality related to osteoarthritis (OA) at baseline. The longitudinal analysis confirmed a significant loss over 4 years of ϳ0.30 mm (6%) for the medial compartment. Multiple regression analysis did not identify significant predictors of JSL among clinical risk factors and biochemical markers of bone and cartilage turnover. Conclusion. In this first longitudinal study of a population-based cohort of women, we have established normal values of JSW and shown that JSW decreases with aging, especially at the medial compartment, even in subjects without any radiographic abnormalities related to OA.

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Section: Knee Joint Space Study In Womensupporting

confidence: 76%

“…Most of the previous studies were performed in patients with knee OA defined by a K/L scale score Ն2 (26). One longitudinal study assessed JSL in knees without radiographic OA in elderly men and women (ages 70 -79 years) with knee pain (27).…”

Section: Discussionmentioning

confidence: 99%

Radiologic assessment of age‐related knee joint space changes in women: A 4‐year longitudinal study

Gensburger

Arlot

Sornay‐Rendu

et al. 2009

Arthritis & Rheumatism

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“…In addition, Günther and Sun [13] described inferior interobserver intraclass correlation coefficients for medial compartment (0.62) and lateral compartment (0.47) JSN as well as medial femorotibial, lateral femorotibial, and tibial spine osteophyte formation (0.75, 0.74, and 0.63, respectively) as compared with the overall KL classification score (0.81) when using three observers, one of whom was an experienced orthopaedic surgeon and two of whom were orthopaedic residents. As discussed by Emrani et al [8], classifications based on JSN may be preferable to the KL system for monitoring progression of OA, whereas the KL system may be better for assessing severity of osteoarthritic disease. A criticism of multiple classification systems (including the KL) is the lack of recognition of patellofemoral arthritis as a distinct or contributory radiographic factor.…”

Section: Limitationsmentioning

confidence: 99%

Classifications in Brief: Kellgren-Lawrence Classification of Osteoarthritis

Kohn

Sassoon

Fernando

2016

Clinical Orthopaedics &Amp; Related Research

992

589

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“…Twenty years later, among those classified as having milder disease (defined as Albäck class I: Ն50% JSN at study entry; n ϭ 47), 39% showed no radiographic progression (18). A 2008 systematic review of 27 observational and randomized controlled trial (RCT) studies of knee OA JSN concluded that estimates ranged from Ϫ0.10 mm/year (indicating an increase in JSW over time) to 0.70 mm/year, with a mean Ϯ SD loss of 0.13 Ϯ 0.15 mm/year (19). In the original parent study for our analysis, radiographic progression of the entire group was only 0.088 mm over 2 years in the European cohort and 0.13 mm in the North American cohort, which was significantly less than an anticipated rate of 0.20 mm per year.…”

Section: (3)mentioning

confidence: 99%

Identifying common trajectories of joint space narrowing over two years in knee osteoarthritis

Bartlett

Ling

Mayo

et al. 2011

Arthritis Care & Research

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Objective. Little is known about the natural history of knee osteoarthritis (OA). We sought to identify common patterns of joint space narrowing (JSN) in well-characterized knee OA patients in the placebo arm of a 2-year international study. Methods. We performed secondary data analyses of 622 adults ages 39 -80 years in North America (n ‫؍‬ 310) and Europe (n ‫؍‬ 312) with symptomatic knee OA. Fluoroscopically positioned semiflexed anteroposterior radiographs were obtained at 0, 12, and 24 months. Group-based trajectory modeling was used to identify distinctive groups of individuals with similar trajectories of JSN, taking into account sex, age, and body mass index. Results. Seven groups were identified. Four exhibited joint space width (JSW) stability over 2 years representing the most common trajectory (71%), which was unrelated to initial JSW. Atypical courses included slow, rapid, and moderate progressors; most had significant JSN at study entry. Slow progressors (20%) had a mean JSN of 0.2 mm over 2 years. Only 2% of the sample demonstrated rapid JSN (2.1 mm), while 7% had JSN of 0.7 mm. Rapid progressors tended to be men, while slow and moderate progressors were older and heavier. Conclusion. Most (70%) people with OA demonstrated no significant JSN over 2 years; 20% showed slow progression, 7% had moderate, and 2% had rapid JSN. Progressors tended to have less JSW at study entry and were older and heavier; rapid progressors were more likely to be men. Understanding common patterns of the course of knee OA may offer new opportunities to target those at greatest risk of disability.

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Joint space narrowing and Kellgren–Lawrence progression in knee osteoarthritis: an analytic literature synthesis

Cited by 151 publications

References 41 publications

Radiologic assessment of age‐related knee joint space changes in women: A 4‐year longitudinal study

Radiologic assessment of age‐related knee joint space changes in women: A 4‐year longitudinal study

Classifications in Brief: Kellgren-Lawrence Classification of Osteoarthritis

Identifying common trajectories of joint space narrowing over two years in knee osteoarthritis

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