Risk factors predictive of joint replacement in a 2-year multicentre clinical trial in knee osteoarthritis using MRI: results from over 6 years of observation

Raynauld, Jean‐Pierre; Martel‐Pelletier, Johanne; Haraoui, Boulos; Choquette, D.; Dorais, Marc; Wildi, Lukas; Abram, F.; Pelletier, Jean‐Pierre

doi:10.1136/ard.2010.146407

Cited by 95 publications

(130 citation statements)

References 42 publications

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“…This allowed a 1:1 matched case-control design with regard to patient sex, age, and radiographic disease status, which was paramount to ensure maximum comparability between cases and controls, as previous investigators had reported that knees with advanced radiographic disease have a higher likelihood for knee replacement (21,22). Of note is the fact that cases differed significantly from controls with regard to symptoms and physical activity at the time point prior to the visit where knee replacement was reported.…”

Section: Discussionmentioning

confidence: 99%

Can Structural Joint Damage Measured with MR Imaging Be Used to Predict Knee Replacement in the Following Year?

et al. 2015

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).q RSNA, 2014 Purpose:To assess whether magnetic resonance (MR) imagingbased cross-sectional measures of structural joint damage can be used to predict knee replacement during the following year. Materials and Methods:Participants were drawn from the Osteoarthritis Initiative, a longitudinal observational study that includes 4796 participants who have knee osteoarthritis or are at risk. The HIPAA-compliant protocol was approved by the institutional review boards of all participating centers, and written informed consent was obtained from all participants. During the 5 years of follow-up, 199 knees underwent knee replacement and were matched with 199 control knees that did not undergo knee replacement. Knees were matched according to radiographic disease stage and patient sex and age. All knees that underwent knee replacement and had MR images available from the year before surgery were included. MR images were assessed for cartilage damage, bone marrow lesions, meniscal damage, meniscal extrusion, synovitis, and effusion prior to reported knee replacement. Conditional logistic regression was applied to assess the risk of knee replacement. Analyses were performed on a compartmental and knee level. Results:Participants had a mean age 6 standard deviation of 64.2 years 6 8. Conclusion:Apart from meniscal extrusion, all features of tissue abnormalities at MR imaging were related to clinical prognosis and could be used to predict knee replacement in the following year.q RSNA, 2014

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Section: Discussionmentioning

confidence: 99%

Can Structural Joint Damage Measured with MR Imaging Be Used to Predict Knee Replacement in the Following Year?

et al. 2015

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“…For instance, it is known that the presence of meniscal lesions or BML is predictive of disease progression (5,11,26,(31)(32)(33)(34). We are now proposing the VM %Fat as a novel and independent risk factor for knee OA progression.…”

Section: Discussionmentioning

confidence: 99%

“…We further looked at the number of long-term total knee replacements (TKRs; 4-7 years after study inception) (11) in both OA subgroups. Interestingly, in comparing the subgroup at higher risk of cartilage volume loss (BMI .30 kg/m 2 , VM area ,14.6 cm 2 , VM %Fat .7.6%; n 5 19)…”

Section: Raynauld Et Almentioning

confidence: 99%

“…Quantitative MRI helps us define risk factors associated with cartilage volume loss, such as meniscal tear/extrusion and subchondral bone marrow lesions (BML) (5)(6)(7)(8)(9). These MRI studies and randomized controlled trials have proven to be instrumental in providing reliable and sensitive infor-mation about these OA changes, as well as predicting clinically relevant outcomes, such as total knee replacement (10,11). An additional factor that could impact knee structure change over time is the vastus medialis (VM) status, since it is one of the principal contributors to functional knee joint stability through muscle support and loading during ambulation (12,13).…”

Section: Introductionmentioning

confidence: 99%

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Magnetic Resonance Imaging–Assessed Vastus Medialis Muscle Fat Content and Risk for Knee Osteoarthritis Progression: Relevance From a Clinical Trial

Raynauld

Pelletier

Roubille

et al. 2015

Arthritis Care & Research

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Objective. Studies have proposed vastus medialis (VM) muscle cross-sectional area change as a variable associated with cartilage volume loss in knee osteoarthritis (OA). However, the VM also includes fat (%Fat), which may influence knee function. This study analyzed the VM area and %Fat data, separately and in combination, to predict symptoms, cartilage volume loss, and bone marrow lesion (BML) change in knee OA. Methods. This study included the according-to-protocol population (n 5 143) of a 2-year knee OA randomized clinical trial having magnetic resonance imaging at baseline and 2 years. Correlations used multivariate analyses. Results. Greater baseline value for VM area and %Fat were significantly associated with sex (male, area; female, %Fat), higher body mass index (BMI), and Western Ontario and McMaster Universities Osteoarthritis Index stiffness, function, and total scores (better, high area; worse, high %Fat). Moreover, a VM %Fat increase of 1% at 2 years was associated with worsening of cartilage volume loss in the global knee (P 5 0.015) and some subregions (P £ 0.030), and with an increment of BML global score change (P < 0.001). A 1% decrease in VM area at 2 years was associated with worsening of knee pain score (P 5 0.048). Importantly, the concurrent presence of low VM area, high VM %Fat, and high BMI identified a subgroup of patients with greater cartilage volume loss in the medial femur (P 5 0.028) than the rest of the cohort. Conclusion. These data demonstrated, for the first time, that VM fat content is a strong predictor of cartilage volume loss and the occurrence and progression of BML. Importantly, the combined data of VM area, VM %Fat, and BMI identified patients at higher risk for OA progression.

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“…Rate of cartilage loss is a good measure of progression as it predicts risk of knee replacements [35,46,49]. Every 1 % increase in the rate of tibial cartilage loss over 2 years confers a 20 % increased risk of knee replacement at 4 years [35].…”

Section: Measuring Disease Progressionmentioning

confidence: 99%

Measuring Disease Progression in Osteoarthritis

Laslett

Pelletier

Cicuttini

et al. 2016

Curr Treat Options in Rheum

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Risk factors predictive of joint replacement in a 2-year multicentre clinical trial in knee osteoarthritis using MRI: results from over 6 years of observation

Abstract: This study shows that in the context of osteoarthritis trials, clinical data and structural changes identified by MRI allow prediction of a 'hard' outcome such as TKR. The findings support the usefulness and predictive value of MRI in defining study outcome in DMOAD trials.

Cited by 95 publications

References 42 publications

Can Structural Joint Damage Measured with MR Imaging Be Used to Predict Knee Replacement in the Following Year?

Can Structural Joint Damage Measured with MR Imaging Be Used to Predict Knee Replacement in the Following Year?

Magnetic Resonance Imaging–Assessed Vastus Medialis Muscle Fat Content and Risk for Knee Osteoarthritis Progression: Relevance From a Clinical Trial

Measuring Disease Progression in Osteoarthritis

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