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Associations Between Knee Effusion-synovitis and Joint Structural Changes in Patients with Knee Osteoarthritis. | LitMetric

Associations Between Knee Effusion-synovitis and Joint Structural Changes in Patients with Knee Osteoarthritis.

J Rheumatol

From the Menzies Institute for Medical Research, and Faculty of Health, University of Tasmania, Hobart; Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, Australia; Translational Research Centre, Academy of Orthopedics; School of Basic Medical Sciences, Southern Medical University, Guangzhou, China.

Published: November 2017

AI Article Synopsis

  • This study explored how knee effusion-synovitis (swelling due to inflammation in the joint) is related to various joint problems in patients with osteoarthritis over a two-year period. !* -
  • Researchers analyzed data from 413 patients, using MRI to assess joint conditions and found that baseline issues like cartilage defects and bone marrow lesions were linked to increases in effusion-synovitis over time. !* -
  • Even though changes in knee effusion-synovitis correlated with worsening pain and stiffness, it did not serve as a reliable predictor for subsequent structural changes in the knee, indicating that other factors are more influential in joint health. !*

Article Abstract

Objective: To describe the associations between effusion-synovitis and joint structural abnormalities in patients with knee osteoarthritis (OA) over 24 months.

Methods: A posthoc analysis using data from a randomized controlled trial in 413 patients with symptomatic OA (aged 63 ± 7 yrs, 208 women). Knee effusion-synovitis volume and score, cartilage defects, cartilage volume, and bone marrow lesions (BML) were assessed using magnetic resonance imaging. Joint space narrowing (JSN) and osteophytes were assessed using radiograph. Least significant change criterion was used to define change in effusion-synovitis volume. Knee symptoms were assessed by Western Ontario and McMaster University OA Index. Multivariable linear/logistic regression and multilevel generalized mixed-effects models were used in longitudinal analyses.

Results: Total effusion-synovitis volume increased modestly from baseline (8.0 ± 8.5 ml) to followup (9.0 ± 10.5 ml). Baseline BML, cartilage defect, JSN, and osteophyte scores were positively associated with change in effusion-synovitis volume (p < 0.05). Baseline cartilage defects and JSN were also associated with change in effusion-synovitis score (p < 0.05). However, neither baseline effusion-synovitis score nor volume consistently predicted change in the above structures except cartilage volume. In the mixed-effects models, knee effusion-synovitis was positively associated with BML (volume: β = 1.19 ml/grade; score: OR = 1.75/grade) and cartilage defects (volume: β = 1.87 ml/grade; score: OR = 2.22/grade), while negatively associated with cartilage volume loss. Change in effusion-synovitis volume was positively correlated with changes in knee pain and stiffness scores (p < 0.05).

Conclusion: Knee cartilage and subchondral bone abnormalities predicted change in effusion-synovitis, but effusion-synovitis did not predict knee structural changes. These findings suggest that synovial inflammation is likely the result of joint structural abnormalities in established OA. ClinicalTrials.gov identifier: NCT01176344. Australian New Zealand Clinical Trials Registry: ACTRN12610000495022.

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Source
http://dx.doi.org/10.3899/jrheum.161596DOI Listing

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