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Changes in structure and symptoms in knee osteoarthritis and prediction of future knee replacement over 8 years

Changes in structure and symptoms in knee osteoarthritis and prediction of future knee replacement over 8 years
Changes in structure and symptoms in knee osteoarthritis and prediction of future knee replacement over 8 years
The objective of this study was to assess the association between changes in joint space width (JSW, i.e., structure) or Western Ontario and McMaster Universities (WOMAC) score (i.e., symptoms) over 3 years in patients with knee osteoarthritis and the occurrence of knee replacement over 8 years. We followed 133 subjects with primary knee osteoarthritis prospectively for a mean of 8 years. JSW (standard radiography) and symptoms (total WOMAC score) were assessed every year for 3 years. The rate of knee replacement was recorded for the following 5 years. Logistic regressions were performed according to the intention-to-treat principle. After 8 years' follow-up, ten patients (7.5 %) had undergone a knee replacement. The changes in JSW or WOMAC score over 3 years were significantly associated with the occurrence of knee replacement during the following 5 years (p = 0.02 and p = 0.03, respectively). Each 0.1-mm narrowing of JSW over 3 years was associated with a 14 % (95 % CI 3-25 %) increased risk for knee replacement. For every 10 % increase in WOMAC score, the risk for joint replacement was increased by 16 % (95 % CI 1-33 %). When JSW and WOMAC score were included in the same statistical model, they were still significantly associated with risk for knee replacement (p = 0.02 and p = 0.03, respectively), but JSW change was the only variable that remained significant after adjusting for all potential confounders. Our results suggest that changes in symptoms and, more particularly, in structure over 3 years in patients with osteoarthritis reflect a clinically relevant progression of the disease.
knee osteoarthritis, joint space width, WOMAC score, prognosis, knee replacement
0171-967X
502-507
Bruyere, Olivier
78e7e880-9871-4463-af87-5bf2b11db696
Cooper, Cyrus
e05f5612-b493-4273-9b71-9e0ce32bdad6
Pavelka, Karel
c99f1e85-9754-493b-927e-2ccecdbb697c
Rabenda, Véronique
cc81b2c5-82bc-490a-ae8b-94d251b7b5ed
Buckinx, Fanny
0367576c-7e1d-4827-aa2f-3c89420cee37
Beaudart, Charlotte
bdc9da98-791a-474b-9745-be0695a4d8a9
Reginster, Jean-Yves
08b05e27-73dd-4ce9-90e5-d64ec922147a
Bruyere, Olivier
78e7e880-9871-4463-af87-5bf2b11db696
Cooper, Cyrus
e05f5612-b493-4273-9b71-9e0ce32bdad6
Pavelka, Karel
c99f1e85-9754-493b-927e-2ccecdbb697c
Rabenda, Véronique
cc81b2c5-82bc-490a-ae8b-94d251b7b5ed
Buckinx, Fanny
0367576c-7e1d-4827-aa2f-3c89420cee37
Beaudart, Charlotte
bdc9da98-791a-474b-9745-be0695a4d8a9
Reginster, Jean-Yves
08b05e27-73dd-4ce9-90e5-d64ec922147a

Bruyere, Olivier, Cooper, Cyrus, Pavelka, Karel, Rabenda, Véronique, Buckinx, Fanny, Beaudart, Charlotte and Reginster, Jean-Yves (2013) Changes in structure and symptoms in knee osteoarthritis and prediction of future knee replacement over 8 years. Calcified Tissue International, 93 (6), 502-507. (doi:10.1007/s00223-013-9781-z). (PMID:23995765)

Record type: Article

Abstract

The objective of this study was to assess the association between changes in joint space width (JSW, i.e., structure) or Western Ontario and McMaster Universities (WOMAC) score (i.e., symptoms) over 3 years in patients with knee osteoarthritis and the occurrence of knee replacement over 8 years. We followed 133 subjects with primary knee osteoarthritis prospectively for a mean of 8 years. JSW (standard radiography) and symptoms (total WOMAC score) were assessed every year for 3 years. The rate of knee replacement was recorded for the following 5 years. Logistic regressions were performed according to the intention-to-treat principle. After 8 years' follow-up, ten patients (7.5 %) had undergone a knee replacement. The changes in JSW or WOMAC score over 3 years were significantly associated with the occurrence of knee replacement during the following 5 years (p = 0.02 and p = 0.03, respectively). Each 0.1-mm narrowing of JSW over 3 years was associated with a 14 % (95 % CI 3-25 %) increased risk for knee replacement. For every 10 % increase in WOMAC score, the risk for joint replacement was increased by 16 % (95 % CI 1-33 %). When JSW and WOMAC score were included in the same statistical model, they were still significantly associated with risk for knee replacement (p = 0.02 and p = 0.03, respectively), but JSW change was the only variable that remained significant after adjusting for all potential confounders. Our results suggest that changes in symptoms and, more particularly, in structure over 3 years in patients with osteoarthritis reflect a clinically relevant progression of the disease.

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More information

e-pub ahead of print date: 31 August 2013
Published date: December 2013
Keywords: knee osteoarthritis, joint space width, WOMAC score, prognosis, knee replacement
Organisations: Faculty of Medicine

Identifiers

Local EPrints ID: 360374
URI: http://eprints.soton.ac.uk/id/eprint/360374
ISSN: 0171-967X
PURE UUID: 988e5c79-70d0-4f68-bb05-3c414a64bb0d
ORCID for Cyrus Cooper: ORCID iD orcid.org/0000-0003-3510-0709

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Date deposited: 05 Dec 2013 12:58
Last modified: 12 Nov 2019 01:57

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Contributors

Author: Olivier Bruyere
Author: Cyrus Cooper ORCID iD
Author: Karel Pavelka
Author: Véronique Rabenda
Author: Fanny Buckinx
Author: Charlotte Beaudart
Author: Jean-Yves Reginster

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