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Greater Rates of Cartilage Loss in Painful Knees Than in Pain-Free Knees After Adjustment for Radiographic Disease Stage Data From the Osteoarthritis Initiative

Eckstein, Felix; Cotofana, Sebastian; Wirth, Wolfgang; Nevitt, Michael; John, Markus R.; Dreher, Donatus and Frobell, Richard LU (2011) In Arthritis and Rheumatism 63(8). p.2257-2267
Abstract
Objective. To investigate whether rates of cartilage loss differ in knees with frequent baseline pain versus those without pain, after adjustment for radiographic osteoarthritis (OA) stage. Methods. One knee in each of 718 Osteoarthritis Initiative participants was examined: 310 with calculated Kellgren/Lawrence (K/L) grade 2, 299 with calculated K/L grade 3, and 109 with calculated K/L grade 4. Twelve-month change in (subregional) cartilage thickness was assessed by magnetic resonance imaging. Change in cartilage thickness in the central subregion of the weight-bearing medial femoral condyle and ordered value 1 (OV1) were selected as primary end points. Frequent knee symptoms were defined as pain, aching, or stiffness on most days of at... (More)
Objective. To investigate whether rates of cartilage loss differ in knees with frequent baseline pain versus those without pain, after adjustment for radiographic osteoarthritis (OA) stage. Methods. One knee in each of 718 Osteoarthritis Initiative participants was examined: 310 with calculated Kellgren/Lawrence (K/L) grade 2, 299 with calculated K/L grade 3, and 109 with calculated K/L grade 4. Twelve-month change in (subregional) cartilage thickness was assessed by magnetic resonance imaging. Change in cartilage thickness in the central subregion of the weight-bearing medial femoral condyle and ordered value 1 (OV1) were selected as primary end points. Frequent knee symptoms were defined as pain, aching, or stiffness on most days of at least 1 month during the previous year. Results. The mean 12-month rate of change in cartilage thickness in the central subregion of the medial femoral condyle was -12 mu m (standardized response mean [SRM] -0.15) in knees without pain (n = 146), -27 mu m (SRM -0.25) in those with infrequent pain (n = 255), and -54 mu m (SRM -0.32) in those with frequent pain (n = 317). Rates differed significantly between frequently painful knees and pain-free knees after adjustment for age, sex, body mass index, and calculated K/L grade (P = 0.011, R-2 = 2.6%, partial R2 for frequent pain = 1.4%). Similar results were found in stratified samples of calculated K/L grade 2/calculated K/L grade 3 knees, and in analyses restricted to knees with consistent pain frequency between baseline and followup. OV1 results showed similar trends but were not significant. Conclusion. Knees with frequent pain display greater rates of medial cartilage loss longitudinally than knees without pain, with or without adjustment or stratification for radiographic disease stage. Enrollment of participants with frequent knee pain in clinical trials can increase the observed rate of structural progression (i.e., cartilage loss) and sensitivity to change. (Less)
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author
organization
publishing date
type
Contribution to journal
publication status
published
subject
in
Arthritis and Rheumatism
volume
63
issue
8
pages
2257 - 2267
publisher
John Wiley & Sons
external identifiers
  • wos:000293840200015
  • scopus:79961111288
ISSN
1529-0131
DOI
10.1002/art.30414
language
English
LU publication?
yes
id
23a906c8-e07a-40e4-8e98-9a08c7346c29 (old id 2162198)
date added to LUP
2011-10-03 08:39:39
date last changed
2017-10-22 03:03:06
@article{23a906c8-e07a-40e4-8e98-9a08c7346c29,
  abstract     = {Objective. To investigate whether rates of cartilage loss differ in knees with frequent baseline pain versus those without pain, after adjustment for radiographic osteoarthritis (OA) stage. Methods. One knee in each of 718 Osteoarthritis Initiative participants was examined: 310 with calculated Kellgren/Lawrence (K/L) grade 2, 299 with calculated K/L grade 3, and 109 with calculated K/L grade 4. Twelve-month change in (subregional) cartilage thickness was assessed by magnetic resonance imaging. Change in cartilage thickness in the central subregion of the weight-bearing medial femoral condyle and ordered value 1 (OV1) were selected as primary end points. Frequent knee symptoms were defined as pain, aching, or stiffness on most days of at least 1 month during the previous year. Results. The mean 12-month rate of change in cartilage thickness in the central subregion of the medial femoral condyle was -12 mu m (standardized response mean [SRM] -0.15) in knees without pain (n = 146), -27 mu m (SRM -0.25) in those with infrequent pain (n = 255), and -54 mu m (SRM -0.32) in those with frequent pain (n = 317). Rates differed significantly between frequently painful knees and pain-free knees after adjustment for age, sex, body mass index, and calculated K/L grade (P = 0.011, R-2 = 2.6%, partial R2 for frequent pain = 1.4%). Similar results were found in stratified samples of calculated K/L grade 2/calculated K/L grade 3 knees, and in analyses restricted to knees with consistent pain frequency between baseline and followup. OV1 results showed similar trends but were not significant. Conclusion. Knees with frequent pain display greater rates of medial cartilage loss longitudinally than knees without pain, with or without adjustment or stratification for radiographic disease stage. Enrollment of participants with frequent knee pain in clinical trials can increase the observed rate of structural progression (i.e., cartilage loss) and sensitivity to change.},
  author       = {Eckstein, Felix and Cotofana, Sebastian and Wirth, Wolfgang and Nevitt, Michael and John, Markus R. and Dreher, Donatus and Frobell, Richard},
  issn         = {1529-0131},
  language     = {eng},
  number       = {8},
  pages        = {2257--2267},
  publisher    = {John Wiley & Sons},
  series       = {Arthritis and Rheumatism},
  title        = {Greater Rates of Cartilage Loss in Painful Knees Than in Pain-Free Knees After Adjustment for Radiographic Disease Stage Data From the Osteoarthritis Initiative},
  url          = {http://dx.doi.org/10.1002/art.30414},
  volume       = {63},
  year         = {2011},
}