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Changes in Structure and Symptoms in Knee Osteoarthritis and Prediction of Future Knee Replacement Over 8 Years

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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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References

  1. European Medicines Agency (2010) Guideline on clinical investigation of medicinal products used in the treatment of osteoarthritis. www.ema.europa.eu. Accessed 18 Jan 2013

  2. Food and Drug Administration (2011) Guidance for industry. Clinical development programs for drugs, devices, and biological products intended for the treatment of osteoarthritis. www.fda.gov. Accessed 18 Jan 2013

  3. Beaton DE, Bombardier C, Katz JN, Wright JG (2001) A taxonomy for responsiveness. J Clin Epidemiol 54:1204–1217

    Article  PubMed  CAS  Google Scholar 

  4. Ornetti P, Brandt K, Hellio-Le Graverand MP, Hochberg M, Hunter DJ, Kloppenburg M, Lane N, Maillefert JF, Mazzuca SA, Spector T, Utard-Wlerick G, Vignon E, Dougados M (2009) OARSI-OMERACT definition of relevant radiological progression in hip/knee osteoarthritis. Osteoarthritis Cartilage 17:856–863

    Article  PubMed  CAS  Google Scholar 

  5. Manno RL, Bingham CO 3rd, Paternotte S, Gossec L, Halhol H, Giacovelli G, Rovati L, Mazzuca SA, Clegg DO, Shi H, Tajana Messi E, Lanzarotti A, Dougados M (2012) OARSI-OMERACT initiative: defining thresholds for symptomatic severity and structural changes in disease modifying osteoarthritis drug (DMOAD) clinical trials. Osteoarthritis Cartilage 20:93–101

    Article  PubMed  CAS  Google Scholar 

  6. Gossec L, Paternotte S, Bingham CO 3rd, Clegg DO, Coste P, Conaghan PG, Davis AM, Giacovelli G, Gunther KP, Hawker G, Hochberg MC, Jordan JM, Katz JN, Kloppenburg M, Lanzarotti A, Lim K, Lohmander LS, Mahomed NN, Maillefert JF, Manno RL, March LM, Mazzuca SA, Pavelka K, Punzi L, Roos EM, Rovati LC, Shi H, Singh JA, Suarez-Almazor ME, Tajana-Messi E, Dougados M (2011) OARSI/OMERACT initiative to define states of severity and indication for joint replacement in hip and knee osteoarthritis. An OMERACT 10 Special Interest Group. J Rheumatol 38:1765–1769

    Article  PubMed  Google Scholar 

  7. Cicuttini FM, Jones G, Forbes A, Wluka AE (2004) Rate of cartilage loss at two years predicts subsequent total knee arthroplasty: a prospective study. Ann Rheum Dis 63:1124–1127

    Article  PubMed  CAS  Google Scholar 

  8. Bruyere O, Richy F, Reginster JY (2005) Three year joint space narrowing predicts long term incidence of knee surgery in patients with osteoarthritis: an eight year prospective follow up study. Ann Rheum Dis 64:1727–1730

    Article  PubMed  CAS  Google Scholar 

  9. Tanamas SK, Wluka AE, Pelletier JP, Pelletier JM, Abram F, Berry PA, Wang Y, Jones G, Cicuttini FM (2010) Bone marrow lesions in people with knee osteoarthritis predict progression of disease and joint replacement: a longitudinal study. Rheumatology (Oxford) 49:2413–2419

    Article  Google Scholar 

  10. Pavelka K, Gatterova J, Olejarova M, Machacek S, Giacovelli G, Rovati LC (2002) Glucosamine sulfate use and delay of progression of knee osteoarthritis: a 3-year, randomized, placebo-controlled, double-blind study. Arch Intern Med 162:2113–2123

    Article  PubMed  CAS  Google Scholar 

  11. Bruyere O, Pavelka K, Rovati LC, Gatterova J, Giacovelli G, Olejarova M, Deroisy R, Reginster JY (2008) Total joint replacement after glucosamine sulphate treatment in knee osteoarthritis: results of a mean 8-year observation of patients from two previous 3-year, randomised, placebo-controlled trials. Osteoarthritis Cartilage 16:254–260

    Article  PubMed  CAS  Google Scholar 

  12. Altman R, Asch E, Bloch D, Bole G, Borenstein D, Brandt K, Christy W, Cooke TD, Greenwald R, Hochberg M et al (1986) Development of criteria for the classification and reporting of osteoarthritis. Classification of osteoarthritis of the knee. Diagnostic and Therapeutic Criteria Committee of the American Rheumatism Association. Arthritis Rheum 29:1039–1049

    Article  PubMed  CAS  Google Scholar 

  13. Bellamy N, Buchanan WW, Goldsmith CH, Campbell J, Stitt LW (1988) Validation study of WOMAC: a health status instrument for measuring clinically important patient relevant outcomes to antirheumatic drug therapy in patients with osteoarthritis of the hip or knee. J Rheumatol 15:1833–1840

    PubMed  CAS  Google Scholar 

  14. Cooper C, Adachi JD, Bardin T, Berenbaum F, Flamion B, Jonsson H, Kanis JA, Pelousse F, Lems WF, Pelletier JP, Martel-Pelletier J, Reiter S, Reginster JY, Rizzoli R, Bruyere O (2013) How to define responders in osteoarthritis. Curr Med Res Opin 29:719–729

    Article  PubMed  Google Scholar 

  15. Raynauld JP, Martel-Pelletier J, Haraoui B, Choquette D, Dorais M, Wildi LM, Abram F, Pelletier JP (2011) 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. Ann Rheum Dis 70:1382–1388

    Article  PubMed  Google Scholar 

  16. Gossec L, Paternotte S, Maillefert JF, Combescure C, Conaghan PG, Davis AM, Gunther KP, Hawker G, Hochberg M, Katz JN, Kloppenburg M, Lim K, Lohmander LS, Mahomed NN, March L, Pavelka K, Punzi L, Roos EM, Sanchez-Riera L, Singh JA, Suarez-Almazor ME, Dougados M (2011) The role of pain and functional impairment in the decision to recommend total joint replacement in hip and knee osteoarthritis: an international cross-sectional study of 1909 patients. Report of the OARSI–OMERACT Task Force on Total Joint Replacement. Osteoarthritis Cartilage 19:147–154

    Article  PubMed  CAS  Google Scholar 

  17. Gossec L, Hawker G, Davis AM, Maillefert JF, Lohmander LS, Altman R, Cibere J, Conaghan PG, Hochberg MC, Jordan JM, Katz JN, March L, Mahomed N, Pavelka K, Roos EM, Suarez-Almazor ME, Zanoli G, Dougados M (2007) OMERACT/OARSI initiative to define states of severity and indication for joint replacement in hip and knee osteoarthritis. J Rheumatol 34:1432–1435

    PubMed  Google Scholar 

  18. Dougados M, Hawker G, Lohmander S, Davis AM, Dieppe P, Maillefert JF, Gossec L (2009) OARSI/OMERACT criteria of being considered a candidate for total joint replacement in knee/hip osteoarthritis as an endpoint in clinical trials evaluating potential disease modifying osteoarthritic drugs. J Rheumatol 36:2097–2099

    Article  PubMed  Google Scholar 

  19. Maheu E, Cadet C, Marty M, Dougados M, Ghabri S, Kerloch I, Mazieres B, Spector TD, Vignon E, Lequesne MG (2005) Reproducibility and sensitivity to change of various methods to measure joint space width in osteoarthritis of the hip: a double reading of three different radiographic views taken with a three-year interval. Arthritis Res Ther 7:R1375–R1385

    Article  PubMed  Google Scholar 

  20. LaValley MP, McLaughlin S, Goggins J, Gale D, Nevitt MC, Felson DT (2005) The lateral view radiograph for assessment of the tibiofemoral joint space in knee osteoarthritis: its reliability, sensitivity to change, and longitudinal validity. Arthritis Rheum 52:3542–3547

    Article  PubMed  Google Scholar 

  21. Ravaud P, Giraudeau B, Auleley GR, Chastang C, Poiraudeau S, Ayral X, Dougados M (1996) Radiographic assessment of knee osteoarthritis: reproducibility and sensitivity to change. J Rheumatol 23:1756–1764

    PubMed  CAS  Google Scholar 

  22. Hunter DJ, Zhang YQ, Tu X, Lavalley M, Niu JB, Amin S, Guermazi A, Genant H, Gale D, Felson DT (2006) Change in joint space width: hyaline articular cartilage loss or alteration in meniscus? Arthritis Rheum 54:2488–2495

    Article  PubMed  CAS  Google Scholar 

  23. Robine JM, Cambois E, Nusselder W, Jeune B, Oyen HV, Jagger C (2013) The joint action on healthy life years (JA: EHLEIS). Arch Public Health 71:2

    Article  PubMed  Google Scholar 

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Authors and Affiliations

  1. Department of Public Health, Epidemiology and Health Economics, University of Liège, CHU Sart-Tilman, Bât B23, 4000, Liège, Belgium

    Olivier Bruyere, Véronique Rabenda, Fanny Buckinx, Charlotte Beaudart & Jean-Yves Reginster

  2. MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton, UK

    Cyrus Cooper

  3. NIHR Musculoskeletal Biomedical Research Unit, University of Oxford, Oxford, UK

    Cyrus Cooper

  4. Department of Medicine and Rheumatology, Charles University, Prague, Czech Republic

    Karel Pavelka

Authors
  1. Olivier Bruyere
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  2. Cyrus Cooper
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  3. Karel Pavelka
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  4. Véronique Rabenda
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  5. Fanny Buckinx
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  6. Charlotte Beaudart
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  7. Jean-Yves Reginster
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Correspondence to Olivier Bruyere.

Additional information

Dr. Bruyere reports grants, personal fees, and nonfinancial support from IBSA, Rottapharm, Servier, and Theramax; grants and nonfinancial support from MSD, Novartis, and Pfizer; grants from Nutraveris; and personal fees from Bayer and SMB outside the submitted work. Dr. Cooper reports personal fees from Amgen, GSK, ABBH, MSD, Eli Lilly, Pfizer, Novartis, Servier, Medtronic, and Roche outside the submitted work. Dr. Reginster reports grants from Bristol Myers Squibb; grants and personal fees from Merck Sharp & Dohme, Rottapharm, Teva, Lilly, Novartis, Roche, GlaxoSmithKline, Amgen, and Servier; personal fees from IBSA, Genevrier, Teijin, Ebewee Pharma, Zodiac, Analis, Theramex, Nycomed, Novo-Nordisk, and Nolver outside the submitted work. All other authors have nothing to disclose.

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Bruyere, O., Cooper, C., Pavelka, K. et al. Changes in Structure and Symptoms in Knee Osteoarthritis and Prediction of Future Knee Replacement Over 8 Years. Calcif Tissue Int 93, 502–507 (2013). https://doi.org/10.1007/s00223-013-9781-z

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  • DOI: https://doi.org/10.1007/s00223-013-9781-z

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