Moderate Physical Activity and Prevention of Cartilage Loss in People With Knee Osteoarthritis: Data From the Osteoarthritis Initiative

Objective: To evaluate whether physical activity on prescription, comprising five sessions, was more effective in increasing physical activity than a one-hour advice session after six months. Design: Randomized, assessor-blinded, controlled trial. Setting: Primary care. Subjects: Patients with clinically verified osteoarthritis of the hip or knee who undertook less than 150 minute/week of moderate physical activity, and were aged 40–74 years. Interventions: The advice group ( n = 69) received a one-hour session with individually tailored advice about physical activity. The physical activity on prescription group ( n = 72) received individually tailored physical activity recommendations with written prescription, and four follow-ups during six months. Main measures: Patients were assessed at baseline and six months: physical activity (accelerometer, questionnaires); fitness (six-minute walk test, 30-second chair-stand test, maximal step-up test, one-leg rise test); pain after walking (VAS); symptoms (HOOS/KOOS); and health-related quality of life (EQ-5D). Results: One hundred four patients had knee osteoarthritis, 102 were women, and mean age was 60.3 ± 8.3 years. Pain after walking decreased significantly more in the prescription group, from VAS 31 ± 22 to 18 ± 23. There was no other between groups difference. Both groups increased self-reported activity minutes significantly, from 105 (95% CI 75–120) to 165 (95% CI 135–218) minute/week in the prescription group versus 75 (95% CI 75–105) to 150 (95% CI 120–225) in the advice group. Also symptoms and quality of life improved significantly in both groups. Conclusion: Individually tailored physical activity with written prescription and four follow-ups does not materially improve physical activity level more than advice about osteoarthritis and physical activity. Trial registration: ClinicalTrials.gov (NCT02387034).

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Does Bisphosphonate Increase the Sclerosis of Tibial Subchondral Bone in the Progression of Knee Osteoarthritis—A Propensity Score Matching Cohort Study Based on Osteoarthritis Initiative

Frontiers in Medicine ◽

10.3389/fmed.2021.781219 ◽

2021 ◽

Vol 8 ◽

Author(s):

Mingyang Li ◽

Yong Nie ◽

Yi Zeng ◽

Yuangang Wu ◽

Yuan Liu ◽

...

Keyword(s):

Physical Activity ◽

Knee Osteoarthritis ◽

Subchondral Bone ◽

Volume Fraction ◽

Short Form ◽

Activity Level ◽

Mineral Density ◽

Trabecular Thickness ◽

Significant Difference ◽

Osteoarthritis Initiative

Bisphosphonate has great potential in KOA therapy, but whether the anti-resorption mechanism of bisphosphonate aggravates sclerosis of subchondral bone remains unclear. We found that bisphosphonate use did not increase sclerosis of subchondral bone in established KOA, perhaps resolving some concerns about bisphosphonate in patients with KOA.Introduction: Most studies have focused on the protective effect of bisphosphonate on early knee osteoarthritis (KOA) through its anti-resorption mechanism in osteoclasts. However, late KOA has a decreased rate of resorption, which is the opposite of early KOA. The risk of subchondral bone sclerosis in late KOA after using bisphosphonate has not been investigated using morphometry.Methods: Forty-five patients who had ever used bisphosphonate (or 33 patients with current use) were matched with controls through propensity matching methods, including age, body mass index (BMI), sex, health status (12-Item Short Form Survey physical health score), physical activity level (Physical Activity Scale for the Elderly score), vitamin D use, and calcium use. At the baseline and 12-month (or 18-month) follow-up, bone mineral density (BMD) of the tibia and hip was measured by dual-energy X-ray absorptiometry (DXA), and medial tibial subchondral bone morphometry: bone volume fraction (BV/TV), trabecular thickness (Tb.Th), trabecular number (Tb.N), and trabecular separation (Tb.Sp) were calculated based on 3-T trabecular MRI. Data were obtained from the Bone Ancillary Study in the Osteoarthritis Initiative (OAI) project.Results: The yearly percentage change in hip BMD of the current bisphosphonate-use group was significantly greater than that of the non-bisphosphonate-use group (0.7% vs. −1%, P = 0.02). The other outcomes (BV/TV, Tb.N, Tb.Sp, Tb.Th, tibia medial BMD, and tibia lateral BMD) between the two groups presented no significant difference. The non-bisphosphonate-use group experienced a significant increase in Tb.Th [2%, 95% CI = (1%, 4%), P = 0.01], while the bisphosphonate-use group presented no significant change [1%, 95% CI = (−2%, 4%), P = 0.54].Conclusions: Bisphosphonate use did not increase sclerosis of subchondral bone in established KOA. Bisphosphonate might have a stage-dependent effect on subchondral bone in KOA initiation and progression.

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Machine learning predicts rate of cartilage loss: data from the osteoarthritis initiative (OAI) and the multicenter osteoarthritis (most) studies

Orthopaedic Journal of Sports Medicine ◽

10.1177/2325967120s00530 ◽

2020 ◽

Vol 8 (9_suppl7) ◽

pp. 2325967120S0053

Author(s):

T. Paixão ◽

M. DiFranco ◽

C. Goetz ◽

R. Ljuhar ◽

P. Meier ◽

...

Keyword(s):

Knee Osteoarthritis ◽

Plain Radiograph ◽

Joint Space Width ◽

Joint Space ◽

Cartilage Loss ◽

Validation Dataset ◽

Deterioration Process ◽

Patients At Risk ◽

Osteoarthritis Initiative ◽

Space Width

Introduction: Loss of cartilage is one of the hallmark radiographic symptoms of osteoarthritis and the direct cause of much of the disability directly related to OA. The rate of cartilage loss can range from a slow deterioration process, lasting decades, to a very rapid deterioration leading to complete loss in as little as 24 months 1. In fact, evidence has been gathering that a subset of OA patients develops an “accelerated” form of knee osteoarthritis 2. Hypotheses: The rate of cartilage loss can vary widely between patients at risk of or suffering from knee osteoarthritis (OA) but its causes remain unknown. We investigate prediction of future joint space width (JSW) loss from single time point quantitative and semi-quantitative radiographic features. Methods: Bilateral knee radiographs acquired at several time points in the context of the MOST study from 2651 patients (1079 female, 1572 male) were collected. Joint space narrowing (JSN), osteophyte and sclerosis OARSI grades, as well as Kellgren-Lawrence (KL) grade and joint space width were obtained from each image using an automated software algorithm. Individuals were classified as fast progressors if the rate of JSW loss, measured via linear regression, was above 10% baseline JSW. Fast progressors were predicted using a logistic regression model trained with KL and OARSI grades at baseline as independent variables. Independent validation was performed on 1900 individuals (1079 female, 821 male) from the Osteoarthritis Initiative (OAI) study. Performance was characterized by the area under the ROC curve (ROC-AUC). Confidence intervals were calculated by bootstrapping. Results: AUCs of 0.84 (0.82; 0.87) were achieved for classifying individual knees as fast progressors on the validation dataset (OAI). KL and sclerosis OARSI grades were the main predictors of rapid cartilage loss. Conclusion: We demonstrate prediction of future rapid cartilage loss from a single plain radiograph with validation on an independent dataset. Sclerosis OARSI grade, but not osteophytes OARSI grade, was a predictor of rapid cartilage loss, suggesting a non-canonical mode of OA progression.

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