THU0675 ASSOCIATION OF GLUCOSE HOMEOSTASIS MEASURES AND METABOLIC SYNDROME WITH KNEE CARTILAGE DEFECTS AND CARTILAGE VOLUME IN YOUNG ADULTS

Objective.To compare the responsiveness of magnetic resonance imaging (MRI)-derived measures of knee osteoarthritis over 2.7 years.Methods.There were 430 community-based participants (mean age 63.0 yrs, range 51–79 yrs; 51% female) measured at baseline and 2.7 years later. MRI of the right knee at both timepoints was performed to assess cartilage volume, cartilage defects, bone marrow lesions (BML), meniscal pathology, and tibial bone area. Global measurements were calculated as the sum of tibial and femoral measures. Standardized response mean (SRM) was calculated as the mean of change divided by the SD of change.Results.Global tibiofemoral cartilage volume and cartilage defects had the best SRM of −0.80 and 0.62, respectively. Site-specific measurements were lower (SRM range for cartilage volume −0.48 to −0.54 and cartilage defects 0.33 to 0.49). The SRM for BML was 0.12, meniscal pathology 0.39, and tibial bone area −0.09. Cartilage volume and/or defects tended to be more responsive in those with knee pain, those who were obese, those who were older, and those with radiographic osteoarthritis.Conclusion.Global cartilage volume demonstrated the best sensitivity to change, suggesting that if we relied solely on SRM to optimize clinical trial design, then cartilage volume would be the best outcome measure. However, clinical trials have shown that cartilage volume may be less responsive to treatment compared to other measures that have lower SRM (such as BML). Therefore, although one can optimize trial efficiency by finding more responsive endpoints, both sensitivity to change and magnitude of benefit should be considered.

Download Full-text

Association between MRI-detected knee joint regional effusion-synovitis and structural changes in older adults: a cohort study

Annals of the Rheumatic Diseases ◽

10.1136/annrheumdis-2014-206676 ◽

2014 ◽

Vol 75 (3) ◽

pp. 519-525 ◽

Cited By ~ 36

Author(s):

Xia Wang ◽

Leigh Blizzard ◽

Andrew Halliday ◽

Weiyu Han ◽

Xingzhong Jin ◽

...

Keyword(s):

Older Adults ◽

Knee Joint ◽

Structural Changes ◽

Cartilage Volume ◽

Joint Effusion ◽

Cartilage Defects ◽

Knee Cartilage ◽

Cross Sectional ◽

Causal Pathways ◽

Suprapatellar Pouch

ObjectiveTo describe the cross-sectional and longitudinal associations between knee regional effusion-synovitis and structural changes in older adults.MethodsA total of 977 subjects were randomly selected from the local community (mean 62 years, 50% female) at baseline and 404 were followed up 2.6 years later. T2-weighted MRI was used to assess knee effusion-synovitis in four subregions: suprapatellar pouch, central portion, posterior femoral recess and subpopliteal recess. Knee cartilage defects, cartilage volume and bone marrow lesions (BMLs) were measured using MRI at baseline and follow-up.ResultsCross-sectionally, effusion-synovitis in most subregions was significantly associated with a higher risk of cartilage defects, BMLs and reduced cartilage volume. Longitudinally, suprapatellar pouch effusion-synovitis at baseline predicted an increase in cartilage defects (p<0.01), loss of cartilage volume (p=0.04) and an increase in BMLs (p=0.02) in multivariable analyses. The significant associations of effusion-synovitis with cartilage volume and BMLs disappeared after adjustment for cartilage defects. Effusion-synovitis in whole knee joint (p<0.01) and subpopliteal recess (p<0.05) was consistently associated with longitudinal changes in cartilage defects but not in cartilage volume and BMLs.ConclusionsThere are independent associations between knee joint effusion-synovitis and knee cartilage defects in both cross-sectional and longitudinal analyses, suggesting a potential causal relationship. The associations of effusion-synovitis with BMLs and cartilage volume were largely dependent on cartilage defects, suggesting potential causal pathways.

Download Full-text