scholarly journals OP0185 KNEE JOINT DISTRACTION IS MORE EFFICIENT IN RESTORING CARTILAGE THICKNESS THAN HIGH TIBIAL OSTEOTOMY IN PATIENTS WITH SEVERE KNEE OSTEOARTHRITIS

2020 ◽  
Vol 79 (Suppl 1) ◽  
pp. 114.2-115
Author(s):  
M. Jansen ◽  
S. Maschek ◽  
R. Van Heerwaarden ◽  
S. Mastbergen ◽  
W. Wirth ◽  
...  
Keyword(s):  
Stock Options ◽  
Joint Space Width ◽  
Joint Space ◽  
Cartilage Thickness ◽  
Tibial Osteotomy ◽  
Knee Oa ◽  
Leg Axis ◽  
Cartilage Restoration ◽  
Joint Distraction ◽  
Space Width

Background:Both high tibial osteotomy (HTO) and knee joint distraction (KJD) are joint preserving surgical techniques unloading the affected femorotibial compartment in patients with knee osteoarthritis (OA). While HTO permanently unloads the more affected compartment (MAC) by overcorrecting the leg axis, KJD temporarily unloads the whole joint by separating the tibia and femur for 5 mm for 6 weeks. In a previous randomized controlled trial (RCT), comparable clinical benefit and radiographic joint space width (JSW) increase over 2 years follow-up were demonstrated for both treatments1. Yet, comparison of JSW before and after HTO may be unreliable, as pseudo-widening of the unloaded compartment may occur due to the induced leg axis change. Therefore, direct cartilage thickness measurements need to be compared between KJD and HTO, to accurately evaluate the efficacy of both treatment options on cartilage structure.Objectives:To compare two-year cartilage thickness changes after treatment with KJDvsHTO and identify factors predicting cartilage thickness restoration.Methods:Patients indicated for HTO were randomized to KJD (KJDHTO) or HTO treatment. Patients indicated for total knee arthroplasty received KJD (KJDTKA). Standardized semi-flexed weight-bearing radiographs and 3T MRIs with 3D spoiled gradient recalled imaging sequence with fat suppression (SPGR-fs) were acquired before and two years after surgical treatment. Cartilage thickness in the knee was measured using Chondrometrics Works 3.0 software. On the radiographs the mean JSW in the MAC were measured with KIDA software. Readers were blinded to the type of intervention and acquisition order. The primary and secondary outcomes were the mean MAC cartilage thickness (ThCtAB) and percentage of denuded bone area (dABp) change before and two years after treatment (MRI), with radiographic joint space width (JSW) used as a reference.Results:No statistically significant differences in the baseline characteristics were seen between KJDHTO(n=18) and HTO (n=33). The KJDTKAgroup (n=18) had a higher age and Kellgren-Lawrence grade (KLG) than the HTO and KJDHTOgroups.KJDHTOpatients did not show significant changes in MAC cartilage thickness, dABp, or JSW over time (all p>0.10; figure 1). HTO patients displayed a decrease in MAC cartilage thickness and an increase in dABp (both p<0.03), but an increase in JSW (p=0.006). KJDTKAshowed a significant increase in MAC cartilage thickness and JSW and decrease in dABp (all p<0.01). Baseline OA severity was the strongest predictor of cartilage restoration. KJD patients with severe OA (KJDsevere; KLG ≥3) showed significant restoration (all p<0.01; figure 2); mild OA patients (KJDmild; KLG ≤2) showed a slight deterioration. KJDsevereshowed a significantly greater cartilage restoration response in the MAC than HTOseverefor cartilage thickness (p=0.005) and dABp (p=0.003), but not JSW change (p=0.521). The changes in all three parameters did not differ significantly between KJDmildand HTOmild(all p>0.08).Conclusion:In patients with severe knee OA, KJD is more efficient in restoring cartilage thickness than HTO is. In these patients, KJD causes significant cartilage restoration while HTO, despite shifting the leg axis and demonstrating radiographic joint space widening, shows loss of cartilage as measured on MRI. In patients with mild knee OA, neither HTO nor KJD treatment results in significant cartilage restoration and both treatments show a slight deterioration that is likely the result of natural OA progression. As such, this research promotes the choice KJD as joint-preserving surgery in case of knee OA patients with more severe structural damage.References:[1]MP Jansenet al, Cartilage 2019.Disclosure of Interests:Mylène Jansen: None declared, Susanne Maschek Shareholder of: Stock/stock options at Condrometrics GmbH, Employee of: Employment at Condrometrics GmbH, Ronald Van Heerwaarden: None declared, Simon Mastbergen: None declared, Wolfgang Wirth Shareholder of: Stock/stock options at Condrometrics GmbH, Consultant of: Consultancy to Galapagos NV, Employee of: Employment at Condrometrics GmbH, Floris Lafeber Shareholder of: Co-founder and shareholder of ArthroSave BV, Felix Eckstein Shareholder of: Stock/stock options at Condrometrics GmbH, Consultant of: Consultancy at Merck KGaA, Samumed, Bioclinica, Galapagos, Servier, Novartis, Employee of: Employment at Condrometrics GmbH, Speakers bureau: Development of educational presentations for Medtronic

scholarly journals Association between disease progression and depression onset in persons with radiographic knee osteoarthritis

Rheumatology ◽  
2020 ◽  
Vol 59 (11) ◽  
pp. 3390-3399
Author(s):  
Alan M Rathbun ◽  
Michelle D Shardell ◽  
Alice S Ryan ◽  
Michelle S Yau ◽  
Joseph J Gallo ◽  
...  
Keyword(s):  
Disease Progression ◽  
Disease Severity ◽  
Gait Speed ◽  
Joint Space Width ◽  
Joint Space ◽  
Knee Oa ◽  
Increased Risk ◽  
Pain Subscale ◽  
Space Width

Abstract Objectives Osteoarthritis (OA) disease progression may lead to deteriorating psychosocial function, but it is unclear what aspects of disease severity are related to the onset of depression. This study assessed which components of OA disease progression cumulatively contribute to depression onset in persons with radiographic knee OA. Methods Osteoarthritis Initiative participants (n = 1651) with radiographic disease (Kellgren-Lawrence grade ≥2) in one or both knees and below the screening threshold for probable depression [Center for Epidemiological Studies Depression (CES-D) scale &lt;16] at baseline were included. Disease severity was measured from baseline to the third annual follow-up visit using joint space width, 20-meter gait speed, and the Western Ontario and McMaster Universities Osteoarthritis Index pain subscale, each categorized into quintiles. Depression onset (CES-D ≥ 16) was assessed annually at four follow-up visits. Marginal structural models that account for time-dependent confounding and attrition evaluated the association between each time-varying disease severity measure and depression onset. Results Each disease severity measure exhibited a non-linear relationship concerning the probability of depression onset, with the higher quintiles generally being associated with a larger risk. The highest quintile (relative to the lowest) of joint space width and gait speed were both significantly associated with depression onset. By contrast, none of the higher pain quintiles compared with the lowest were significantly associated with the onset of depression. Conclusion Faster disease progression as measured by either worsening structural severity or decreasing physical performance corresponds to an increased risk of depression among individuals with radiographic knee OA.

scholarly journals The change of joint space width after medial open wedge high tibial osteotomy

2020 ◽  
Vol 28 ◽  
pp. S400-S401
Author(s):  
S.-H. Kim ◽  
H.-S. Moon ◽  
C.-H. Choi ◽  
M. Jung ◽  
T.-H. Lee
Keyword(s):  
High Tibial Osteotomy ◽  
Joint Space Width ◽  
Joint Space ◽  
Tibial Osteotomy ◽  
Open Wedge ◽  
Wedge High Tibial Osteotomy ◽  
Space Width

scholarly journals The responsiveness of 3D bone shape compared with radiographic joint space width and MR cartilage thickness

2013 ◽  
Vol 21 ◽  
pp. S177-S178
Author(s):  
M.A. Bowes ◽  
C.B. Wolstenholme ◽  
K. De Souza ◽  
G.R. Vincent ◽  
P. Conaghan
Keyword(s):  
Joint Space Width ◽  
Joint Space ◽  
Cartilage Thickness ◽  
Space Width

Medial joint space width and convergence angle change with time after medial opening-wedge high tibial osteotomy

The Knee ◽  
2020 ◽  
Vol 27 (6) ◽  
pp. 1923-1930
Author(s):  
Yueh-Cheng Tsai ◽  
Tzu-Hao Tseng ◽  
Cheng-Han Ho ◽  
Chun-Chieh Wang ◽  
Yin-Chuan Shih ◽  
...  
Keyword(s):  
High Tibial Osteotomy ◽  
Joint Space Width ◽  
Joint Space ◽  
Tibial Osteotomy ◽  
Opening Wedge ◽  
Convergence Angle ◽  
Angle Change ◽  
Wedge High Tibial Osteotomy ◽  
Space Width

Change in regional cartilage morphology and joint space width in osteoarthritis participants versus healthy controls: a multicentre study using 3.0 Tesla MRI and Lyon–Schuss radiography

2008 ◽  
Vol 69 (01) ◽  
pp. 155-162 ◽  
Author(s):  
M-P Hellio Le Graverand ◽  
R J Buck ◽  
B T Wyman ◽  
E Vignon ◽  
S A Mazzuca ◽  
...  
Keyword(s):  
Joint Space Width ◽  
Joint Space ◽  
Cartilage Thickness ◽  
Quantitative Mri ◽  
Sensitivity To Change ◽  
3.0 Tesla ◽  
Thickness Change ◽  
Risk Of Progression ◽  
3.0 T ◽  
Space Width

Objective:Cartilage morphology displays sensitivity to change in osteoarthritis (OA) with quantitative MRI (qMRI). However, (sub)regional cartilage thickness change at 3.0 Tesla (T) has not been directly compared with radiographic progression of joint space narrowing in OA participants and non-arthritic controls.Methods:A total of 145 women were imaged at 7 clinical centres: 86 were non-obese and asymptomatic without radiographic OA and 55 were obese with symptomatic and radiographic OA (27 Kellgren–Lawrence grade (KLG)2 and 28 KLG3). Lyon–Schuss (LS) and fixed flexion (FF) radiographs were obtained at baseline, 12 and 24 months, and coronal spoiled gradient echo MRI sequences at 3.0 T at baseline, 6, 12 and 24 months. (Sub)regional, femorotibial cartilage thickness and minimum joint space width (mJSW) in the medial femorotibial compartment were measured and the standardised response means (SRMs) determined.Results:At 6 months, qMRI demonstrated a −3.7% “annualised” change in cartilage thickness (SRM −0.33) in the central medial femorotibial compartment (cMFTC) of KLG3 subjects, but no change in KLG2 subjects. The SRM for mJSW in 12-month LS/FF radiographs of KLG3 participants was −0.68/−0.13 and at 24 months was −0.62/−0.20. The SRM for cMFTC changes measured with qMRI was −0.32 (12 months; −2.0%) and −0.48 (24 months; −2.2%), respectively.Conclusions:qMRI and LS radiography detected significant change in KLG3 participants at high risk of progression, but not in KLG2 participants, and only small changes in controls. At 12 and 24 months, LS displayed greater, and FF less, sensitivity to change in KLG3 participants than qMRI.

Identifying Phenotypes of Knee Osteoarthritis by Separate Quantitative Radiographic Features May Improve Patient Selection for More Targeted Treatment

2013 ◽  
Vol 40 (6) ◽  
pp. 891-902 ◽  
Author(s):  
Margot B. Kinds ◽  
Anne C.A. Marijnissen ◽  
Max A. Viergever ◽  
Pieter J. Emans ◽  
Floris P.J.G. Lafeber ◽  
...  
Keyword(s):  
Bone Density ◽  
Clinical Characteristics ◽  
Joint Space Width ◽  
Specific Treatment ◽  
Joint Space ◽  
Radiographic Features ◽  
Knee Oa ◽  
Improve Patient Selection ◽  
Space Width ◽  
Varus Angle

Objective.Expression of osteoarthritis (OA) varies significantly between individuals, and over time, suggesting the existence of different phenotypes, possibly with specific etiology and targets for treatment. Our objective was to identify phenotypes of progression of radiographic knee OA using separate quantitative features.Methods.Separate radiographic features of OA were measured by Knee Images Digital Analysis (KIDA) in individuals with early knee OA (the CHECK cohort: Cohort Hip & Cohort Knee), at baseline and at 2-year and 5-year followup. Hierarchical clustering was performed to identify phenotypes of radiographic knee OA progression. The phenotypes identified were compared for changes in joint space width (JSW), varus angle, osteophyte area, eminence height, bone density, for Kellgren-Lawrence (K-L) grade, and for clinical characteristics. Logistic regression analysis evaluated whether baseline radiographic features and demographic/clinical characteristics were associated with each of the specific phenotypes.Results.The 5 clusters identified were interpreted as “Severe” or “No,” “Early” or “Late” progression of the radiographic features, or specific involvement of “Bone density.” Medial JSW, varus angle, osteophyte area, eminence height, and bone density at baseline were associated with the Severe and Bone density phenotypes. Lesser eminence height and bone density were associated with Early and Late progression. Larger varus angle and smaller osteophyte area were associated with No progression.Conclusion.Five phenotypes of radiographic progression of early knee OA were identified using separate quantitative features, which were associated with baseline radiographic features. Such phenotypes might require specific treatment and represent relevant subgroups for clinical trials.

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