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Knee effusion-synovitis volume measurement and effects of vitamin D supplementation in patients with knee osteoarthritis


Wang, X and Cicuttini, F and Jin, X and Wluka, AE and Han, W and Zhu, Z and Blizzard, L and Antony, B and Winzenberg, T and Jones, G and Ding, C, Knee effusion-synovitis volume measurement and effects of vitamin D supplementation in patients with knee osteoarthritis, Osteoarthritis and Cartilage, 25, (8) pp. 1304-1312. ISSN 1063-4584 (2017) [Refereed Article]

Copyright Statement

© 2017 Osteoarthritis Research Society International. Published by Elsevier Ltd. All rights reserved.

DOI: doi:10.1016/j.joca.2017.02.804


Objective: To develop a measure of knee joint effusion-synovitis volume and to examine the effect of vitamin D supplementation on effusion-synovitis in people with knee osteoarthritis (OA) and low vitamin D levels over 24 months.

Method: Symptomatic knee OA patients with low 25-(OH)D levels (12.5-60 nmol/l) were recruited for a multi-centre, randomised, placebo-controlled and double-blind trial. Participants (age 63 ± 7 years, 208 females) were allocated to either 50,000 IU monthly vitamin D3 (n = 209) or placebo (n = 204) for 24 months. Knee effusion-synovitis volume in suprapatellar and other regions was measured on magnetic resonance imaging (MRI) using OsiriX software. The intra-class correlation coefficients (ICCs) were used to test inter- and intra-rater reliabilities. The least significant change criterion was used to define the increase/decrease in effusion-synovitis volume.

Result: The reproducibilities of effusion-synovitis volume measurement were high with ICCs ranging from 0.93 to 0.99. Over 24 months, effusion-synovitis volume remained stable in the vitamin D group but increased in placebos with a significant between-group difference (-1.94 ml, 95% confidence interval (CI): -3.54, -0.33). This effect was evident in those with baseline effusion-synovitis and with suprapatellar effusion-synovitis. The proportion with an increase in effusion-synovitis volume was lower in the vitamin D group than placebo (risk ratio (RR): 0.87, 95% CI: 0.77, 0.97).

Conclusion: This highly reproducible effusion-synovitis volume measurement could be a promising outcome measure in OA trials. Vitamin D supplementation could retard the progression of effusion-synovitis which can potentially benefit people with an inflammatory OA phenotype.

Item Details

Item Type:Refereed Article
Keywords:effusion, knee osteoarthritis, randomised controlled trial, synovitis, vitamin D
Research Division:Biomedical and Clinical Sciences
Research Group:Clinical sciences
Research Field:Rheumatology and arthritis
Objective Division:Health
Objective Group:Clinical health
Objective Field:Clinical health not elsewhere classified
UTAS Author:Wang, X (Ms Xia Wang)
UTAS Author:Jin, X (Mr Xingzhong Jin)
UTAS Author:Han, W (Dr Weiyu Han)
UTAS Author:Zhu, Z (Mr Zhaohua Zhu)
UTAS Author:Blizzard, L (Professor Leigh Blizzard)
UTAS Author:Antony, B (Dr Benny Eathakkattu Antony)
UTAS Author:Winzenberg, T (Professor Tania Winzenberg)
UTAS Author:Jones, G (Professor Graeme Jones)
UTAS Author:Ding, C (Professor Chang-Hai Ding)
ID Code:121407
Year Published:2017
Web of Science® Times Cited:31
Deposited By:Menzies Institute for Medical Research
Deposited On:2017-09-27
Last Modified:2022-08-29

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