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 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:	26
Deposited By:	Menzies Institute for Medical Research
Deposited On:	2017-09-27
Last Modified:	2018-06-22
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