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Associations between knee effusion-synovitis and joint structural changes in patients with knee osteoarthritis


Wang, X and Jin, X and Blizzard, L and Antony, B and Han, W and Zhu, Z and Cicuttini, F and Wluka, AE and Winzenberg, T and Jones, G and Ding, C, Associations between knee effusion-synovitis and joint structural changes in patients with knee osteoarthritis, Journal of Rheumatology, 44, (11) pp. 1644-1651. ISSN 0315-162X (2017) [Refereed Article]

Copyright Statement

The Journal of Rheumatology Copyright © 2017

DOI: doi:10.3899/jrheum.161596


Objective: To describe the associations between effusion-synovitis and joint structural abnormalities in patients with knee osteoarthritis (OA) over 24 months.

Methods: A posthoc analysis using data from a randomized controlled trial in 413 patients with symptomatic OA (aged 63 ± 7 yrs, 208 women). Knee effusion-synovitis volume and score, cartilage defects, cartilage volume, and bone marrow lesions (BML) were assessed using magnetic resonance imaging. Joint space narrowing (JSN) and osteophytes were assessed using radiograph. Least significant change criterion was used to define change in effusion-synovitis volume. Knee symptoms were assessed by Western Ontario and McMaster University OA Index. Multivariable linear/logistic regression and multilevel generalized mixed-effects models were used in longitudinal analyses.

Results: Total effusion-synovitis volume increased modestly from baseline (8.0 ± 8.5 ml) to followup (9.0 ± 10.5 ml). Baseline BML, cartilage defect, JSN, and osteophyte scores were positively associated with change in effusion-synovitis volume (p < 0.05). Baseline cartilage defects and JSN were also associated with change in effusion-synovitis score (p < 0.05). However, neither baseline effusion-synovitis score nor volume consistently predicted change in the above structures except cartilage volume. In the mixed-effects models, knee effusion-synovitis was positively associated with BML (volume: β = 1.19 ml/grade; score: OR = 1.75/grade) and cartilage defects (volume: β = 1.87 ml/grade; score: OR = 2.22/grade), while negatively associated with cartilage volume loss. Change in effusion-synovitis volume was positively correlated with changes in knee pain and stiffness scores (p < 0.05).

Conclusion: Knee cartilage and subchondral bone abnormalities predicted change in effusion-synovitis, but effusion-synovitis did not predict knee structural changes. These findings suggest that synovial inflammation is likely the result of joint structural abnormalities in established OA.

Item Details

Item Type:Refereed Article
Keywords:effusion, knee osteoarthritis, magnetic resonance imaging, synovitis
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:Blizzard, L (Professor Leigh Blizzard)
UTAS Author:Antony, B (Dr Benny Eathakkattu Antony)
UTAS Author:Han, W (Dr Weiyu Han)
UTAS Author:Zhu, Z (Mr Zhaohua Zhu)
UTAS Author:Winzenberg, T (Professor Tania Winzenberg)
UTAS Author:Jones, G (Professor Graeme Jones)
UTAS Author:Ding, C (Professor Chang-Hai Ding)
ID Code:121500
Year Published:2017
Web of Science® Times Cited:23
Deposited By:Menzies Institute for Medical Research
Deposited On:2017-09-30
Last Modified:2022-08-29

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