Abstract
Objective: There is significant variability in the trajectory of structural progression across people with knee osteoarthritis (OA). We aimed to identify distinct trajectories of femorotibial cartilage thickness over 2 years and develop a prediction model to identify individuals experiencing progressive cartilage loss. Methods: We analysed data from the Osteoarthritis Initiative (OAI) (n = 1,014). Latent class growth analysis (LCGA) was used to identify trajectories of medial femorotibial cartilage thickness assessed on magnetic resonance imaging (MRI) at baseline, 1 and 2 years. Baseline characteristics were compared between trajectory-based subgroups and a prediction model was developed including those with frequent knee symptoms at baseline (n = 686). To examine clinical relevance of the trajectories, we assessed their association with concurrent changes in knee pain and incidence of total knee replacement (TKR) over 4 years. Results: The optimal model identified three distinct trajectories: (1) stable (87.7% of the population, mean change −0.08 mm, SD 0.19); (2) moderate cartilage loss (10.0%, −0.75 mm, SD 0.16) and (3) substantial cartilage loss (2.2%, −1.38 mm, SD 0.23). Higher Western Ontario & McMaster Universities Osteoarthritis Index (WOMAC) pain scores, family history of TKR, obesity, radiographic medial joint space narrowing (JSN) ≥1 and pain duration ≤1 year were predictive of belonging to either the moderate or substantial cartilage loss trajectory [area under the curve (AUC) 0.79, 95% confidence interval (CI) 0.74, 0.84]. The two progression trajectories combined were associated with pain progression (OR 1.99, 95% CI 1.34, 2.97) and incidence of TKR (OR 4.34, 1.62, 11.62). Conclusions: A minority of individuals follow a progressive cartilage loss trajectory which was strongly associated with poorer clinical outcomes. If externally validated, the prediction model may help to select individuals who may benefit from cartilage-targeted therapies.
| Language | English |
|---|---|
| Pages | 257-265 |
| Number of pages | 9 |
| Journal | Osteoarthritis and Cartilage |
| Volume | 27 |
| Issue number | 2 |
| Early online date | 19 Oct 2018 |
| DOIs | |
| Publication status | Published - Feb 2019 |
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Keywords
- osteoarthritis
- knee
- cartilage
- magnetic resonance imaging
- disease progression
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Trajectories of femorotibial cartilage thickness among persons with or at risk of knee osteoarthritis : development of a prediction model to identify progressors. / Deveza, L. A.; Downie, A.; Tamez-Peña, J. G.; Eckstein, F.; Van Spil, W. E.; Hunter, D. J.
In: Osteoarthritis and Cartilage, Vol. 27, No. 2, 02.2019, p. 257-265.Research output: Contribution to journal › Article › Research › peer-review
TY - JOUR
T1 - Trajectories of femorotibial cartilage thickness among persons with or at risk of knee osteoarthritis
T2 - Osteoarthritis and Cartilage
AU - Deveza,L. A.
AU - Downie,A.
AU - Tamez-Peña,J. G.
AU - Eckstein,F.
AU - Van Spil,W. E.
AU - Hunter,D. J.
PY - 2019/2
Y1 - 2019/2
N2 - Objective: There is significant variability in the trajectory of structural progression across people with knee osteoarthritis (OA). We aimed to identify distinct trajectories of femorotibial cartilage thickness over 2 years and develop a prediction model to identify individuals experiencing progressive cartilage loss. Methods: We analysed data from the Osteoarthritis Initiative (OAI) (n = 1,014). Latent class growth analysis (LCGA) was used to identify trajectories of medial femorotibial cartilage thickness assessed on magnetic resonance imaging (MRI) at baseline, 1 and 2 years. Baseline characteristics were compared between trajectory-based subgroups and a prediction model was developed including those with frequent knee symptoms at baseline (n = 686). To examine clinical relevance of the trajectories, we assessed their association with concurrent changes in knee pain and incidence of total knee replacement (TKR) over 4 years. Results: The optimal model identified three distinct trajectories: (1) stable (87.7% of the population, mean change −0.08 mm, SD 0.19); (2) moderate cartilage loss (10.0%, −0.75 mm, SD 0.16) and (3) substantial cartilage loss (2.2%, −1.38 mm, SD 0.23). Higher Western Ontario & McMaster Universities Osteoarthritis Index (WOMAC) pain scores, family history of TKR, obesity, radiographic medial joint space narrowing (JSN) ≥1 and pain duration ≤1 year were predictive of belonging to either the moderate or substantial cartilage loss trajectory [area under the curve (AUC) 0.79, 95% confidence interval (CI) 0.74, 0.84]. The two progression trajectories combined were associated with pain progression (OR 1.99, 95% CI 1.34, 2.97) and incidence of TKR (OR 4.34, 1.62, 11.62). Conclusions: A minority of individuals follow a progressive cartilage loss trajectory which was strongly associated with poorer clinical outcomes. If externally validated, the prediction model may help to select individuals who may benefit from cartilage-targeted therapies.
AB - Objective: There is significant variability in the trajectory of structural progression across people with knee osteoarthritis (OA). We aimed to identify distinct trajectories of femorotibial cartilage thickness over 2 years and develop a prediction model to identify individuals experiencing progressive cartilage loss. Methods: We analysed data from the Osteoarthritis Initiative (OAI) (n = 1,014). Latent class growth analysis (LCGA) was used to identify trajectories of medial femorotibial cartilage thickness assessed on magnetic resonance imaging (MRI) at baseline, 1 and 2 years. Baseline characteristics were compared between trajectory-based subgroups and a prediction model was developed including those with frequent knee symptoms at baseline (n = 686). To examine clinical relevance of the trajectories, we assessed their association with concurrent changes in knee pain and incidence of total knee replacement (TKR) over 4 years. Results: The optimal model identified three distinct trajectories: (1) stable (87.7% of the population, mean change −0.08 mm, SD 0.19); (2) moderate cartilage loss (10.0%, −0.75 mm, SD 0.16) and (3) substantial cartilage loss (2.2%, −1.38 mm, SD 0.23). Higher Western Ontario & McMaster Universities Osteoarthritis Index (WOMAC) pain scores, family history of TKR, obesity, radiographic medial joint space narrowing (JSN) ≥1 and pain duration ≤1 year were predictive of belonging to either the moderate or substantial cartilage loss trajectory [area under the curve (AUC) 0.79, 95% confidence interval (CI) 0.74, 0.84]. The two progression trajectories combined were associated with pain progression (OR 1.99, 95% CI 1.34, 2.97) and incidence of TKR (OR 4.34, 1.62, 11.62). Conclusions: A minority of individuals follow a progressive cartilage loss trajectory which was strongly associated with poorer clinical outcomes. If externally validated, the prediction model may help to select individuals who may benefit from cartilage-targeted therapies.
KW - osteoarthritis
KW - knee
KW - cartilage
KW - magnetic resonance imaging
KW - disease progression
UR - http://www.scopus.com/inward/record.url?scp=85055878667&partnerID=8YFLogxK
U2 - 10.1016/j.joca.2018.09.015
DO - 10.1016/j.joca.2018.09.015
M3 - Article
VL - 27
SP - 257
EP - 265
JO - Osteoarthritis and Cartilage
JF - Osteoarthritis and Cartilage
SN - 1063-4584
IS - 2
ER -