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. 2004 Apr 28;63(9):1124–1127. doi: 10.1136/ard.2004.021253

Rate of cartilage loss at two years predicts subsequent total knee arthroplasty: a prospective study

F Cicuttini 1, G Jones 1, A Forbes 1, A Wluka 1
PMCID: PMC1755122  PMID: 15115714

Abstract

Objective: To determine whether cartilage volume loss is an independent predictor of knee replacement.

Design: Prospective community based, four year prospective cohort study.

Methods: 123 subjects with mild to moderate symptomatic radiographic knee osteoarthritis were recruited by either advertising, the Victorian branch of the Arthritis Foundation of Australia, treating general practitioners, orthopaedic surgeons, or rheumatologists; 113 completed the study. Magnetic resonance imaging was carried out at baseline and at 2 years on the symptomatic knee. Rate of change in tibial cartilage volume was calculated. Subjects were then followed up at year 4 to determine whether they had undergone a knee replacement.

Results: The rate of tibial cartilage loss over two years was an independent predictor of knee replacement at four years. For every 1% increase in the rate of tibial cartilage loss there was a 20% increase risk of undergoing a knee replacement at four years (95% confidence interval, 10% to 30%). Those in the highest tertile of tibial cartilage loss had 7.1 (1.4 to 36.5) higher odds of undergoing a knee replacement than those in the lowest tertile. WOMAC score at baseline, female sex, and tibial bone size (but not age and radiographic score) were also predictors of knee replacement.

Conclusions: The data suggest that treatment targeted at reducing the rate of knee cartilage loss in subjects with symptomatic osteoarthritis may delay knee replacement. This has important implications in terms of prevention and therapeutic interventions in osteoarthritis.

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Selected References

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  1. Altman R. D., Hochberg M., Murphy W. A., Jr, Wolfe F., Lequesne M. Atlas of individual radiographic features in osteoarthritis. Osteoarthritis Cartilage. 1995 Sep;3 (Suppl A):3–70. [PubMed] [Google Scholar]
  2. Altman R., Asch E., Bloch D., Bole G., Borenstein D., Brandt K., Christy W., Cooke T. D., Greenwald R., Hochberg M. Development of criteria for the classification and reporting of osteoarthritis. Classification of osteoarthritis of the knee. Diagnostic and Therapeutic Criteria Committee of the American Rheumatism Association. Arthritis Rheum. 1986 Aug;29(8):1039–1049. doi: 10.1002/art.1780290816. [DOI] [PubMed] [Google Scholar]
  3. Altman R., Brandt K., Hochberg M., Moskowitz R., Bellamy N., Bloch D. A., Buckwalter J., Dougados M., Ehrlich G., Lequesne M. Design and conduct of clinical trials in patients with osteoarthritis: recommendations from a task force of the Osteoarthritis Research Society. Results from a workshop. Osteoarthritis Cartilage. 1996 Dec;4(4):217–243. doi: 10.1016/s1063-4584(05)80101-3. [DOI] [PubMed] [Google Scholar]
  4. Bellamy N. Outcome measurement in osteoarthritis clinical trials. J Rheumatol Suppl. 1995 Feb;43:49–51. [PubMed] [Google Scholar]
  5. Birrell Fraser, Afzal Cara, Nahit Elizabeth, Lunt Mark, Macfarlane Gary J., Cooper Cyrus, Croft Peter R., Hosie Gillian, Silman Alan J. Predictors of hip joint replacement in new attenders in primary care with hip pain. Br J Gen Pract. 2003 Jan;53(486):26–30. [PMC free article] [PubMed] [Google Scholar]
  6. Cicuttini F. M., Wluka A. E., Forbes A., Wolfe R. Comparison of tibial cartilage volume and radiologic grade of the tibiofemoral joint. Arthritis Rheum. 2003 Mar;48(3):682–688. doi: 10.1002/art.10840. [DOI] [PubMed] [Google Scholar]
  7. Cicuttini F., Forbes A., Morris K., Darling S., Bailey M., Stuckey S. Gender differences in knee cartilage volume as measured by magnetic resonance imaging. Osteoarthritis Cartilage. 1999 May;7(3):265–271. doi: 10.1053/joca.1998.0200. [DOI] [PubMed] [Google Scholar]
  8. Drake Cynthia, Ace Marcia, Maale Gerhard E. Revision total hip arthroplasty. AORN J. 2002 Sep;76(3):414-7, 419-27; quiz 428, 431-2. doi: 10.1016/s0001-2092(06)61655-4. [DOI] [PubMed] [Google Scholar]
  9. Eckstein F., Schnier M., Haubner M., Priebsch J., Glaser C., Englmeier K. H., Reiser M. Accuracy of cartilage volume and thickness measurements with magnetic resonance imaging. Clin Orthop Relat Res. 1998 Jul;(352):137–148. [PubMed] [Google Scholar]
  10. Hawker G. A., Wright J. G., Coyte P. C., Williams J. I., Harvey B., Glazier R., Badley E. M. Differences between men and women in the rate of use of hip and knee arthroplasty. N Engl J Med. 2000 Apr 6;342(14):1016–1022. doi: 10.1056/NEJM200004063421405. [DOI] [PubMed] [Google Scholar]
  11. Hawker G. A., Wright J. G., Coyte P. C., Williams J. I., Harvey B., Glazier R., Wilkins A., Badley E. M. Determining the need for hip and knee arthroplasty: the role of clinical severity and patients' preferences. Med Care. 2001 Mar;39(3):206–216. doi: 10.1097/00005650-200103000-00002. [DOI] [PubMed] [Google Scholar]
  12. Hawker Gillian A., Wright James G., Glazier Richard H., Coyte Peter C., Harvey Bart, Williams J. Ivan, Badley Elizabeth M. The effect of education and income on need and willingness to undergo total joint arthroplasty. Arthritis Rheum. 2002 Dec;46(12):3331–3339. doi: 10.1002/art.10682. [DOI] [PubMed] [Google Scholar]
  13. Jones G., Ding Changhai, Scott F., Glisson M., Cicuttini F. Early radiographic osteoarthritis is associated with substantial changes in cartilage volume and tibial bone surface area in both males and females. Osteoarthritis Cartilage. 2004 Feb;12(2):169–174. doi: 10.1016/j.joca.2003.08.010. [DOI] [PubMed] [Google Scholar]
  14. McAlindon T. Glusoamine for osteoarthritis: dawn of a new era? Lancet. 2001 Jan 27;357(9252):247–248. doi: 10.1016/S0140-6736(00)03606-0. [DOI] [PubMed] [Google Scholar]
  15. Peterfy C. G., van Dijke C. F., Janzen D. L., Glüer C. C., Namba R., Majumdar S., Lang P., Genant H. K. Quantification of articular cartilage in the knee with pulsed saturation transfer subtraction and fat-suppressed MR imaging: optimization and validation. Radiology. 1994 Aug;192(2):485–491. doi: 10.1148/radiology.192.2.8029420. [DOI] [PubMed] [Google Scholar]
  16. Reginster J. Y., Deroisy R., Rovati L. C., Lee R. L., Lejeune E., Bruyere O., Giacovelli G., Henrotin Y., Dacre J. E., Gossett C. Long-term effects of glucosamine sulphate on osteoarthritis progression: a randomised, placebo-controlled clinical trial. Lancet. 2001 Jan 27;357(9252):251–256. doi: 10.1016/S0140-6736(00)03610-2. [DOI] [PubMed] [Google Scholar]
  17. Williams M. H. Challenges for clinical decision making in the management of osteoarthritis of the knee. J Rheumatol. 1996 Apr;23(4):586–589. [PubMed] [Google Scholar]
  18. Wluka A. E., Wolfe R., Davis S. R., Stuckey S., Cicuttini F. M. Tibial cartilage volume change in healthy postmenopausal women: a longitudinal study. Ann Rheum Dis. 2004 Apr;63(4):444–449. doi: 10.1136/ard.2003.008433. [DOI] [PMC free article] [PubMed] [Google Scholar]
  19. Wluka Anita E., Stuckey Stephen, Snaddon Judith, Cicuttini Flavia M. The determinants of change in tibial cartilage volume in osteoarthritic knees. Arthritis Rheum. 2002 Aug;46(8):2065–2072. doi: 10.1002/art.10460. [DOI] [PubMed] [Google Scholar]

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