Orthopedics Medical News about knee OA;predictors of joint replacement

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Clinical and ultrasonographic predictors of joint replacement for knee osteoarthritis: Results from a large, 3 year, prospective EULAR study
Annals of Rheumatic Diseases, 06/02/09

Conaghan PG et al. – Longitudinal evaluation of the OA cohort demonstrated significant progression to joint replacement. In addition to severity of radiographic damage and pain, ultrasonographic detected effusion was a predictor of subsequent joint replacement.

Methods

Aim was to determine clinical and ultrasonographic predictors of joint replacement surgery across Europe in primary OA of the knee
3-year prospective study of a painful OA knee cohort
All subjects had clinical evaluation, radiographs and ultrasonography (US) at study entry
Rate of knee replacement surgery over 3-yr f/u period was determined using Kaplan-Meier survival data analyses
Potential baseline predictors included demographic, clinical, radiographic and US features

Results

531/600 (88.5%) pts, mean age 67±10 yrs, mean disease duration 6.1±6.9 yrs had f/u data and were analysed
During f/u knee replacement was done or required for 94 pts
Multivariate analysis- predictors of joint replacement were:
- Kellgren & Lawrence radiographic grade
- Ultrasonographic knee effusion
- Knee pain intensity on a 0-100 mm VAS and
- Disease duration
Clinically detected effusion and US synovitis were not associated with joint replacement in the univariate analysis

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