Is the Severity of Knee Osteoarthritis on Magnetic Resonance Imaging Associated With Outcome of Exercise Therapy?
Is the Severity of Knee Osteoarthritis on Magnetic Resonance Imaging Associated With Outcome of Exercise Therapy?
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DOI：
10.1002/acr.22128
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发表时间：
2014-01-01
影响因子：
4.7
通讯作者：
Lems, W. F.
中科院分区：
文献类型：
--
作者：
Knoop, J.;Dekker, J.;Lems, W. F.
目的：在一项探索性研究中，评估磁共振成像 (MRI) 上的膝骨关节炎 (OA) 严重程度与接受运动疗法治疗的膝骨关节炎 (OA) 患者的治疗结果之间的关联。方法在为期 12 周的运动计划中，95 名膝骨关节炎 (OA) 患者在治疗前获得了膝关节的 3.0T MRI 扫描。根据波士顿利兹骨关节炎膝关节评分方法，对 MRI 数据的多个特征（软骨完整性、骨髓病变、骨赘形成、积液/滑膜炎和半月板异常）的 OA 严重程度进行系统评估。进行回归分析来分析 MRI 上的 OA 严重程度（针对胫股骨和髌股 [PF] 室）与运动治疗结果之间的关联，即活动限制的变化（西安大略大学和麦克马斯特大学骨关节炎指数身体功能；主要结果）、疼痛和大腿肌肉力量以及治疗反应（风湿病/国际骨关节炎研究协会的结果测量）结果经过 12 周的运动治疗，活动限制、疼痛和肌肉力量平均分别改善了 24%、34% 和 21%（P < 0.001）。 PF 软骨完整性异常的严重程度与活动限制 (P = 0.01) 和肌肉力量 (P = 0.04) 的改善较少显着相关。 PF 骨赘形成的严重程度与肌肉力量改善较少显着相关（P < 0.01）。 MRI 上的所有其他特征均与治疗结果无关。结论 除了 PF 室中软骨完整性和骨赘形成的异常之外，运动疗法的有效性似乎与 MRI 上 OA 的严重程度无关。我们的研究表明，MRI 上显示的所有级别的 OA 严重程度都可以从专业监督的运动疗法中受益，尽管对于晚期 PF OA 患者的效果可能会降低。
ObjectiveTo evaluate associations between severity of knee osteoarthritis (OA) on magnetic resonance imaging (MRI) and treatment outcomes in knee OA patients treated with exercise therapy in an exploratory study.MethodsNinety-five participants with knee OA in a 12-week exercise program had obtained 3.0T MRI scans of the knee joint prior to treatment. MRI data were systematically assessed for OA severity of multiple features (cartilage integrity, bone marrow lesions, osteophyte formation, effusion/synovitis, and meniscal abnormalities) according to the Boston Leeds Osteoarthritis Knee Score method. Regression analyses were performed to analyze associations between OA severity on MRI (for the tibiofemoral and patellofemoral [PF] compartments) and outcome of exercise therapy, i.e., changes in activity limitations (Western Ontario and McMaster Universities Osteoarthritis Index physical function; primary outcome), pain and upper leg muscle strength, and treatment response (Outcome Measures in Rheumatology/Osteoarthritis Research Society International criteria).ResultsImprovements of 24%, 34%, and 21% on average in activity limitations, pain, and muscle strength, respectively, after 12-week exercise therapy were found (P < 0.001). Severity of abnormalities in PF cartilage integrity was significantly associated with fewer improvements in both activity limitations (P = 0.01) and muscle strength (P = 0.04). Severity of PF osteophyte formation was significantly associated with fewer improvements in muscle strength (P < 0.01). All other features on MRI were not associated with treatment outcome.ConclusionEffectiveness of exercise therapy seems to be independent of OA severity on MRI, except for abnormalities in cartilage integrity and osteophyte formation, both in the PF compartment. Our study suggests that all grades of OA severity on MRI can benefit from professionally supervised exercise therapy, although the effects might be reduced in patients with advanced PF OA.