Three year joint space narrowing predicts long term incidence of knee surgery in patients with osteoarthritis: an eight year prospective follow up study
Three year joint space narrowing predicts long term incidence of knee surgery in patients with osteoarthritis: an eight year prospective follow up study
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DOI：
10.1136/ard.2005.037309
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发表时间：
2005-12-01
影响因子：
27.4
通讯作者：
Reginster, JY
中科院分区：
文献类型：
--
作者：
Bruyere, O;Richy, F;Reginster, JY
目的：评估股胫关节间隙狭窄（JSN）的平均值和最小值的临床相关性，预测未来的骨关节炎相关手术在膝骨关节炎patients with knee osteoarthritis.Methods：126例原发性膝骨关节炎患者进行了前瞻性随访，平均8年。最小和平均关节间隙宽度（JSW）在基线和随访3年后根据标准X线片进行评估。结果：经过平均8年的随访，16例（12.7%）患者接受了骨关节炎相关的关节手术。用于预测骨关节炎手术的受试者工作特征曲线分析得出的曲线下面积（AUC）对于最小JSN为0.73（p = 0.006），对于平均JSN为0.55（p = 0.54）。最小JSN最大化预测未来手术的灵敏度和特异性的截止值是三年内最小关节间隙宽度变化0.7 mm或更多。然而，对于0.5和0.8 mm之间的临界值，未观察到有意义的差异。（根据年龄、体重指数、基线症状和基线JSW调整）在8年随访期间经历骨关节炎相关手术的患者为5.15（95%置信区间，1.70至15.60）（p = 0.004）在研究的前三年内，关节间隙最小狭窄0.7 mm或以上的患者。在标准X线片上测量的最小JSN的临界值为0.5至0.8 mm，反映了膝关节骨关节炎患者的临床相关进展。
Objective: To assess the clinical relevance of mean and minimum femorotibial joint space narrowing (JSN) for predicting future osteoarthritis related surgery in patients with knee osteoarthritis.Methods: 126 subjects with primary knee osteoarthritis were followed prospectively for a mean eight years. Minimum and mean joint space width (JSW) were assessed from standard x rays at baseline and after a follow up of three years. The rate of knee osteoarthritis related surgery was recorded for the following five years.Results: After a mean follow up of eight years, 16 patients (12.7%) had received osteoarthritis related joint surgery. The areas under the curves (AUC) resulting from the receiver operating characteristic curve analyses for predicting osteoarthritis surgery were 0.73 (p = 0.006) for minimum JSN and 0.55 (p = 0.54) for mean JSN. The cut off for minimum JSN maximising sensitivity and specificity for predicting future surgery was a change of 0.7 mm or more in minimum joint space width over a period of three years. However, no meaningful differences were observed for cut off values between 0.5 and 0.8 mm The relative risk (adjusted for age, body mass index, baseline symptoms, and baseline JSW) of experiencing osteoarthritis related surgery during the eight year of follow up was 5.15 (95% confidence interval, 1.70 to 15.60) (p = 0.004) in patients with a minimum joint space narrowing of 0.7 mm or more during the first three years of the study.Conclusions: A cut off of 0.5 to 0.8 mm in minimum JSN, measured on standard x rays, reflects a clinically relevant progression in patients with knee osteoarthritis.