Can Structural Joint Damage Measured with MR Imaging Be Used to Predict Knee Replacement in the Following Year?
Can Structural Joint Damage Measured with MR Imaging Be Used to Predict Knee Replacement in the Following Year?
复制标题
DOI：
10.1148/radiol.14140991
复制
发表时间：
2015-03-01
期刊：
影响因子：
19.7
通讯作者：
Guermazi, Ali
中科院分区：
文献类型：
--
作者：
Roemer, Frank W.;Kwoh, C. Kent;Guermazi, Ali
目的：为了评估是否磁共振（MR）成像为基础的横截面措施的结构性关节损伤可以用来预测膝关节置换术在接下来的year.Materials和Methods：参与者来自骨关节炎倡议，纵向观察研究，包括4796名参与者有膝关节骨关节炎或风险。所有参与中心的机构审查委员会批准了符合HIPAA的方案，并获得了所有参与者的书面知情同意书。在5年的随访期间，199个膝关节接受了膝关节置换术，并与199个未接受膝关节置换术的对照膝关节进行了匹配。根据影像学疾病分期以及患者性别和年龄匹配膝关节。纳入了接受膝关节置换术并在术前一年获得MR图像的所有膝关节。在报告的膝关节置换术前，评估了MR图像的软骨损伤、骨髓损伤、关节损伤、关节挤压、滑膜炎和积液。应用条件Logistic回归分析评估膝关节置换术的风险。在房室和膝关节level.Results进行分析：参与者的平均年龄+/-标准差为64.2岁+/- 8.4（范围，47-82岁），主要是女性（398名参与者中有232名，58.3%）。膝关节置换术的风险显着增加，表现出两个或两个以上的亚区严重软骨损失的膝盖（比值比[OR]，16.5; 95%置信区间[CI]：3.96，68.76），两个以上亚区有骨髓病变（OR，4.00; 95% CI：1.75，9.16），内侧踝关节浸渍（OR，1.84; 95% CI：1.13，2.99），积液（OR，4.75; 95% CI：2.55，8.85）或滑膜炎（OR，2.17; 95% CI：1.33，3.56），但未挤出（OR，1.00; 95% CI：0.60，1.67），与未表现出这些特征的膝关节相比，作为参考标准。除膝关节挤压外，MR成像中所有组织异常特征均与临床预后相关，并可用于预测下一年的膝关节置换术。(C)RSNA，2014年
Purpose: To assess whether magnetic resonance (MR) imaging-based cross-sectional measures of structural joint damage can be used to predict knee replacement during the following year.Materials and Methods: Participants were drawn from the Osteoarthritis Initiative, a longitudinal observational study that includes 4796 participants who have knee osteoarthritis or are at risk. The HIPAA-compliant protocol was approved by the institutional review boards of all participating centers, and written informed consent was obtained from all participants. During the 5 years of follow-up, 199 knees underwent knee replacement and were matched with 199 control knees that did not undergo knee replacement. Knees were matched according to radiographic disease stage and patient sex and age. All knees that underwent knee replacement and had MR images available from the year before surgery were included. MR images were assessed for cartilage damage, bone marrow lesions, meniscal damage, meniscal extrusion, synovitis, and effusion prior to reported knee replacement. Conditional logistic regression was applied to assess the risk of knee replacement. Analyses were performed on a compartmental and knee level.Results: Participants had a mean age +/- standard deviation of 64.2 years +/- 8.4 (range, 47-82 years) and were predominantly women (232 of 398 participants, 58.3%). Risk for knee replacement was significantly increased for knees that exhibited two or more subregions with severe cartilage loss (odds ratio [OR], 16.5; 95% confidence interval [CI]: 3.96, 68.76), more than two subregions with bone marrow lesions (OR, 4.00; 95% CI: 1.75, 9.16), medial meniscal maceration (OR, 1.84; 95% CI: 1.13, 2.99), effusion (OR, 4.75; 95% CI: 2.55, 8.85), or synovitis (OR, 2.17; 95% CI: 1.33, 3.56), but not extrusion (OR, 1.00; 95% CI: 0.60, 1.67), when compared with knees that did not exhibit these features as the reference standard.Conclusion: Apart from meniscal extrusion, all features of tissue abnormalities at MR imaging were related to clinical prognosis and could be used to predict knee replacement in the following year. (C) RSNA, 2014