Logo of annrheumdAnnals of the Rheumatic DiseasesVisit this articleSubmit a manuscriptReceive email alertsContact usBMJ
Ann Rheum Dis. Sep 2004; 63(9): 1124–1127.
Published online Apr 28, 2004. doi:  10.1136/ard.2004.021253
PMCID: PMC1755122

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

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.

Full Text

The Full Text of this article is available as a PDF (65K).

Selected References

These references are in PubMed. This may not be the complete list of references from this article.
  • Reginster JY, Deroisy R, Rovati LC, Lee RL, Lejeune E, Bruyere O, Giacovelli G, Henrotin Y, Dacre JE, 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. [PubMed]
  • McAlindon T. Glusoamine for osteoarthritis: dawn of a new era? Lancet. 2001 Jan 27;357(9252):247–248. [PubMed]
  • Hawker GA, Wright JG, Coyte PC, Williams JI, Harvey B, Glazier R, Wilkins A, Badley EM. Determining the need for hip and knee arthroplasty: the role of clinical severity and patients' preferences. Med Care. 2001 Mar;39(3):206–216. [PubMed]
  • Drake Cynthia, Ace Marcia, Maale Gerhard E. Revision total hip arthroplasty. AORN J. 2002 Sep;76(3):414–432. [PubMed]
  • Hawker GA, Wright JG, Coyte PC, Williams JI, Harvey B, Glazier R, Badley EM. 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. [PubMed]
  • 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. [PubMed]
  • 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]
  • Williams MH. Challenges for clinical decision making in the management of osteoarthritis of the knee. J Rheumatol. 1996 Apr;23(4):586–589. [PubMed]
  • Peterfy CG, van Dijke CF, Janzen DL, Glüer CC, Namba R, Majumdar S, Lang P, Genant HK. 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. [PubMed]
  • Eckstein F, Schnier M, Haubner M, Priebsch J, Glaser C, Englmeier KH, Reiser M. Accuracy of cartilage volume and thickness measurements with magnetic resonance imaging. Clin Orthop Relat Res. 1998 Jul;(352):137–148. [PubMed]
  • 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. [PubMed]
  • Cicuttini FM, Wluka AE, Forbes A, Wolfe R. Comparison of tibial cartilage volume and radiologic grade of the tibiofemoral joint. Arthritis Rheum. 2003 Mar;48(3):682–688. [PubMed]
  • 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. [PubMed]
  • Wluka AE, Wolfe R, Davis SR, Stuckey S, Cicuttini FM. Tibial cartilage volume change in healthy postmenopausal women: a longitudinal study. Ann Rheum Dis. 2004 Apr;63(4):444–449. [PMC free article] [PubMed]
  • Altman R, Asch E, Bloch D, Bole G, Borenstein D, Brandt K, Christy W, Cooke TD, Greenwald R, Hochberg M, et al. 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. [PubMed]
  • Bellamy N. Outcome measurement in osteoarthritis clinical trials. J Rheumatol Suppl. 1995 Feb;43:49–51. [PubMed]
  • Altman RD, Hochberg M, Murphy WA, Jr, Wolfe F, Lequesne M. Atlas of individual radiographic features in osteoarthritis. Osteoarthritis Cartilage. 1995 Sep;3 (Suppl A):3–70. [PubMed]
  • Altman R, Brandt K, Hochberg M, Moskowitz R, Bellamy N, Bloch DA, Buckwalter J, Dougados M, Ehrlich G, Lequesne M, et al. 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. [PubMed]
  • 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. [PubMed]

Articles from Annals of the Rheumatic Diseases are provided here courtesy of BMJ Group

Formats:

Related citations in PubMed

See reviews...See all...

Cited by other articles in PMC

See all...

Links

  • PubMed
    PubMed
    PubMed citations for these articles

Recent Activity

Your browsing activity is empty.

Activity recording is turned off.

Turn recording back on

See more...