Clinical and ultrasonographic predictors of joint replacement for knee osteoarthritis: results from a large, 3-year, prospective EULAR study.

Détails

ID Serval
serval:BIB_745691004A62
Type
Article: article d'un périodique ou d'un magazine.
Collection
Publications
Titre
Clinical and ultrasonographic predictors of joint replacement for knee osteoarthritis: results from a large, 3-year, prospective EULAR study.
Périodique
Annals of the Rheumatic Diseases
Auteur(s)
Conaghan P.G., D'Agostino M.A., Le Bars M., Baron G., Schmidely N., Wakefield R., Ravaud P., Grassi W., Martin-Mola E., So A., Backhaus M., Malaise M., Emery P., Dougados M.
ISSN
1468-2060[electronic], 0003-4967[linking]
Statut éditorial
Publié
Date de publication
2010
Volume
69
Numéro
4
Pages
644-647
Langue
anglais
Résumé
OBJECTIVES: To determine clinical and ultrasonographic predictors of joint replacement surgery across Europe in primary osteoarthritis (OA) of the knee. METHODS: This was a 3-year prospective study of a painful OA knee cohort (from a EULAR-sponsored, multicentre study). All subjects had clinical evaluation, radiographs and ultrasonography (US) at study entry. The rate of knee replacement surgery over the 3-year follow-up period was determined using Kaplan-Meier survival data analyses. Predictive factors for joint replacement were identified by univariate log-rank test then multivariate analysis using a Cox proportional-hazards regression model. Potential baseline predictors included demographic, clinical, radiographic and US features. RESULTS: Of the 600 original patients, 531 (88.5%), mean age 67+/-10 years, mean disease duration 6.1+/-6.9 years, had follow-up data and were analysed. During follow-up (median 3 years; range 0-4 years), knee replacement was done or required for 94 patients (estimated event rate of 17.7%). In the multivariate analysis, predictors of joint replacement were as follows: Kellgren and Lawrence radiographic grade (grade > or =III vs <III, hazards ratio (HR) = 4.08 (95% CI 2.34 to 7.12), p<0.0001); ultrasonographic knee effusion (> or =4 mm vs <4 mm) (HR = 2.63 (95% CI 1.70 to 4.06), p<0.0001); knee pain intensity on a 0-100 mm visual analogue scale (> or =60 vs <60) (HR = 1.81 (95% CI 1.15 to 2.83), p=0.01) and disease duration (> or =5 years vs <5 years) (HR=1.63 (95% CI 1.08 to 2.47), p=0.02). Clinically detected effusion and US synovitis were not associated with joint replacement in the univariate analysis. CONCLUSION: Longitudinal evaluation of this OA cohort demonstrated significant progression to joint replacement. In addition to severity of radiographic damage and pain, US-detected effusion was a predictor of subsequent joint replacement.
Mots-clé
Aged, Arthroplasty, Replacement, Knee, Disease Progression, Epidemiologic Methods, Exudates and Transudates/ultrasonography, Female, Humans, Knee Joint/ultrasonography, Male, Middle Aged, Osteoarthritis, Knee/radiography, Osteoarthritis, Knee/surgery, Pain Measurement, Prognosis
Pubmed
Web of science
Création de la notice
12/02/2010 14:11
Dernière modification de la notice
03/03/2018 18:21
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