Is the Severity of Knee Osteoarthritis on Magnetic Resonance Imaging Associated With Outcome of Exercise Therapy?

Arthritis Care and Research - Tập 66 Số 1 - Trang 63-68 - 2014
J. Knoop1, Joost Dekker2, M. van der Leeden3, M. van der Esch1, J.-P. Klein4, David J. Hunter5, Leo D. Roorda1, Martijn Steultjens6, Willem F. Lems7
1Amsterdam Rehabilitation Research Center, Reade, Amsterdam, The Netherlands
2EMGO Institute and VU University Medical Center; Amsterdam The Netherlands
3Amsterdam Rehabilitation Research Center|Reade, EMGO Institute, and VU University Medical Center Amsterdam The Netherlands
4VU University Medical Center, Amsterdam, The Netherlands
5Royal North Shore Hospital and Kolling Institute, University of Sydney, Sydney; New South Wales Australia
6Institute for Applied Health Research, Glasgow Caledonian University, Glasgow, UK
7Jan van Breemen Research Institute | Reade and VU University Medical Center, Amsterdam, The Netherlands

Tóm tắt

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.

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Arthritis Care and Research

Tập 66 Số 1

63-68

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