TRANSITION PREDICTORS OF X-RAY 0 STAGE FOR KNEE OSTEOARTHRITIS INTO THE 1ST STAGE (BASED ON THE COMPLEX EVALUATION OF THE KNEE JOINT BY MRI WORMS)

• Published in: Traumatology and Orthopedics of Russia
• Main Authors: М. V. Makarova, M. Yu. Valkov, L. E. Valkova, A. S. Revchuk, A. V. Agapitov, I. A. Chernykh, A. R. Parfenova, A. M. Grjibovski
• Format: Article in Journal/Newspaper
• Language: Russian
• Published: Vreden Russian Research Institute of Traumatology and Orthopedics 2017
• Subjects: : osteoarthritis; magnetic resonance imaging; synovitis; Orthopedic surgery; RD701-811; Northwest Russia
• Online Access: https://doi.org/10.21823/2311-2905-2017-23-1-33-44; https://doaj.org/article/89cf948ab0894866964f9d167a626fa0

Background. Osteoarthritis (OA) is the most common disease among all rheumatological diseases. Approximately 70-80% of all OA cases of are gonarthritis. Routine X-ray examination is not informative to assess non-bone structures. Magnetic resonance imaging (MRI) allows visualizing all the structural elements of a joint, such as articular soft tissue structures and subcortical parts. To achieve objective data, the researcher needs to adhere a protocol allowing to assess of all joint parts, the so-called method of evaluation of the whole body (Whole Organ Magnetic Resonance Imaging Score –WORMS). Aim. to determine predictors of OA progression for X-ray 0 stage on the basis of the knee MRI procedure byWORMS.Methods. A cohort study. The sample consisted of patients with gonarthritis in all hospitals inArkhangelsk,Northwest Russia. The main inclusion criterion was clinically confirmed with knee OA by Altman 1991 without X-ray pathological changes. X-ray examinations of the knee joints were performed during the initial diagnosis and after one year. After the first X-ray examination patients underwent an MRI provided by machines with a magnetic field strength of 1.5 Tesla. The study included 76 patients, 22 patients were lost to follow up. Altogether, 54 (71.1%) patients completed the study. MRI evaluation of the data was carried out byWORMS protocol.Results. The progression of X-ray 0 stage into the first stage by Kellgren-Lawrence after one year has occurred in 45 (8.3%) patients of the 54 patients. Clinically significant predictors of progression of OA of the knee based on MRI were: degeneration of the medial meniscus (OR = 5.0, 95% CI: 1.1-22.5), and synovitis (OR = 7.0, 95% CI: 1.5-33.1), degeneration of the medial meniscus and synovitis were included Regression model. Regression model revealed the most significant predictor of progression of knee OA was synovitis (OR = 5.49, 95% CI: 1.13-26.72). The sensitivity of model was 95,1% (95% CI: 85.8-94.9), specificity was 71,4% (95% CI: 33.3-94.4), positive predictive ...