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Reducing progression of knee OA features assessed by MRI in overweight and obese women: secondary outcomes of a preventive RCT.

Published on Jun 1, 2016in Osteoarthritis and Cartilage4.879
· DOI :10.1016/j.joca.2015.12.016
M.L. Landsmeer2
Estimated H-index: 2
(EUR: Erasmus University Rotterdam),
Jos Runhaar13
Estimated H-index: 13
(EUR: Erasmus University Rotterdam)
+ 6 AuthorsSita M. A. Bierma-Zeinstra72
Estimated H-index: 72
(EUR: Erasmus University Rotterdam)
Abstract
Summary Objective To evaluate the preventive effects of a randomized controlled trial on progression of Magnetic Resonance Imaging (MRI) features of knee osteoarthritis (OA) in overweight and obese women. Design In a 2 × 2 factorial design, 2.5 years effects of a diet and exercise program and of glucosamine sulphate (double-blind, placebo-controlled) were evaluated in 407 middle-aged women with body mass index (BMI) ≥ 27 kg/m 2 without clinical signs of knee OA at baseline (ISRCTN 42823086). MRIs were scored with the MRI Osteoarthritis Knee Score (MOAKS). Progression was defined for bone marrow lesions (BMLs), cartilage defects, osteophytes, meniscal abnormalities and meniscal extrusion. Analyses on knee level were performed over the four intervention groups using adjusted Generalized Estimating Equations (GEE). Results 687 knees of 347 women with mean age 55.7 years (±3.2 SD) and mean BMI 32.3 kg/m 2 (±4.2 SD) were analyzed. Baseline prevalence was 64% for BMLs, 70% for cartilage defects, 24% for osteophytes, 66% for meniscal abnormalities and 52% for meniscal extrusions. The diet and exercise program + placebo intervention showed significantly less progression of meniscal extrusion compared to placebo only (12% vs 22%, OR 0.50, 95% CI [0.27–0.92]). The interventions did not result in significant differences on other OA MRI features. Conclusions In subjects at high risk for future knee OA development, a diet and exercise program, glucosamine sulphate and their combination showed small and mainly non-significant effects on the progression of OA MRI features. Only progression of meniscal extrusion was significantly diminished by the diet and exercise program.
  • References (41)
  • Citations (5)
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References41
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#1B.J.E. de Lange-Brokaar (LEI: Leiden University)H-Index: 7
#2J. Bijsterbosch (LEI: Leiden University)H-Index: 15
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Objective: To investigate patterns of MRI abnormalities in the patellofemoral (PFJ) and tibiofemoral joint (TFJ) and their association with radiographic progression, using hypothesis free analyses. Design: 205 patients from the GARP study with symptomatic OA at multiple sites (mean age 60 years, 80% woman, median BMI 26 kg/m2), underwent knee MRI at baseline. Cartilage damage, osteophytes, cysts, bone marrow lesions (BMLs) and effusion/synovitis were scored according to a validated scoring metho...
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Abstract Background and objectives The PRevention of knee Osteoarthritis in Overweight Females (PROOF) study (ISRCTN 42823086) described a trend for a decrease in the incidence of knee osteoarthritis (OA) by a tailored diet and exercise program (DEP) or by oral glucosamine sulfate in women at risk for the disease, using a composite clinical and/or radiological outcome. The aim of this updated post-hoc analysis was to re-assess the results according to more precise techniques and take advantage o...
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#1Ewa M. RoosH-Index: 65
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Osteoarthritis (OA) is a chronic condition that is associated with pain and disability. In this Review, Roos and Arden consider the strategies that are available for modification of risk factors contributing to the development of knee OA. Interventions for prevention and early care of knee OA could help to avoid joint-replacement surgery.
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Abstract Background With accumulating knowledge on osteoarthritis development, the next step is to focus on possibilities for primary prevention. Methods In a 2 × 2 factorial design, the effects of a diet-and-exercise program and of oral glucosamine sulfate (double blind and placebo-controlled) on the incidence of knee osteoarthritis were evaluated in a high-risk group of 407 middle-aged women with a body mass index ≥ 27 kg/m 2 without clinical signs of knee osteoarthritis at baseline (ISRCTN 42...
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Introduction We performed a systematic review of prognostic factors for the progression of symptomatic knee osteoarthritis (OA), defined as increase in pain, decline in physical function or total joint replacement.
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Summary Objective Recently, the MRI Osteoarthritis Knee Score (MOAKS), a new semi-quantitative magnetic resonance imaging (MRI) scoring tool, was introduced by a panel of experienced researchers in osteoarthritis (OA). The MOAKS is primarily applicable to quantify OA status, since the interpretation of change in the MOAKS features was not described. In order to enable longitudinal evaluation, we propose definitions for progression and improvement of the main MOAKS features. Method Clear definiti...
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