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OP0051 Synovitis predicts the arthroscopic progression of medial tibiofemoral knee osteoarthritis (oa)
  1. X Ayral1,
  2. EH Pickering2,
  3. TG Woodworth2,
  4. N Mackillop3,
  5. L Loose2,
  6. M Dougados1
  1. 1Rheumatology B, Cochin Hospital, Paris, France
  2. 2R&D Global, Pfizer, Groton, USA
  3. 3R&D Global, Pfizer, Sandwich, UK

Abstract

Objectives To evaluate the prevalence of synovitis in painful medial tibiofemoral knee OA and to evaluate correlations between such synovitis and the structural severity of medial knee OA.

Methods Multicenter, prospective, one year duration study; primary painful knee OA (ACR criteria) of the medial compartment; medial joint space width > or = 2 mm; at least 10% of one cartilage surface of the medial compartment affected by superficial fibrillation or worse. Arthroscopy under local anaesthesia performed and videorecorded at entry and after one year; medial chondropathy scored by using SFA score (0–100) and reader’s overall assessment (VAS score 100 mm); medial perimeniscal synovial scored as normal (few villi, fine vascular network), reactive (proliferation of opaque villi), inflammatory (hypervascularization and/or proliferation of hypertrophic and hyperemic villi). Progression of medial chondropathy defined by an increase in SFA and VAS scores of at least 4.5 and 8.0 after one year, respectively, as previously reported;1 assessment of severity of chondropathy by a single reader blind to chronology of paired videotapes.

Results 506 patients were enrolled and 498 completed the one year longitudinal study (mean age: 61.2 ± 7.7 years, female sex: 58.9%, BMI: 30.4 ± 4.7, mean disease duration: 3.8 ± 2.9 years). The Table 1 summarises cross-sectional and longitudinal correlations between synovitis and chondropathy.

Medial perimeniscal
Normal
Synovial membrane
Reactive
At baseline
Inflammatory
BASELINE N = 252N = 145N = 109
SFA score 30 ± 1938 ± 20*41 ± 18*
VAS score 34 ± 1741 ± 19*44 ± 17*
CHANGES N = 251N = 144N = 103
% SFA progressors 13.1%14.6%23.3%**
% VAS progressors 13.9%13.2%30.1%***
  • * p-value vs Normal: p < or = 0.0003

  • ** p = 0.02

  • *** p = 0.0005.

  • Abstract OP0051 Table 1

    Conclusion This study suggests that synovitis is a common feature of painful knee OA, associated with more severe chondropathy, but it also suggests that synovitis could be considered as a predictive factor of subsequent chondrolysis.

    Reference

    1. Ayral X, et al. Arthroscopic evaluation of chondropathy in osteoarthritis of the knee. J Rheumatol. 1996;23:698–706

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