Background Prediction of osteoarthritis (OA) course presents certain difficulties, as early diagnostics of the disease is practically absent, the data on risk factors of progressing are controversial till now.
Objectives To single out the risk factors of structural knee joints OA progressing during 5-years prospective observation.
Methods 5-years prospective investigation includes 110 women aged 42 - 80 with primary knee joints OA according ACR criteria, examined in 2004 – 2006 and once again in 2009 – 2011. All patients questioned, index Womac was assessed, they had radiography, ultrasound investigation (US) of knee joints, densitometry of subchonrdal regions of femoral and tibial bones at the beginning and end of observation.
Results During the 5-years period of observation knee joints OA progressing (increase of X-ray stage) was noticed in 40 patients, 70 demonstrated the same stage. During the first examination of the group of patients with gonarthritis progressing the 1st radiological stage was found in 30% of patients, 2nd and 3 –d in 70%, 4th stage was not found, during the second examination in the same group in 5 years the 1-st stage was not found in anybody, 2nd and 3d were found in 62,5% and 4th almost in 40% of patients. Patients in both were comparable by age and disease duration. During the first examination patiens with progressing had more intensive pain in knees at walking 57,86±16,63 against 48,77±13,33 mm by WASH (p=0,002), higher values of BMI 33,2±6,05 against 30,51±5,63 kg/m2 (p=0,021), knee jonts synovitis was more frequently found according US data 50,0% against 18,6% (p=0,002), during densitometry of subchondral regions of femoral and tibial bones a tendency was noted to increase of mineral density of bone tissue (BMD) in the region of medial condyle of the femur in all the length, which could be regarded as risk factors of knee joints OA progressing. After second examination in 5 years the growth of values of the mentioned factors was observed. Thus, BMI from 33,2±6,05 to 34,18±6,24, pain intensity from 57,86±16,63 to 67,68±21,49, knee joints synovites from 50,0% to 62,5% and BMD increase in subchondral regions of the femur in all the length from 0,7 [0,6-0,8] to 0,8 [0,5-0,9]. Basing on discriminate analysis these variables were singled out as risk factors of knee joints OA progressing (Table 1). Correctness of grouped cases: 68,1% observations were classified right.
Conclusions Thus, the obtained data of 5-year long observation testify to the fact, that factors of OA progressing include: high indices of pain intensity, BMI, presence of synovitis and BMD increase in sunchondral regions of the femur in all the length.
Disclosure of Interest None declared