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The presence of extensive
effusion synovitis for a period of 18 months or more is significantly linked to
the progression of cartilage damage.
The research recently confirmed that the existing effusion‐synovitis for past one and a half year or more can lead to progression of cartilage damage. Synovitis is a term that represents the synovial membrane inflammation which is the main characteristic of articular cartilage damage and knee osteoarthritis. The study investigated the relationships between baseline and changes in effusion-synovitis on changes in cartilage damage depth and size past one and a half years among 221 patients with OA and meniscal tear.
The data was collected from the Meniscal Tear in Osteoarthritis Research (MeTeOR) trial of surgery vs physical therapy. Semiquantitative grading of cartilage damage and effusion-synovitis was done as extensive (medium/large) or minimal (none/small) using dichotomized effusion-synovitis and magnetic resonance imaging (MRI). Poisson regression models were used to evaluate the associations between baseline and changes in effusion-synovitis on changes in cartilage damage. Analyses were adjusted for baseline cartilage damage, treatment and demographics.
A total of 21.3% and
45.3% of patients presented persistently extensive and minimal
effusion-synovitis, respectively after one and a half year. Other 33.5%
exhibited extensive synovitis on one time and minimal on the other. The
extensive effusion-synovitis at baseline was correlated with the progression of
cartilage damage depth (relative risk (RR) of 1.7) during the adjusted
analyses. Moreover, the persistently extensive effusion-synovitis showed a
significant risk of progression of cartilage damage depth as compared to
persistently minimal effusion-synovitis (RR 2.0). Also, due to the persistence
of extensive effusion-synovitis over time, the risk of concomitant cartilage
damage raises. These results showed a significant association between cartilage
damage and extensive effusion-synovitis.
Arthritis Rheumatol
Association of Changes in Effusion-Synovitis and Progression of Cartilage Damage Over 18 Months in Patients with Osteoarthritis and Meniscal Tear.
Lindsey A. MacFarlane et al.
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