Relationship of Radiographic Osteoarthritis Severity with Treatment Outcomes after Imaging-Guided Knee Injections: A Prospective Outcomes Study

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Relationship of Radiographic Osteoarthritis Severity with Treatment Outcomes after Imaging-Guided Knee Injections: A Prospective Outcomes Study
Key Take-Away: 

The Osteoarthritis Research Society International (OARSI) grading system was found to be more relible than the Kellgren and Lawrence (KL) 5 and 3 grading systems for Knee Osteoarthritis

Knee osteoarthritis is a form of arthritis that occurs when flexible tissue at the ends of bones wears down. 

ABSTRACT: 
Background: 

Knee osteoarthritis is a form of arthritis that occurs when flexible tissue at the ends of bones wears down.

The main objective of the study was to compare outcomes after intra-articular corticosteroid knee injections with the Kellgren and Lawrence (KL) 5 and 3 grading systems for knee osteoarthritis, the Osteoarthritis Research Society International (OARSI) grading system and actual joint space measurements; and to compare the reliability of these grading systems.

Methods: 

Knee radiographs of 117 patients who received intra-articular corticosteroid injections were independently evaluated by two radiologists blinded to the outcome.

Evaluation included the KL5, KL3, OARSI systems and actual joint space widths. The numerical rating scale for pain was collected at baseline and along with the Patient's Global Impression of Change on day 1, in week 1 and month 1. The number of 'improved' patients were compared between the OA grades using the Chi-square test. Logistic regression determined which findings were predictive for improvement. Agreement was assessed using Kappa statistics and the intraclass correlation coefficient (ICC). 

Results: 

Patients with OARSI grade 2 reported the highest rates of 'improvement' at all time points, which was significant on day 1 (p = 0.004).

No relationship with improvement was found with KL5, KL3 or actual joint space measurements. Patients with OARSI grade 2 were 8 times more likely to report improvement on day 1 (p = 0.024). Reliability was best for joint space measurements (ICC = 0.812 - 0.882), followed by the OARSI.

Conclusion: 

The OARSI for joint space narrowing grade 2 (34 - 66 % narrowing) was linked with a better outcome on day 1 with trends in week 1 and month 1. The reliability of the OARSI was better than the KL5 or KL3 systems.

 

Source:

 Rofo. 2017 Jun 26. doi: 10.1055/s-0043-112337

Link to the source:

http://www.ncbi.nlm.nih.gov/pubmed/28651262

The original title of the article:

 Relationship of Radiographic Osteoarthritis Severity with Treatment    Outcomes after Imaging-Guided Knee Injections: A Prospective    Outcomes Study

Authors

Miletic et al.

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