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16.05.2020 | Original Article

Periarticular osteophyte formation protects against total knee arthroplasty in rheumatoid arthritis patients with advanced joint damage

verfasst von: Shuji Asai, Nobunori Takahashi, Kenya Terabe, Yasumori Sobue, Tsuyoshi Nishiume, Mochihito Suzuki, Yutaka Yokota, Naoki Ishiguro, Toshihisa Kojima

Erschienen in: Clinical Rheumatology | Ausgabe 11/2020

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Abstract

Objective

Periarticular osteophyte formation is observed during the repair of damaged joints in rheumatoid arthritis (RA); however, little is known about its clinical and functional roles. This study aimed to determine the influence of periarticular osteophyte formation on the incidence of total knee arthroplasty (TKA) (a surrogate for long-term outcomes of joint destruction) in patients with RA.

Methods

This retrospective longitudinal study included a total of 130 symptomatic (tender and/or swollen) knee joints in 80 patients starting biologics. Cumulative incidences of TKA were compared according to the presence or absence of osteophyte on plain anteroposterior radiograph (osteophyte (±)) and the extent of advanced joint damage as defined by Larsen’s grading system (0–II vs. III–V).

Results

Kaplan-Meier estimates showed a significantly lower cumulative incidence of TKA for the osteophyte (+) group (n = 33) compared with the osteophyte (−) group (n = 31) in the Larsen grades III–V group (38 vs. 74% at 10 years, P = 0.010), whereas no significant difference was observed between the osteophyte (+) (n = 11) and osteophyte (−) (n = 55) groups in the Larsen grades 0–II group (9 vs. 10% at 10 years). Multivariate Cox proportional hazards analysis revealed that older age (hazard ratio (HR), 1.04 per 1 year; 95% confidence interval (CI), 1.01–1.08) and osteophyte formation (HR, 0.39; 95% CI, 0.19–0.79) independently predicted TKA in the Larsen grades III–V group, whereas none of the assessed variables predicted TKA in the Larsen grades 0–II group.

Conclusion

Osteophyte formation reduces the incidence of TKA in patients with RA who have advanced joint damage.

Key Points

• Older age and Larsen grade were independent predictors of total knee arthroplasty (TKA) in rheumatoid arthritis (RA) patients.

• Periarticular osteophyte formation reduced the incidence of TKA in RA patients with Larsen grades III–V.

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Titel: Periarticular osteophyte formation protects against total knee arthroplasty in rheumatoid arthritis patients with advanced joint damage
verfasst von: Shuji Asai
Nobunori Takahashi
Kenya Terabe
Yasumori Sobue
Tsuyoshi Nishiume
Mochihito Suzuki
Yutaka Yokota
Naoki Ishiguro
Toshihisa Kojima
Publikationsdatum: 16.05.2020
Verlag: Springer International Publishing
Erschienen in: Clinical Rheumatology / Ausgabe 11/2020
Print ISSN: 0770-3198
Elektronische ISSN: 1434-9949
DOI: https://doi.org/10.1007/s10067-020-05140-1

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Periarticular osteophyte formation protects against total knee arthroplasty in rheumatoid arthritis patients with advanced joint damage

Abstract

Objective

Methods

Results

Conclusion

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Antihypertensiva schützen auch alte Menschen noch vor Demenz

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Denken Sie bei starker Blutung auch an die Hemmkörper-Hämophilie

Update Innere Medizin

Live-Webinar: Aktuelle Leitlinien bei Herz-Kreislauf-Erkrankungen

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Abstract

Objective

Methods

Results

Conclusion

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