Ab1804

Radiographic progression of knee osteoarthritis in a Czech cohort

K. Pavelka, J. Gatterova, R.D. Altman

Institute of Rheumatology, Prague, Czech Republic; Department of Medicine, University of Miami School of Medicine, Miami, Florida, USA

ABSTRACT
Objective
To determine the 5-year radiographic progression of osteoarthritis (OA) of the knee in a Czech cohort.

Methods
139 patients with idiopathic OA were followed for 5 years, receiving only physical therapy and non-steroidal antiinflammatory drugs as needed. Weight-bearing radiographs of both knees were performed at the initial and final evaluation by a single technician using the same instrument and a standardized procedure. Radiographs were evaluated using the Kellgren-Lawrence scale (KL). Joint space width (JSW) was determined by 2 independent trained readers, and discrepancies re-reviewed.

Results
JSW decreased 0.39 ± 0.95 mm in 5 years, or 0.078 ± 0.19 annually. The reduction of JSW was greatest in the KL grade III radiographs (0.099 ± 0,18 mm). The smallest reduction in JSW was seen in those with KL grade I (0.044 ± 0.14 mm). However, only 25% of those with KL stage II or stage III demonstrated any change in JSW over the 5-year period. The reduction in JSW was not constant, being most rapid in the first year and then much slower. The coefficient of variation (CV) of the method was good (intra- and inter-observer CV 3.6%).

Conclusion
This 5-year follow up of Czech patients with OA of the knee demonstrated a low rate of radiographic progression of JSW. The most rapid progression appeared in KL stage III. The progression was most rapid in the first year.

Key words
Knee osteoarthritis, radiographic progression, quantitative radiography.

This work was supported in part by grant of Ministry of Health of Czech Republik Nr 2153-3 and Pierre Fabre Medicament, Castres, Cedex, F 81106

Please address correspondence and reprint requests to: Assoc. Prof. Karel Pavelka M.D., Ph.D., Institute of Rheumatology, Na slupi 4, 128 50 Prague, Cech Republic.