MOST Study: End Stage Knee Osteoarthritis Shows Dynamic Change by MRI Save
Guermazi and colleagues have investigated whether end-stage knee osteoarthritis (OA), assessed as grade 4 Kellgren and Lawrence (KL) radiographic changes, are really "end stage".
The Multicenter Osteoarthritis Study Trial (MOST) included 140 subjects (164 knees) with KL grade 4 knees at baseline and had baseline and 30-month MRI evaluations. They showed that one-third of compartments had increased cartilage damage and 25% of other compartments also increased cartilage damage. Bone marrow lesions from the index compartment increased in 33% and decreased in 21%. Synovial effusion worsened in 25% and improved in 9% and synovitis worsened in 10% and improved in 4%.
These findings suggest dynamic changes exist in "end stage" knee OA that may require ongoing attention and treatment.
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