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Knee effusion-synovitis volume measurement and effects of vitamin D supplementation in patients with knee osteoarthritis

Wang, X, Cicuttini, F, Jin, X, Wluka, AE, Han, W ORCID: 0000-0003-1590-7433, Zhu, Z ORCID: 0000-0003-3913-2564, Blizzard, L ORCID: 0000-0002-9541-6943, Antony, B ORCID: 0000-0001-8704-6084, Winzenberg, T ORCID: 0000-0002-4112-3491, Jones, G ORCID: 0000-0002-9814-0006 and Ding, C ORCID: 0000-0002-9479-730X 2017 , 'Knee effusion-synovitis volume measurement and effects of vitamin D supplementation in patients with knee osteoarthritis' , Osteoarthritis and Cartilage, vol. 25, no. 8 , pp. 1304-1312 , doi: 10.1016/j.joca.2017.02.804.

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Abstract

Objective: To develop a measure of knee joint effusion-synovitis volume and to examine the effect of vitamin D supplementation on effusion-synovitis in people with knee osteoarthritis (OA) and low vitamin D levels over 24 months.Method: Symptomatic knee OA patients with low 25-(OH)D levels (12.5-60 nmol/l) were recruited for a multi-centre, randomised, placebo-controlled and double-blind trial. Participants (age 63 ± 7 years, 208 females) were allocated to either 50,000 IU monthly vitamin D3 (n = 209) or placebo (n = 204) for 24 months. Knee effusion-synovitis volume in suprapatellar and other regions was measured on magnetic resonance imaging (MRI) using OsiriX software. The intra-class correlation coefficients (ICCs) were used to test inter- and intra-rater reliabilities. The least significant change criterion was used to define the increase/decrease in effusion-synovitis volume.Result: The reproducibilities of effusion-synovitis volume measurement were high with ICCs ranging from 0.93 to 0.99. Over 24 months, effusion-synovitis volume remained stable in the vitamin D group but increased in placebos with a significant between-group difference (-1.94 ml, 95% confidence interval (CI): -3.54, -0.33). This effect was evident in those with baseline effusion-synovitis and with suprapatellar effusion-synovitis. The proportion with an increase in effusion-synovitis volume was lower in the vitamin D group than placebo (risk ratio (RR): 0.87, 95% CI: 0.77, 0.97).Conclusion: This highly reproducible effusion-synovitis volume measurement could be a promising outcome measure in OA trials. Vitamin D supplementation could retard the progression of effusion-synovitis which can potentially benefit people with an inflammatory OA phenotype.

Item Type: Article
Authors/Creators:Wang, X and Cicuttini, F and Jin, X and Wluka, AE and Han, W and Zhu, Z and Blizzard, L and Antony, B and Winzenberg, T and Jones, G and Ding, C
Keywords: effusion, knee osteoarthritis, randomised controlled trial, synovitis, vitamin D
Journal or Publication Title: Osteoarthritis and Cartilage
Publisher: W B Saunders Co Ltd
ISSN: 1063-4584
DOI / ID Number: 10.1016/j.joca.2017.02.804
Copyright Information:

© 2017 Osteoarthritis Research Society International. Published by Elsevier Ltd. All rights reserved.

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