Background/Purpose:

To evaluate associations between severity of knee osteoarthritis (OA) on MRI and treatment outcome in knee OA patients treated with exercise therapy.

Methods:

Ninety-five participants with knee OA in a 12-week exercise program had obtained 3.0 Tesla MRI scans of the knee joint, prior to treatment. MRI data were systematically assessed for OA severity of multiple features (cartilage loss, bone marrow lesions, osteophytes, effusion/synovitis, and meniscal abnormalities) according to the BLOKS scoring system. Regression analyses were performed to analyze associations between OA severity on MRI and outcome of exercise therapy, i.e. changes in activity limitations (WOMAC physical function; primary outcome), pain (NRS), and upper leg muscle strength, and treatment response (OMERACT-OARSI criteria).

Results:

Improvements of on average 24%, 34%, and 21% in WOMAC physical function, NRS pain and upper leg muscle strength, respectively, after 12-week exercise therapy were found. Moderate-to-severe patellofemoral (PF) cartilage loss was significantly associated with less improvements in both activity limitations (p=.01) and upper leg muscle strength (p=.04), while moderate-to-severe PF osteophytes with less improvements in upper leg muscle strength (p<.01). Severity of other features on MRI were not found to be associated with treatment outcome.

Conclusion: Effectiveness of exercise therapy was found to be independent of OA severity on MRI, except for cartilage loss and osteophytes, both in the PF compartment. Our study suggests that all grades of OA severity on MRI can benefit from professionally supervised exercise therapy, although effects might be reduced in patients with advanced PF OA.

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ACR Meeting Abstracts - https://acrabstracts.org/abstract/is-the-severity-of-knee-osteoarthritis-on-mri-associated-with-outcome-of-exercise-therapy/