High kellgren-lawrence grade and bone marrow lesions predict worsening rates of radiographic joint space narrowing the SEKOIA study

Mark H. Edwards, Camille Parsons, Olivier Bruyère, Forence Petit Dop, Roland Chapurlat, Frank W. Roemer, Ali Guermazi, Souhil Zaim, Harry Genant, Jean Yves Reginster, Elaine M. Dennison, Cyrus Cooper, C. Christiansen, P. Delmas, N. Bellamy, C. Speirs, G. Bréart, O. Meyer, D. Gensburger, M. ArlotJ. P. Roux, R. Chapurlat, R. Deroisy, J. Y. Reginster, P. Sambrook, B. Leeb, A. Verbruggen, W. Bensen, T. Hala, M. Holm-Bentzen, I. Valter, X. Chevalier, B. Swoboda, S. Adami, M. Kloppenburg, E. Grazuleviciute, J. Badurski, J. Branco, E. Nasonov, F. Navarro, T. Spector, L. Barnsley, S. Hall, G. Jones, A. Klestov, L. March, P. Nash, E. Romas, R. Will, L. Erlacher, F. B. Leeb, H. Resch, F. Rainer, O. Zamani, T. Appelboom, J. P. Devogelaer, A. Kvasz, F. Raeman, A. Verbruggen, A. D. Beaulieu, W. G. Bensen, J. Brown, A. A. Cividino, F. Morin, W. P. Olszynski, J. P. Raynauld, J. C. Thorne, T. Hala, K. Pavelka, P. Alexandersen, H. C. Hoeck, M. Holm-Bentzen, P. Lundqvist, I. Valter, L. Aim, P. Audouy, P. Beaunier, C. L. Benhamou, F. Berenbaum, E. Chabaud, D. Chalet, X. Chevalier, M. Cohen-Solal, D. Delbecq, L. Euller-Ziegler, P. Fardellone, P. Hilliquin, E. Jacquety, N. Jude, D. Lechevalier, J. C. Mouchet, P. Richette, E. De Sainte Lorette, T. Schaeverbeke, A. Sebbah, E. Vignot, T. Brabant, G. R. Burmester, J. Grifka, P. E M Müller, B. Swoboda, J. Zacher, S. Adami, G. Bianchi, W. Grassi, L. Di Matteo, V. Modena, O. Di Munno, S. Ortolani, L. Punzi, M. Zangari, E. Grazuleviciute, M. Kloppenburg, L. D. Roorda, P. L C M Van Riel, J. Badurski, E. Czerwinski, A. Gorecki, W. Tlustochowicz, J. Branco, J. Canas Da Silva, J. A. Melo Gomes, L. M. Miranda, F. Radulescu, L. I. Alexeeva, A. V. Orlov-Morozov, E. G. Pikhlak, V. G. Pilyaev, N. A. Shostak, E. I. Shmidt, N. V. Zagorodniy, L. Arboleya Rodríguez, P. Benito Ruiz, E. Chamizo Carmona, E. Collantes Estévez, G. Herrero-Beaumont, E. Martín Mola, A. Moreno, A. Naranjo Hernández, F. Navarro Sarabia, J. M. Padrino, C. Palacios, A. Rodríguez De La Serna, J. A Román Ivorra, A. Torrijos, E. Abdulhakim, N. Arden, F. Birrell, H. Donnachie, W. Fraser, R. Keen, R. Sarmiento, M. D. Stone

Research output: Contribution to journalArticlepeer-review


Objective. Determinants of radiographic progression in osteoarthritis (OA) are poorly understood. We investigated which features on baseline magnetic resonance imaging (MRI) acted as predictors of change in joint space width (JSW). Methods. A total of 559 men and women over the age of 50 years with clinical knee OA [Kellgren-Lawrence (KL) grade 2-3] were recruited to the placebo arm of the SEKOIA study (98 centers 18 countries). Minimal tibiofemoral joint space and KL grade on plain radiograph of the knee were assessed at baseline and at yearly followup up to 3 years. In a subset, serial knee MRI examinations were performed. Individuals with a bone marrow lesion (BML) ≥ grade 2 at the tibiofemoral joint at baseline were classified as BML-positive. Relationships between change in JSW and risk factors were assessed using linear regression. Results. The mean age of study participants was 62.8 (SD 7.5) years and 73% were female 38.6% had BML. Mean baseline JSW was 3.65 mm. This reduced by 0.18 (0.30) mm/year in men and 0.13 (0.23) mm/year in women. Those with BML had a significantly higher rate of annualized change in JSW this relationship remained robust after adjustment for age, sex, and baseline KL grade [β = -0.10 (95% CI -0.18, -0.02) mm/yr]. Age, sex, baseline KL grade, and other MRI findings did not influence the rate of change in JSW. Conclusion. The rate of change in JSW was similar in men and women. BML on knee MRI predicted the rate of radiographic change in JSW. This relationship was independent of age, sex, and baseline KL grade.

Original languageEnglish
Pages (from-to)657-665
Number of pages9
JournalJournal of Rheumatology
Issue number3
Publication statusPublished - Mar 1 2016


  • Joint space narrowing
  • Knee
  • Magnetic resonance imaging
  • Natural history
  • Osteoarthritis
  • Progression
  • Radiographic

ASJC Scopus subject areas

  • Rheumatology
  • Immunology
  • Immunology and Allergy


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