SAT0553 Chondrocalcinosis of the knee and the risk for knee or hip osteoarthritis progression: data from the khoala cohort. (12th June 2018)

• Record Type: Journal Article
• Authors: Latourte, A.; Rat, A.C.; Ngueyon Sime, W.; Roux, C.; Guillemin, F.; Richette, P.
• Is Part Of: Annals of the rheumatic diseases. Volume 77(2018)Supplement 2
• Page Start: 1130
• Page End: 1130
• Publication Date: 2018-06-12
• Subjects: Rheumatism -- Periodicals; 616.723005
• DOI: 10.1136/annrheumdis-2018-eular.4700
• Languages: English
• ISSNs: 0003-4967

Abstract

Abstract : Background: Cross-sectional studies repeatedly found that chondrocalcinosis (CC) is associated with osteoarthritis (OA). However, whether CC worsens preexisting knee or hip OA is unclear. Objectives: We conducted this study to assess the impact of knee CC on the risk of 1) incident joint replacement surgery, 2) worsening of pain or function and 3) radiographic progression in patients with symptomatic knee OA. Methods: The KHOALA cohort is a French multicenter population-based cohort of 878 patients with symptomatic knee and/or hip OA (ACR criteria), aged 40–75 years. Patients were followed annually by self-reported questionnaires and by clinical examination and radiography at baseline (year 0), years 3 and 5. Only patients with knee OA were kept for this analysis. CC, defined by the presence of calcium deposits within hyaline or fibro-cartilage on knee radiograph (anteroposterior view), was recorded as present or absent. We used Cox proportional-hazard regression modelling to estimate the local or systemic impact of CC at one knee (index knee) on the 5 year risk of incident total knee replacement (TKR) at the index knee or incident total hip or knee joint replacement (TJR), respectively. In the subgroup of patients without incident TJR during follow-up, logistic regression was performed to assess whether CC was associated with the worsening of Western Ontario and McMaster Universities Arthritis Index (WOMAC) for OA pain or function, or with radiographic progression as defined by a change in Kellgren and Lawrence (KL) grade, between years 0 and 5. Results: Among the 656 patients included (mean ±SD age 62.2±8.5 years; 70.3% females), 93 (14.2%) had CC in at least one knee at baseline. As compared with patients without CC, those with CC were older (64.3±9.6 vs 61.9±8.2 years; p=0.009), had longer disease duration (16.4±10.5 vs 13.0±7.6 years; p<0.001) and lower body mass index (29.1±5.3 vs 30.5±6.3 kg/m²; p=0.047). Patients with/without CC did not differ in baseline pain (7.1±4.3 vs 6.6±3.8; p=0.26) and function (22.2±14.7 vs 20.7±13.5; p=0.32) scores, or KL grade (p=0.69). Overall, 105 (16.0%) and 91 (13.9%) patients underwent TJR and TKR of the index knee, respectively, during follow-up. The presence of CC at one knee did not affect the risk of TKR in the same index knee (HR=1.0; 95% CI 0.6 to 1.8), or risk of TJR (HR=0.9; 95% CI 0.5 to 1.6). In patients without incident TJR surgery (n=551), the presence of CC did not affect the risk of worsened WOMAC pain/function scores or KL grade at year 5. Conclusions: In a population-based cohort of symptomatic knee OA, the presence of CC in the knee did not affect the risk of subsequent TKR or TJR, nor clinical or radiographic outcomes at 5 years. These results suggest that CC is not a risk factor for worsening clinical or structural outcomes in knee OA. Disclosure of Interest: None declared