The draft of a new classification of gonarthrosis in terms of its preclinical stage

Subjects and methods. Examinations were made in 819 patients at a high risk of GA, including 445 (54.3%) without its clinical manifestations at the beginning of the study and 374 (45.7%) with its clinical manifestations. A total of 450 people (216 without clinical manifestations and 234 with manifest GA) received combined chondroprotective therapy (CPT) for two years. At baseline and after two years, all underwent ultrasound examination of the knee joint. The dynamics of the minimum hyaline cartilage thickness was analyzed. Results. The patients with clinical GA had the greatest decrease in articular cartilage over a 2-year period. During the follow-up period, they lost 0.24±0.11 mm of the baseline articular cartilage (AC) height; moreover, CPT could reduce this value by more than twice (to 0.10±0.11 mm). However, it was especially interesting that patients without clinical and radiological signs of GA, who had high risk factors for the disease, also showed a significant AC decrease, although to a lesser extent (0.17±0.13 mm). In this case, CPT could reduce the loss of hyaline cartilage by 54% or by 0.08±0.11 mm during two years. Conclusion. The results of the study may propose a new classification of GA with emphasis on the preclinical pre-radiological stage of the disease and recommend early CPT for X-ray-negative patients having risk factors and (or) early ultrasonographic articular cartilage changes in the knee joints.

rheumatology, osteoarthritis, gonarthrosis, preclinical stage, classification of gonarthrosis, hyaline cartilage