title: Knee effusion-synovitis volume measurement and effects of vitamin D supplementation in patients with knee osteoarthritis.
abstract: 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.
  
  
  
  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.
  
  
  
  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).
  
  
  
  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.
authors.affiliation: Menzies Institute for Medical Research, University of Tasmania, Hobart, Tasmania, Australia.
authors.forename: X
authors.initials: X
authors.lastname: Wang
authors.affiliation: Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, Victoria, Australia.
authors.forename: F
authors.initials: F
authors.lastname: Cicuttini
authors.affiliation: Menzies Institute for Medical Research, University of Tasmania, Hobart, Tasmania, Australia.
authors.forename: X
authors.initials: X
authors.lastname: Jin
authors.affiliation: Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, Victoria, Australia.
authors.forename: A E
authors.initials: AE
authors.lastname: Wluka
authors.affiliation: Menzies Institute for Medical Research, University of Tasmania, Hobart, Tasmania, Australia; Translational Research Centre, Academy of Orthopedics, Guangdong Province, School of Basic Medical Sciences, Southern Medical University, Guangzhou, Guangdong, China.
authors.forename: W
authors.initials: W
authors.lastname: Han
authors.affiliation: Menzies Institute for Medical Research, University of Tasmania, Hobart, Tasmania, Australia.
authors.forename: Z
authors.initials: Z
authors.lastname: Zhu
authors.affiliation: Menzies Institute for Medical Research, University of Tasmania, Hobart, Tasmania, Australia.
authors.forename: L
authors.initials: L
authors.lastname: Blizzard
authors.affiliation: Menzies Institute for Medical Research, University of Tasmania, Hobart, Tasmania, Australia.
authors.forename: B
authors.initials: B
authors.lastname: Antony
authors.affiliation: Menzies Institute for Medical Research, University of Tasmania, Hobart, Tasmania, Australia.
authors.forename: T
authors.initials: T
authors.lastname: Winzenberg
authors.affiliation: Menzies Institute for Medical Research, University of Tasmania, Hobart, Tasmania, Australia.
authors.forename: G
authors.initials: G
authors.lastname: Jones
authors.affiliation: Menzies Institute for Medical Research, University of Tasmania, Hobart, Tasmania, Australia; Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, Victoria, Australia; Translational Research Centre, Academy of Orthopedics, Guangdong Province, School of Basic Medical Sciences, Southern Medical University, Guangzhou, Guangdong, China. Electronic address: Changhai.Ding@utas.edu.au.
authors.forename: C
authors.initials: C
authors.lastname: Ding
mesh_terms: D050071:Bone Density Conservation Agents / Q000008:administration & dosage*; D019587:Dietary Supplements; D004311:Double-Blind Method; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D020370:Osteoarthritis, Knee / Q000178:diet therapy* / Q000209:etiology* / Q000473:pathology; D013585:Synovitis / Q000178:diet therapy* / Q000473:pathology / Q000517:prevention & control; D016896:Treatment Outcome; D014807:Vitamin D / Q000008:administration & dosage* / Q000031:analogs & derivatives / Q000378:metabolism
chemical_list: D050071:Bone Density Conservation Agents; D014807:Vitamin D; C104450:25-hydroxyvitamin D
keywords: Effusion; Knee osteoarthritis; Randomised controlled trial; Synovitis; Vitamin D