Abstract
BackgroundThe aim of this study was to examine whether cartilage volume as measured by MRI and radiographic osteoarthritis (OA) at baseline predict cartilage volume loss over ten years independent of each other and other structural co-pathologies.Methods219 participants [mean-age 45(26–61); 57 % female] were studied at baseline and ten years. Approximately half were the adult offspring of subjects who underwent knee replacement for OA and the remainder were randomly selected controls. Joint space narrowing (JSN) and osteophytes were assessed on radiographs and cartilage volume (tibiofemoral), cartilage defects, bone marrow lesions and meniscal tears/extrusion were assessed on MRI.ResultsMean absolute and percentage per annum cartilage volume loss was 1284 mm3 and 1.91 % respectively in the medial compartment and 1007 mm3 and 1.38 % respectively in the lateral compartment. Higher baseline tibiofemoral cartilage volume was independently associated with greater absolute cartilage volume loss in both medial (β(95 % CI) = −300 (−399,−200)) and lateral (β = −338 (−443,−233)) compartments and percentage per annum loss in the lateral compartment(β = −0.15 (−0.29, −0.01)). Baseline JSN and osteophytes were associated with cartilage volume loss in the univariable analysis, however these associations did not persist after adjustment for other structural co-pathologies.ConclusionCross-sectional cartilage volume measurement independently predicts cartilage volume loss over 10 years and can be used to identify fast progressors in clinical trials. Radiographic JSN and osteophytes on the other hand are a reflection of other co-pathologies assessed on MRI and do not independently predict cartilage volume loss over 10 years.
Highlights
The aim of this study was to examine whether cartilage volume as measured by MRI and radiographic osteoarthritis (OA) at baseline predict cartilage volume loss over ten years independent of each other and other structural co-pathologies
Other studies have shown that knees with definite osteophytes but without joint space narrowing (JSN) do not show significantly greater rates of cartilage volume loss compared to healthy knees over a one-year period [11]
The characteristics of participants who were followed up compared to participants who were lost to follow up were as follows, respectively: age: 45.25 (±6.67) vs 45.07 (±7.15) years, p = 0.806; female sex: 57 % vs 59 %, p = 0.749; Body mass index (BMI): 27.2 (±4.96) vs 26.8 (±4.31), p = 0.499; offspring 52 % vs 47 %, p = 0.891; knee Radiographic osteoarthritis (ROA): 18 % vs 15 %, p = 0.486 and total tibiofemoral cartilage volume at baseline: 14199 (±3463) vs 14113 (±3410), p = 0.611
Summary
The aim of this study was to examine whether cartilage volume as measured by MRI and radiographic osteoarthritis (OA) at baseline predict cartilage volume loss over ten years independent of each other and other structural co-pathologies. [8] In early OA cartilage swelling appears to precede volume loss [6, 9]. In patients with established OA, lower baseline cartilage volume appears to predict loss over a similar period [3]. Radiographic osteoarthritis (ROA) score has been found to predict cartilage volume loss [10]. Whether this association is due to the presence of osteophytes or joint space narrowing (JSN) remains controversial. Other studies have shown that knees with definite osteophytes but without JSN do not show significantly greater rates of cartilage volume loss compared to healthy knees over a one-year period [11]. To our knowledge no papers have looked at the association between ROA scores in early disease and volume loss over a ten-year period
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