Abstract
IntroductionThe aim was to investigate the relationship of cartilage loss (change in medial femorotibial cartilage thickness measured with magnetic resonance imaging (MRI)) with compartment-specific baseline radiographic findings and MRI cartilage morphometry features, and to identify which baseline features can be used for stratification of fast progressors.MethodsAn age and gender stratified subsample of the osteoarthritis (OA) initiative progression subcohort (79 women; 77 men; age 60.9 ± 9.9 years; body mass index (BMI) 30.3 ± 4.7) with symptomatic, radiographic OA in at least one knee was studied. Baseline fixed flexion radiographs were read centrally and adjudicated, and cartilage morphometry was performed at baseline and at one year follow-up from coronal FLASH 3 Tesla MR images of the right knee.ResultsOsteophyte status at baseline was not associated with medial cartilage loss. Knees with medial joint space narrowing tended to show higher rates of change than those without, but the relationship was not statistically significant. Knees with medial femoral subchondral bone sclerosis (radiography), medial denuded subchondral bone areas (MRI), and low cartilage thickness (MRI) at baseline displayed significantly higher cartilage loss than those without, both with and without adjusting for age, sex, and BMI. Participants with denuded subchondral bone showed a standardized response mean of up to -0.64 versus -0.33 for the entire subcohort.ConclusionsThe results indicate that radiographic and MRI cartilage morphometry features suggestive of advanced disease appear to be associated with greater cartilage loss. These features may be suited for selecting patients with a higher likelihood of fast progression in studies that attempt to demonstrate the cartilage-preserving effect of disease-modifying osteoarthritis drugs.
Highlights
The aim was to investigate the relationship of cartilage loss (change in medial femorotibial cartilage thickness measured with magnetic resonance imaging (MRI)) with compartment-specific baseline radiographic findings and MRI cartilage morphometry features, and to identify which baseline features can be used for stratification of fast progressors
The results indicate that radiographic and MRI cartilage morphometry features suggestive of advanced disease appear to be associated with greater cartilage loss
The following baseline features of quantitative MRI of cartilage morphology were examined in the context of predicting change: mean cartilage thickness over the total subchondral bone area (ThCtAB) in medial tibia (MT), cMF, and MFTC, and presence of a denuded area of more than 1% of the total subchondral bone area in MT, cMF, or MFTC
Summary
The aim was to investigate the relationship of cartilage loss (change in medial femorotibial cartilage thickness measured with magnetic resonance imaging (MRI)) with compartment-specific baseline radiographic findings and MRI cartilage morphometry features, and to identify which baseline features can be used for stratification of fast progressors. To this end, fixed flexion radiography [1,2,3,4,5] and 3 Tesla magnetic resonance imaging. ANOVA: analysis of variance; BMD: bone mineral density; BMI: body mass index; ccMF: central aspect of the weight bearing medial femoral condyle; cMF: weight bearing medial femoral condyle; cMFTC: central medial femorotibial compartment; cMT: central medial tibia; FLASH: fast low angle shot; GLM: general linear models; JSN: joint space narrowing; JSW: joint space width; KLG: Kellgren Lawrence grade; MFTC: medial femorotibial compartment; mJSN: medial joint space narrowing; MRI: magnetic resonance imaging; MT: medial tibia; OA: osteoarthritis; SRM: standardized response mean; ThCtAB: change in cartilage thickness. The limitation of the KLG [13], is that it mixes distinct constructs (osteophytes, joint space narrowing (JSN), subchondral sclerosis, subchondral bone shape changes, cysts, etc) into one scale with the invalid assumptions that changes are linear [14]
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