Abstract

ObjectiveTo determine whether 3D meniscal measures had similar sensitivity to longitudinal change as cartilage thickness; to what extent these measures are associated with longitudinal joint space width (JSW) change; and whether the latter associations differ between minimum (mJSW) and fixed-location JSW.MethodsTwo-year changes in medial meniscal position and morphology, cartilage thickness (MRI) and minimum and fixed-location JSW (radiography) were determined in 35 Osteoarthritis Initiative knees [12 men, age: 67 (51-77) years; 23 women, age: 65 (54-78) years], progressing from baseline Kellgren-Lawrence grade ≤2 to knee replacement within 3-5 years. Multiple linear regression assessed the features contributing to JSW change.ResultsMeniscal measures, cartilage thickness and JSW displayed similar sensitivity to change (standardised response mean≤|0.76|). Meniscal changes were strongly associated with JSW change (r≤|0.66|), adding ≤20% to its variance in addition to cartilage thickness change. Fixed-location JSW change (multiple r2=72%) was more strongly related to cartilage and meniscal change than mJSW (61%). Meniscal morphology explained more of fixed-location JSW and meniscal position more of mJSW.ConclusionMeniscal measures provide independent information in explaining the variance of radiographic JSW change. Fixed-location JSW appears to be more reflective of structural change than mJSW and, hence, a potentially superior measure of structural progression.Key Points• 3D positional/morphological meniscal measures change in rapidly progressing knees.• Similar sensitivity to 2-year change of quantitative meniscal/cartilage measures in rapid progression.• Changes in meniscal measures are strongly associated with radiographic JSW change.• Meniscal change provides information to explain JSW variance independent of cartilage.• Fixed-location JSW reflects structural disease stage more closely than minimum JSW.

Highlights

  • Radiographic joint space width (JSW) is the structural measure currently accepted by regulatory agencies for testing disease-modifying drugs in knee osteoarthritis (KOA) [1]

  • The results of this study showed that sensitivity to change is similar among positional and morphological meniscal measures, MRI cartilage thickness and radiographic minimum JSW (mJSW) during a 2-year observation interval before knee replacement (KR)

  • Meniscal extrusion appeared to play a greater role in explaining longitudinal variability of mJSW, and meniscal morphology in explaining that of fixed-location JSW change

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Summary

Results

Thirty-five knees of 33 OAI participants (23 women; baseline age 64.7±7.1, body mass index 30.0±4.0 kg/m2, KLG0/1/2: 5/8/22, 33 total/two medial unicompartmental KRs) received a KR between the 36M and 60M follow-up visit (13 at 36M, seven at 48M, and 15 at 60M; Fig. 1). The highest correlation with mJSW change was observed for change in tibial meniscal surface area not covering the tibial plateau (r=-0.66; p

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