An efficient subset of morphological measures for articular cartilage in the healthy and diseased human knee

Buck, Robert J.; Wyman, Bradley T.; Graverand, Marie‐Pierre Hellio Le; Wirth, W.; Eckstein, F.; Investigators, Adni

doi:10.1002/mrm.22207

Cited by 42 publications

(36 citation statements)

References 32 publications

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“…1). Several regions of interest have been proposed for mean thickness measurements [4,5,[7][8][9], and the method can be adapted to characterize the thickness shape in these regions rather than in the regions of thicker cartilage, as done in the present study.…”

Section: Discussionmentioning

confidence: 99%

“…More recently, magnetic resonance imaging (MRI) has replaced radiography, notably because it can visualize articular cartilage with high resolution and is noninvasive [5,6]. In this case, cartilage thickness is usually analyzed by segmenting consecutive MR images to build a three-dimensional thickness map for the cartilage and then mean thickness measurements are performed on the map [4,5,[7][8][9]. While mean thickness measurements have provided important insights into the characteristics of knee OA [6,10], they suffer from a limited ability to detect OA-related differences; specifically, differences between asymptomatic knees and knees at early disease stages [6,11,12].…”

Section: Introductionmentioning

confidence: 99%

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Patterns of Femoral Cartilage Thickness are Different in Asymptomatic and Osteoarthritic Knees and Can be Used to Detect Disease-Related Differences Between Samples

Favre¹,

Scanlan

Erhart‐Hledik³

et al. 2013

Journal of Biomechanical Engineering

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Measures of mean cartilage thickness over predefined regions in the femoral plate using magnetic resonance imaging have provided important insights into the characteristics of knee osteoarthritis (OA), however, this quantification method suffers from the limited ability to detect OA-related differences between knees and loses potentially important information regarding spatial variations in cartilage thickness. The objectives of this study were to develop a new method for analyzing patterns of femoral cartilage thickness and to test the following hypotheses: (1) asymptomatic knees have similar thickness patterns, (2) thickness patterns differ with knee OA, and (3) thickness patterns are more sensitive than mean thicknesses to differences between OA conditions. Bi-orthogonal thickness patterns were extracted from thickness maps of segmented magnetic resonance images in the medial, lateral, and trochlea compartments. Fifty asymptomatic knees were used to develop the method and establish reference asymptomatic patterns. Another subgroup of 20 asymptomatic knees and three subgroups of 20 OA knees each with a Kellgren/Lawrence grade (KLG) of 1, 2, and 3, respectively, were selected for hypotheses testing. The thickness patterns were similar between asymptomatic knees (coefficient of multiple determination between 0.8 and 0.9). The thickness pattern alterations, i.e., the differences between the thickness patterns of an individual knee and reference asymptomatic thickness patterns, increased with increasing OA severity (Kendall correlation between 0.23 and 0.47) and KLG 2 and 3 knees had significantly larger thickness pattern alterations than asymptomatic knees in the three compartments. On average, the number of significant differences detected between the four subgroups was 4.5 times greater with thickness pattern alterations than mean thicknesses. The increase was particularly marked in the medial compartment, where the number of significant differences between subgroups was 10 times greater with thickness pattern alterations than mean thickness measurements. Asymptomatic knees had characteristic regional thickness patterns and these patterns were different in medial OA knees. Assessing the thickness patterns, which account for the spatial variations in cartilage thickness and capture both cartilage thinning and swelling, could enhance the capacity to detect OA-related differences between knees.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Patterns of Femoral Cartilage Thickness are Different in Asymptomatic and Osteoarthritic Knees and Can be Used to Detect Disease-Related Differences Between Samples

Favre¹,

Scanlan

Erhart‐Hledik³

et al. 2013

Journal of Biomechanical Engineering

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“…Cartilage parameters were computed using custom software (Chondrometrics, Ainring, Germany). The primary structural outcomes16 were thickness of cartilage over total area of bone (ThCtAB) and the percentage area of denuded bone (dABp). Secondary structural outcome parameter was thickness of cartilage over area of bone covered with cartilage (ThCcAB).…”

Section: Methodsmentioning

confidence: 99%

Tissue structure modification in knee osteoarthritis by use of joint distraction: an open 1-year pilot study

Intema

Roermund

Marijnissen

et al. 2011

Annals of the Rheumatic Diseases

141

161

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BackgroundModification of joint tissue damage is challenging in late-stage osteoarthritis (OA). Few options are available for treating end-stage knee OA other than joint replacement.ObjectivesTo examine whether joint distraction can effectively modify knee joint tissue damage and has the potential to delay prosthesis surgery.Methods20 patients (<60 years) with tibiofemoral OA were treated surgically using joint distraction. Distraction (∼5 mm) was applied for 2 months using an external fixation frame. Tissue structure modification at 1 year of follow-up was evaluated radiographically (joint space width (JSW)), by MRI (segmentation of cartilage morphology) and by biochemical markers of collagen type II turnover, with operators blinded to time points. Clinical improvement was evaluated by Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) and Visual Analogue Scale (VAS) pain score.ResultsRadiography demonstrated an increase in mean and minimum JSW (2.7 to 3.6 mm and 1.0 to 1.9 mm; p<0.05 and <0.01). MRI revealed an increase in cartilage thickness (2.4 to 3.0 mm; p<0.001) and a decrease of denuded bone areas (22% to 5%; p<0.001). Collagen type II levels showed a trend towards increased synthesis (+103%; p<0.06) and decreased breakdown (−11%; p<0.08). The WOMAC index increased from 45 to 77 points, and VAS pain decreased from 73 to 31 mm (both p<0.001).ConclusionsJoint distraction can induce tissue structure modification in knee OA and could result in clinical benefit. No current treatment is able to induce such changes. Larger, longer and randomised studies on joint distraction are warranted.

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“…qMRI measures of the cartilage were derived after three-dimensional surface reconstruction, using Chondrometrics software:27 specifically mean cartilage thickness over the total area of subchondral bone ThCtAB.Me, percentage denuded subchondral bone area dAB%, and the total subchondral bone area tAB,28 because these measures have been shown to provide independent and comprehensive information on cartilage change and status in healthy and in osteoarthritic knees 29. Cartilage thickness in the medial femorotibial compartment (MFTC) was determined as: …”

Section: Methodsmentioning

confidence: 99%

Quantitative MRI measures of cartilage predict knee replacement: a case–control study from the Osteoarthritis Initiative

et al. 2012

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Abstract:Objective: Knee osteoarthritis is a highly prevalent disease, commonly requiring joint replacement; it substantially reduces quality of life and increases health care utilization and costs. We aimed to identify whether quantitative measures of articular cartilage structure predict knee replacement, and to establish their utility as outcomes in clinical trials of disease modifying therapy. Methods:A nested case-control study was performed in Osteoarthritis Initiative participants, a multicenter observational cohort of 4796 participants with or at risk of knee osteoarthritis. 127 knees were replaced between baseline and four years follow-up, and one control knee per case matched for baseline radiographic disease stage (KellgrenLawrence grade, KLG), gender, and age. Quantitative cartilage measures were obtained from 3 Tesla magnetic resonance images at the exam before knee replacement, and longitudinal change during the prior 12 months when available (n=110).Results: Cartilage thickness loss in the central and total medial femoro-tibial compartment (primary and secondary outcomes) was significantly greater in case than in control knees (AUC=0.59/ 0.58). Differences in cartilage loss were greater at earlier than at later radiographic disease stages (p<0.01 for interaction with KLG). Cartilage thickness loss in the central tibia was the most predictive longitudinal measure (AUC=0.64). Cross-sectionally, denuded bone areas in the medial femur distinguished case and control knees most strongly (AUC=0.66). Conclusions:This study demonstrates the predictive value of quantitative, magnetic resonance imaging-based measures of cartilage for the clinically relevant endpoint of 4 knee replacement, providing support for their utility in clinical trials to evaluate the effectiveness of structure modifying intervention.

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An efficient subset of morphological measures for articular cartilage in the healthy and diseased human knee

Cited by 42 publications

References 32 publications

Patterns of Femoral Cartilage Thickness are Different in Asymptomatic and Osteoarthritic Knees and Can be Used to Detect Disease-Related Differences Between Samples

Patterns of Femoral Cartilage Thickness are Different in Asymptomatic and Osteoarthritic Knees and Can be Used to Detect Disease-Related Differences Between Samples

Tissue structure modification in knee osteoarthritis by use of joint distraction: an open 1-year pilot study

Quantitative MRI measures of cartilage predict knee replacement: a case–control study from the Osteoarthritis Initiative

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