Association of cartilage degeneration with four year weight gain – 3T MRI data from the Osteoarthritis Initiative

Abstract

Objective To determine the effect of weight gain on progression of early knee morphologic abnormalities using magnetic resonance imaging (MRI) in a longitudinal study over 48 months. Design We studied the right knee of 100 subjects from the Osteoarthritis Initiative, selecting subjects aged ≥ 45 with osteoarthritis risk factors who demonstrated weight gain (minimum 5% increase in body mass index, BMI, n=50) or no change in weight (BMI change < 2%, n=50), frequency matched for age, gender, and baseline BMI. Baseline and 48 month knee MRI studies were scored for lesions using a modified whole organ MRI score (WORMS). Logistic regression models were used to compare the differences between the two groups. Results The odds of worsening maximum cartilage (11.3, 95%, CI 3.5–51.4) and meniscal WORMS (4.5, 95% CI 1.4–17.3) were significantly greater in the weight gain group compared to the no change group, in addition to the odds of worsening cartilage defects at the patella and average meniscal WORMS (p<0.05). Odds of worsening average bone marrow edema pattern (BMEP) were significantly greater for the weight gain group compared to the no change cohort (p<0.05). Conclusion Our study demonstrated that weight gain is strongly associated with increased progression of cartilage degeneration in middle-aged individuals with risk factors for osteoarthritis.

Is Weight Loss Associated with Less Progression of Changes in Knee Articular Cartilage among Obese and Overweight Patients as Assessed with MR Imaging over 48 Months? Data from the Osteoarthritis Initiative

“…Moreover, our study was a retrospective analysis of the weight loss of participants included in the OAI, and analyses did not consider methods and weight loss regimens used, including diet, exercise, or bariatric surgery. This is a major limitation of our study and may have introduced confounding effects into our analysis that cannot be estimated because different regimens may have different effects on joint structures (eg, cartilage health might develop differently in participants starting a rigorous exercise training program compared with participants undergoing bariatric effect in patients with weight gain (18). However, given the inconsistency in the previous literature, caution is needed in estimating the clinical relevance of associations between weight loss and MR findings over time.…”

“…Complete BMI data for baseline and 12-, 24-, and 48-month follow-up were available for 4526 study participants. Of those, we excluded participants with a baseline Kellgren-Lawrence score higher than 3 in the right knee, associated with exacerbation of knee joint degeneration, especially with worsening cartilage and meniscal degeneration over 48 months, when compared with stable weight (18).…”

“…In case of diverging findings (n = 82), a consensus reading was performed with a third board-certified musculoskeletal radiologist (T.M.L., 24 years of experience). The images were evaluated for three osteoarthritis features by using the semiquantitative WORMS grading system (35), modified as previously described (18,36): Meniscal defects were graded from 0 to 4 in each of the three subregions of the medial and lateral meniscus (anterior, body, and posterior). The meniscal defects and abnormalities were graded according to the WORMS subscale from 0 to 4 (0 = intact, 1 = intrasubstance signal abnormalities, 2 = nondisplaced tear, 3 = displaced or complex tear, 4 = maceration).…”

Hyperintense signal alteration in the suprapatellar fat pad on MRI is associated with degeneration of the patellofemoral joint over 48 months: data from the Osteoarthritis Initiative

“…Complete baseline and follow-up patellofemoral WORMS readings were available for the right knees of a sample of 443 of these potentially eligible subjects previously obtained by our group for several NIH-funded studies (Fig. 1) [22][23][24][25][26][27][28]. To minimize any potential influence caused by abnormalities of the extensor mechanism, and especially the quadriceps tendon in addition to inflammatory processes leading to effusion-synovitis, subjects showing these findings at baseline (extensor mechanism, n = 7; effusion-synovitis, n = 10) were excluded.…”

Regional Articular Cartilage Abnormalities of the Hip

“…Epidemiologic studies have shown that focal cartilage lesions progress over time and that obesity and high-impact physical activities are associated with cartilage degeneration [10,11]. Lifestyle changes have a significant influence on disease progression [12], and early detection of cartilage damage and patient education therefore may delay hip replacement.…”