Bone marrow lesions in people with knee osteoarthritis predict progression of disease and joint replacement: a longitudinal study

Tanamas, Stephanie K.; Wluka, Anita E.; Pelletier, Jean‐Pierre; Pelletier, Johanne Martel; Abram, F.; Berry, Patricia; Wang, Yuanyuan; Jones, Graeme; Cicuttini, Flavia Maria

doi:10.1093/rheumatology/keq286

Cited by 190 publications

(169 citation statements)

References 21 publications

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“…The present results and those from previous knee MRI studies (28)(29)(30) highlight the importance of evaluating risk factors predictive of cartilage volume loss in knee OA. For instance, it is known that the presence of meniscal lesions or BML is predictive of disease progression (5,11,26,(31)(32)(33)(34).…”

Section: Discussionsupporting

confidence: 76%

Magnetic Resonance Imaging–Assessed Vastus Medialis Muscle Fat Content and Risk for Knee Osteoarthritis Progression: Relevance From a Clinical Trial

Raynauld

Pelletier

Roubille

et al. 2015

Arthritis Care & Research

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Objective. Studies have proposed vastus medialis (VM) muscle cross-sectional area change as a variable associated with cartilage volume loss in knee osteoarthritis (OA). However, the VM also includes fat (%Fat), which may influence knee function. This study analyzed the VM area and %Fat data, separately and in combination, to predict symptoms, cartilage volume loss, and bone marrow lesion (BML) change in knee OA. Methods. This study included the according-to-protocol population (n 5 143) of a 2-year knee OA randomized clinical trial having magnetic resonance imaging at baseline and 2 years. Correlations used multivariate analyses. Results. Greater baseline value for VM area and %Fat were significantly associated with sex (male, area; female, %Fat), higher body mass index (BMI), and Western Ontario and McMaster Universities Osteoarthritis Index stiffness, function, and total scores (better, high area; worse, high %Fat). Moreover, a VM %Fat increase of 1% at 2 years was associated with worsening of cartilage volume loss in the global knee (P 5 0.015) and some subregions (P £ 0.030), and with an increment of BML global score change (P < 0.001). A 1% decrease in VM area at 2 years was associated with worsening of knee pain score (P 5 0.048). Importantly, the concurrent presence of low VM area, high VM %Fat, and high BMI identified a subgroup of patients with greater cartilage volume loss in the medial femur (P 5 0.028) than the rest of the cohort. Conclusion. These data demonstrated, for the first time, that VM fat content is a strong predictor of cartilage volume loss and the occurrence and progression of BML. Importantly, the combined data of VM area, VM %Fat, and BMI identified patients at higher risk for OA progression.

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Section: Discussionsupporting

confidence: 76%

Magnetic Resonance Imaging–Assessed Vastus Medialis Muscle Fat Content and Risk for Knee Osteoarthritis Progression: Relevance From a Clinical Trial

Raynauld

Pelletier

Roubille

et al. 2015

Arthritis Care & Research

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“…BMLs are a strong predictor of car tilage loss in OA, and both subregional BML load and maximum grade play an important role in predicting knee replacement (25)(26)(27). Meniscal damage, replacement 1 year later.…”

Section: Discussionmentioning

confidence: 99%

Can Structural Joint Damage Measured with MR Imaging Be Used to Predict Knee Replacement in the Following Year?

et al. 2015

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).q RSNA, 2014 Purpose:To assess whether magnetic resonance (MR) imagingbased cross-sectional measures of structural joint damage can be used to predict knee replacement during the following year. Materials and Methods:Participants were drawn from the Osteoarthritis Initiative, a longitudinal observational study that includes 4796 participants who have knee osteoarthritis or are at risk. The HIPAA-compliant protocol was approved by the institutional review boards of all participating centers, and written informed consent was obtained from all participants. During the 5 years of follow-up, 199 knees underwent knee replacement and were matched with 199 control knees that did not undergo knee replacement. Knees were matched according to radiographic disease stage and patient sex and age. All knees that underwent knee replacement and had MR images available from the year before surgery were included. MR images were assessed for cartilage damage, bone marrow lesions, meniscal damage, meniscal extrusion, synovitis, and effusion prior to reported knee replacement. Conditional logistic regression was applied to assess the risk of knee replacement. Analyses were performed on a compartmental and knee level. Results:Participants had a mean age 6 standard deviation of 64.2 years 6 8. Conclusion:Apart from meniscal extrusion, all features of tissue abnormalities at MR imaging were related to clinical prognosis and could be used to predict knee replacement in the following year.q RSNA, 2014

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“…BMLs are strong and independent predictors of knee cartilage loss, especially site-specific cartilage loss [67,68,69••], and progression of knee cartilage lesions [24,28,67,68,[70][71][72]. BMLs also predict total knee replacement over periods of up to 4 years [49,50,[73][74][75]. In some studies, BMLs predicted knee replacements more strongly than other predictors assessed in the same cohort [49,74].…”

Section: Bone Marrow Lesionsmentioning

confidence: 99%

Measuring Disease Progression in Osteoarthritis

Laslett

Pelletier

Cicuttini

et al. 2016

Curr Treat Options in Rheum

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Bone marrow lesions in people with knee osteoarthritis predict progression of disease and joint replacement: a longitudinal study

Cited by 190 publications

References 21 publications

Magnetic Resonance Imaging–Assessed Vastus Medialis Muscle Fat Content and Risk for Knee Osteoarthritis Progression: Relevance From a Clinical Trial

Magnetic Resonance Imaging–Assessed Vastus Medialis Muscle Fat Content and Risk for Knee Osteoarthritis Progression: Relevance From a Clinical Trial

Can Structural Joint Damage Measured with MR Imaging Be Used to Predict Knee Replacement in the Following Year?

Measuring Disease Progression in Osteoarthritis

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