Risk factors for progressive cartilage loss in the knee

Abstract

Objective. To evaluate the rate of progression of cartilage loss in the knee joint using magnetic resonance imaging (MRI) and to evaluate potential risk factors for more rapid cartilage loss.Methods. We evaluated baseline and followup MRIs of the knees in 43 patients (minimum time interval of 1 year, mean 1.8 years, range 52-285 weeks). Cartilage loss was graded in the anterior, central, and posterior regions of the medial and lateral knee compartments. Knee joints were also evaluated for other pathology. Data were analyzed using analysis of variance models.Results. Patients who had sustained meniscal tears showed a higher average rate of progression of cartilage loss (22%) than that seen in those who had intact menisci (14.9%) (P < 0.018). Anterior cruciate ligament (ACL) tears had a borderline significant influence (P < 0.06) on the progression of cartilage pathology. Lesions located in the central region of the medial compartment were more likely to progress to more advanced cartilage pathology (progression rate 28%; P < 0.003) than lesions in the anterior (19%; P < 0.564) and posterior (17%; P < 0.957) regions or lesions located in the lateral compartment (average progression rate 15%; P < 0.707). Lesions located in the anterior region of the lateral compartment showed less progression of cartilage degradation (6%; P < 0.001). No specific grade of lesion identified at baseline had a predilection for more rapid cartilage loss (P < 0.93).Conclusion. MRI can detect interval cartilage loss in patients over a short period (<2 years). The presence of meniscal and ACL tears was associated with more rapid cartilage loss. Cartilage lesions located in the central region of the medial compartment showed more rapid progression of cartilage loss than cartilage lesions in the anterior and posterior portions of the medial compartment. The findings in this study suggest that patients entering clinical trials investigating antiarthritis regimens may need to be randomized based on location of the lesion.

Association of Meniscal Status, Lower Extremity Alignment, and Body Mass Index With Chondrosis at Revision Anterior Cruciate Ligament Reconstruction

“…However, that study did not look at the status of the meniscus at the time of rACLR. The current study confirms that an intact meniscus at the time of rACLR reduces the risk of articular cartilage damage which is not surprising given that meniscus tears are associated with chondrosis and osteoarthritis in the knee 5,25,31,36,38 . While one previous study reported six times more arthrosis in knees with concomitant partial meniscectomy at the time of ACL reconstruction 28 , another study did not find any association between the development of arthrosis and meniscal injury at the time of ACL reconstruction 12 .…”

Obesity increases the prevalence and severity of focal knee abnormalities diagnosed using 3T MRI in middle-aged subjects—data from the Osteoarthritis Initiative

“…MR imaging indeed has proven sensitivity to detect signal and morphologic changes in knee structures within relatively short time periods, such as 1–2 years [12, 31, 32]. Of note, the relative anatomical distribution of knee lesions within each BMI subgroup did not change significantly in our study at 36-month follow-up, unlike in Biswal et al [31].…”

“…MR imaging indeed has proven sensitivity to detect signal and morphologic changes in knee structures within relatively short time periods, such as 1–2 years [12, 31, 32]. Of note, the relative anatomical distribution of knee lesions within each BMI subgroup did not change significantly in our study at 36-month follow-up, unlike in Biswal et al [31]. We also identified progression to “higher-grade” cartilage defects and for meniscal lesions of “any grade.” However, these observations were not statistically significant, perhaps due to the relatively short 36-month follow-up interval and/or relatively small sample size.…”

Measurement and visualisation of focal cartilage thickness change by MRI in a study of knee osteoarthritis using a novel image analysis tool

“…The second and more novel is that the apparent lack of change in the global measures of volume conceals substantial focal loss of cartilage in many locations, almost balanced by equally substantial gains in cartilage thickness in other locations. This increase in thickness may be due to tissue swelling, which is known to be an early feature of cartilage degeneration in OA as a result of proteoglycan loss [22,23]. Intriguingly, there was more loss and gain of cartilage thickness in patients with the more severe KL grades.…”