Longitudinal MRI structural findings observed in accelerated knee osteoarthritis: data from the Osteoarthritis Initiative.

Abstract

OBJECTIVE:

To analyze structural, longitudinal MRI findings during the development of accelerated knee osteoarthritis (AKOA) over 4 years.

MATERIALS AND METHODS:

From the Osteoarthritis Initiative (OAI), knees with no radiographic osteoarthritis (KL 0/1) developing advanced-stage osteoarthritis (KL 3/4; AKOA) within a 4-year (y) timeframe were selected. MRIs were graded using the modified Whole-Organ Magnetic Resonance Imaging Score (WORMS) at the beginning of the 4-year timeframe (index visit), at 2-year, and 4-year follow-up. Morphological and clinical findings associated with KL 3/4 onset within 2 years compared to 4 years were assessed using generalized estimating equations.

RESULTS:

AKOA was found in 162 knees of 149 subjects (age 63.25 ± 8.3; 103 females; BMI 29.4 ± 3.9). Moderate to severe meniscal lesions WORMS ≥ 3 were present in 25% (41/162) at the index visit, 64% (104/162) at 2-year and 93% (151/162) at 4-year follow-up. Meniscal extrusion was the most prevalent finding (ranging from 18% at the index visit, 45% at 2-year and 94% at 4-year follow-up) and root tears were the most common types of tears (9% at the index visit; 22% at 2 years and 38% at 4 years). Risk factors associated with KL 3/4 onset within 2 years included root tears at the index visit (adjusted OR, 2.82; 95% CI: 1.33, 6.00; p = 0.007) and incident knee injury (42%, 49/116 vs. 24%, 11/46, p = 0.032).

CONCLUSIONS:

Meniscal abnormalities, in particular extrusion and root tears, were the most prevalent morphological features found in subjects with AKOA. These results suggest that meniscal abnormalities have a significant role in accelerated progression of OA.

• Authors: Sarah C Foreman, Jan Neumann, Gabby B Joseph, Michael C Nevitt, Charles E McCulloch, Nancy E Lane, Thomas M Link
• Journal: Skeletal radiology (Skeletal Radiol) Vol. 48 Issue 12 Pg. 1949-1959 (Dec 2019) ISSN: 1432-2161 [Electronic] Germany
• PMID: 31209509 (Publication Type: Journal Article, Observational Study)

Topics

• Arthroscopy
• Disease Progression
• Female
• Humans
• Longitudinal Studies
• Magnetic Resonance Imaging (methods)
• Male
• Middle Aged
• Osteoarthritis, Knee (diagnostic imaging, pathology, surgery)
• Reproducibility of Results
• Risk Factors