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Multicenter Study
. 2016 Jul;24(7):1160-6.
doi: 10.1016/j.joca.2016.01.981. Epub 2016 Feb 4.

Changes in patellofemoral and tibiofemoral joint cartilage damage and bone marrow lesions over 7 years: the Multicenter Osteoarthritis Study

J J Stefanik  1 , A Guermazi  2 , F W Roemer  3 , G Peat  4 , J Niu  5 , N A Segal  6 , C E Lewis  7 , M Nevitt  8 , D T Felson  9
Affiliations
Multicenter Study

Changes in patellofemoral and tibiofemoral joint cartilage damage and bone marrow lesions over 7 years: the Multicenter Osteoarthritis Study

J J Stefanik et al. Osteoarthritis Cartilage. 2016 Jul.

Abstract

Objectives: To investigate changes in cartilage damage and bone marrow lesions (BMLs) on MRI in the patellofemoral and tibiofemoral joints (TFJs) over 7 years.

Methods: The Multicenter Osteoarthritis (MOST) Study is a cohort study of persons aged 50-79 years at baseline with or at high risk for knee osteoarthritis (OA). Knees were eligible for the current study if they had knee MRI (1.0T) assessed for cartilage damage and BMLs at the baseline and 84-month visits. Knees were categorized as having MRI-detected structural damage (cartilage and BMLs) isolated to the patellofemoral joint (PFJ), isolated to the TFJ, mixed or no damage at baseline and 84-months. We determined the changes in PFJ and TFJ structural damage over 7 years and used logistic regression to assess the relation of baseline compartment distribution to incident isolated PFJ, isolated TFJ and mixed damage.

Results: Among 339 knees that had full-thickness cartilage loss isolated to the PFJ or TFJ at baseline, only 68 (20.1%) developed full-thickness cartilage loss in the other compartment while 271 (79.9%) continued to only have the initial compartment affected. Compared to knees without full-thickness cartilage damage (n = 582), those with isolated TFJ and PFJ full-thickness cartilage damage had 2.7 (1.5, 4.9) and 5.8 (3.6, 9.6) times the odds of incident mixed full-thickness cartilage damage, respectively. Similar results were seen when using other definitions of MRI-defined structural damage.

Conclusions: Most knees with structural damage at baseline do not develop it in the other compartment. Knees that develop mixed structural damage are more likely to start with it isolated to the PFJ.

Keywords: Knee osteoarthritis; MRI; Pain.

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Figures

Figure 1
Figure 1
Isolated patello-femoral strucutral damage. A. Axial proton density-weighted image shows fissure-like full thickness defect at the lateral patellar facet (arrow). No additional structural damage was observed. B.Diiffuse and extensive but still isolated full thickness cartilage damage in the medial patellar facet is shown in this axial proton-density-weighted image (arrows).
Figure 2
Figure 2
Isolated early tibio-femoral structural damage. A. Coronal STIR image shows bone marrow lesion at the medial tibial plateau (short white arrows) with adjacent superficial focal cartilage lesion (long white arrow). In addition there is a small bone marrow lesion at the medial femur (gray arrow). B. Another example shows a superficial cartilage defect at the central medial femur (arrow).
Figure 3
Figure 3. Knee eligibility flow chart
Figure 4
Figure 4. Changes in full-thickness cartilage damage in the patellofemoral and tibiofemoral joints over 84 months (n=921 knees)
Figure 5
Figure 5. Changes in any cartilage damage in the patellofemoral and tibiofemoral joints over 84 months (n=420 knees)
Figure 6
Figure 6. Changes in BMLs in the patellofemoral and tibiofemoral joints over 84 months (n=565 knees)
See this image and copyright information in PMC

References

    1. Callaghan MJ, Parkes MJ, Hutchinson CE, Gait AD, Forsythe LM, Marjanovic EJ, et al. A randomised trial of a brace for patellofemoral osteoarthritis targeting knee pain and bone marrow lesions. Ann Rheum Dis. 2015;74(6):1164–70. - PMC - PubMed
    1. Crossley KM, Marino GP, Macilquham MD, Schache AG, Hinman RS. Can patellar tape reduce the patellar malalignment and pain associated with patellofemoral osteoarthritis? Arthritis Rheum. 2009;61(12):1719–25. - PubMed
    1. Hunter DJ, Harvey W, Gross KD, Felson D, McCree P, Li L, et al. A randomized trial of patellofemoral bracing for treatment of patellofemoral osteoarthritis. Osteoarthritis Cartilage. 2011;19(7):792–800. - PMC - PubMed
    1. Duncan R, Peat G, Thomas E, Hay EM, Croft P. Incidence, progression and sequence of development of radiographic knee osteoarthritis in a symptomatic population. Ann Rheum Dis. 2011;70(11):1944–8. - PubMed
    1. Guermazi A, Roemer FW, Burstein D, Hayashi D. Why radiography should no longer be considered a surrogate outcome measure for longitudinal assessment of cartilage in knee osteoarthritis. Arthritis Res Ther. 2011;13(6):247. - PMC - PubMed

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