Early pre-radiographic structural pathology precedes the onset of accelerated knee osteoarthritis

Matthew S Harkey^{1

2}, Julie E Davis³, Bing Lu⁴, Lori Lyn Price^{5

6}, Robert J Ward⁷, James W MacKay⁸, Charles B Eaton⁹, Grace H Lo^{10

11}, Mary F Barbe¹², Ming Zhang^{3

13}, Jincheng Pang¹⁴, Alina C Stout¹⁵, Timothy E McAlindon³, Jeffrey B Driban³

Affiliations

¹ Division of Rheumatology, Allergy, and Immunology, Tufts Medical Center, 800 Washington Street, Box 406, Boston, MA, 02111, USA. mharkey@tuftsmedicalcenter.org.
² Department of Population and Quantitative Health Sciences, University of Massachusetts Medical School, Worcester, MA, USA. mharkey@tuftsmedicalcenter.org.
³ Division of Rheumatology, Allergy, and Immunology, Tufts Medical Center, 800 Washington Street, Box 406, Boston, MA, 02111, USA.
⁴ Division of Rheumatology, Immunology & Allergy, Brigham & Women's Hospital and Harvard Medical School, Boston, MA, USA.
⁵ The Institute for Clinical Research and Health Policy Studies, Tufts Medical Center, Boston, MA, USA.
⁶ Tufts Clinical and Translational Science Institute, Tufts University, Boston, MA, USA.
⁷ Department of Radiology, Tufts Medical Center, Boston, MA, USA.
⁸ Department of Radiology, University of Cambridge School of Clinical Medicine, Cambridge, UK.
⁹ Center for Primary Care and Prevention, Alpert Medical School of Brown University, Pawtucket, RI, USA.
¹⁰ Medical Care Line and Research Care Line, Houston Health Services Research and Development (HSR&D) Center of Excellence Michael E. DeBakey VAMC, Houston, TX, USA.
¹¹ Section of Immunology, Allergy, and Rheumatology, Baylor College of Medicine, Houston, TX, USA.
¹² Department of Anatomy and Cell Biology, Temple University School of Medicine, Philadelphia, PA, USA.
¹³ Department of Computer Science & Networking, Wentworth Institute of Technology, Boston, MA, USA.
¹⁴ Pfizer Inc., Cambridge, MA, USA.
¹⁵ Public Health Institute, Northeastern University, Boston, MA, USA.

PMID: 31113401
PMCID: PMC6530034
DOI: 10.1186/s12891-019-2624-y

Early pre-radiographic structural pathology precedes the onset of accelerated knee osteoarthritis

Matthew S Harkey et al. BMC Musculoskelet Disord. 2019.

. 2019 May 22;20(1):241.

doi: 10.1186/s12891-019-2624-y.

Authors

Affiliations

¹ Division of Rheumatology, Allergy, and Immunology, Tufts Medical Center, 800 Washington Street, Box 406, Boston, MA, 02111, USA. mharkey@tuftsmedicalcenter.org.
² Department of Population and Quantitative Health Sciences, University of Massachusetts Medical School, Worcester, MA, USA. mharkey@tuftsmedicalcenter.org.
³ Division of Rheumatology, Allergy, and Immunology, Tufts Medical Center, 800 Washington Street, Box 406, Boston, MA, 02111, USA.
⁴ Division of Rheumatology, Immunology & Allergy, Brigham & Women's Hospital and Harvard Medical School, Boston, MA, USA.
⁵ The Institute for Clinical Research and Health Policy Studies, Tufts Medical Center, Boston, MA, USA.
⁶ Tufts Clinical and Translational Science Institute, Tufts University, Boston, MA, USA.
⁷ Department of Radiology, Tufts Medical Center, Boston, MA, USA.
⁸ Department of Radiology, University of Cambridge School of Clinical Medicine, Cambridge, UK.
⁹ Center for Primary Care and Prevention, Alpert Medical School of Brown University, Pawtucket, RI, USA.
¹⁰ Medical Care Line and Research Care Line, Houston Health Services Research and Development (HSR&D) Center of Excellence Michael E. DeBakey VAMC, Houston, TX, USA.
¹¹ Section of Immunology, Allergy, and Rheumatology, Baylor College of Medicine, Houston, TX, USA.
¹² Department of Anatomy and Cell Biology, Temple University School of Medicine, Philadelphia, PA, USA.
¹³ Department of Computer Science & Networking, Wentworth Institute of Technology, Boston, MA, USA.
¹⁴ Pfizer Inc., Cambridge, MA, USA.
¹⁵ Public Health Institute, Northeastern University, Boston, MA, USA.

PMID: 31113401
PMCID: PMC6530034
DOI: 10.1186/s12891-019-2624-y

Abstract

Background: Accelerated knee osteoarthritis (AKOA) is characterized by more pain, impaired physical function, and greater likelihood to receive a joint replacement compared to individuals who develop the typical gradual onset of disease. Prognostic tools are needed to determine which structural pathologies precede the development of AKOA compared to individuals without AKOA. Therefore, the purpose of this manuscript was to determine which pre-radiographic structural features precede the development of AKOA.

Methods: The sample comprised participants in the Osteoarthritis Initiative (OAI) who had at least one radiographically normal knee at baseline (Kellgren-Lawrence [KL] grade < 1). Participants were classified into 2 groups based on radiographic progression from baseline to 48 months: AKOA (KL grade change from < 1 to > 3) and No AKOA. The index visit was the study visit when participants met criteria for AKOA or a matched timepoint for those who did not develop AKOA. Magnetic resonance (MR) images were assessed for 12 structural features at the OAI baseline, and 1 and 2 years prior to the index visit. Separate logistic regression models (i.e. OAI baseline, 1 and 2 years prior) were used to determine which pre-radiographic structural features were more likely to antedate the development of AKOA compared to individuals not developing AKOA.

Results: At the OAI baseline visit, degenerative cruciate ligaments (Odds Ratio [OR] = 2.2, 95% Confidence Interval [CI] = 1.3,3.5), infrapatellar fat pad signal intensity alteration (OR = 2.0, 95%CI = 1.2,3.2), medial/lateral meniscal pathology (OR = 2.1/2.4, 95%CI = 1.3,3.4/1.5,3.8), and greater quantitative knee effusion-synovitis (OR = 2.2, 95%CI = 1.4,3.4) were more likely to antedate the development of AKOA when compared to those that did not develop AKOA. These results were similar at one and two years prior to disease onset. Additionally, medial meniscus extrusion at one year prior to disease onset (OR = 3.5, 95%CI = 2.1,6.0) increased the likelihood of developing AKOA.

Conclusions: Early ligamentous degeneration, effusion/synovitis, and meniscal pathology precede the onset of AKOA and may be prognostic biomarkers.

Keywords: Bone marrow lesion; Cartilage; Effusion-synovitis; Extensor mechanism; Ligament; MRI; Meniscus; Tendons.

PubMed Disclaimer

Conflict of interest statement

JBD, MFB, and MSH are members of the Editorial Board of BMC Musculoskeletal Disorders. The other authors declare that they have no competing interests.

References

1. Driban JB, Eaton CB, Lo GH, Ward RJ, Lu B, McAlindon TE. Association of knee injuries with accelerated knee osteoarthritis progression: data from the osteoarthritis initiative. Arthritis Care Res (Hoboken) 2014;66(11):1673–1679. doi: 10.1002/acr.22359. - DOI - PMC - PubMed
1. Driban JB, Price LL, Eaton CB, Lu B, Lo GH, Lapane KL, McAlindon TE. Individuals with incident accelerated knee osteoarthritis have greater pain than those with common knee osteoarthritis progression: data from the osteoarthritis initiative. Clin Rheumatol. 2016;35(6):1565–1571. doi: 10.1007/s10067-015-3128-2. - DOI - PMC - PubMed
1. Driban JB, Stout AC, Lo GH, Eaton CB, Price LL, Lu B, Barbe MF, McAlindon TE. Best performing definition of accelerated knee osteoarthritis: data from the osteoarthritis initiative. Ther Adv Musculoskelet Dis. 2016;8(5):165–171. doi: 10.1177/1759720X16658032. - DOI - PMC - PubMed
1. Davis JE, Liu SH, Lapane K, Harkey MS, Price LL, Lu B, Lo GH, Eaton CB, Barbe MF, McAlindon TE, et al. Adults with incident accelerated knee osteoarthritis are more likely to receive a knee replacement: data from the osteoarthritis initiative. Clin Rheumatol. 2018;37(4):1115–1118. doi: 10.1007/s10067-018-4025-2. - DOI - PMC - PubMed
1. Driban JB, Ward RJ, Eaton CB, Lo GH, Price LL, Lu B, McAlindon TE. Meniscal extrusion or subchondral damage characterize incident accelerated osteoarthritis: data from the osteoarthritis initiative. Clin Anat. 2015;28(6):792–799. doi: 10.1002/ca.22590. - DOI - PMC - PubMed

MeSH terms

Actions
Actions
Actions
Actions
Actions
Actions
Actions
Actions
Actions
Actions
Actions
Actions
Actions
Actions
Actions
Actions
Actions
Actions
Actions
Actions
Actions

Grants and funding

LinkOut - more resources

Full Text Sources
Miscellaneous
- NCI CPTAC Assay Portal

Save citation to file

Email citation

Add to Collections

Add to My Bibliography

Your saved search

Create a file for external citation management software

Your RSS Feed

Early pre-radiographic structural pathology precedes the onset of accelerated knee osteoarthritis

Affiliations

Early pre-radiographic structural pathology precedes the onset of accelerated knee osteoarthritis

Authors

Affiliations

Abstract

Conflict of interest statement

References

MeSH terms

Grants and funding

LinkOut - more resources

Full Text Sources

Miscellaneous