Association between age and knee structural change: a cross sectional MRI based study

Abstract

Objective: To describe the associations between age, knee cartilage morphology, and bone size in adults. Methods: A cross sectional convenience sample of 372 male and female subjects (mean age 45 years, range 26-61) was studied. Knee measures included a cartilage defect five site score (0-4 respectively) and prevalence (defect score of >2 at any site), cartilage volume and thickness, and bone surface area and/or volume. These were determined at the patellar, medial, and lateral tibial and femoral sites using T 1 weighted fat saturation MRI. Height, weight, and radiographic osteoarthritis (ROA) were measured by standard protocols. Results: In multivariate analysis, age was significantly associated with knee cartilage defect scores (b = +0.016 to +0.073/year, all p,0.01) and prevalence (OR = 1.05-1.10/year, all p,0.05) in all compartments. Additionally, age was negatively associated with knee cartilage thickness at all sites (b = 20.013 to 20.035 mm/year, all p,0.05), and with patellar (b = 211.5 ml/year, p,0.01) but not tibial cartilage volume. Lastly, age was significantly positively associated with medial and lateral tibial surface bone area (b = +3.0 to +4.7 mm 2 /year, all p,0.05) and patellar bone volume (b = +34.4 ml/ year, p,0.05). Associations between age and tibiofemoral cartilage defect score, cartilage thickness, and bone size decreased in magnitude after adjustment for ROA, suggesting these changes are directly relevant to OA. Conclusion: The most consistent knee structural changes with increasing age are increase in cartilage defect severity and prevalence, cartilage thinning, and increase in bone size with inconsistent change in cartilage volume. Longitudinal studies are needed to determine which of these changes are primary and confirm their relevance to knee OA.

Quantitative MRI of cartilage and bone: degenerative changes in osteoarthritis

“…MR sequences used for semiquantitative scoring of cartilage lesions involve T 1 -weighted spoiled gradient recalled acquisition at steady state (SPGR ¼ spoiled gradient echo or FLASH ¼ fast low-angle shot) with fat suppression (38,(40)(41)(42)(43)(44)(45)(46)(47) the internal structure of the cartilage displays a more heterogeneous signal and 'internal' pathological changes may be more readily displayed. Also, cartilage surface lesions are well depicted with these sequences, because of the steep gradient of signal intensity between the cartilage and the synovial fluid, in particular when effusion is present [ Fig.…”

“…MR sequences used for semiquantitative scoring of cartilage lesions involve T 1 -weighted spoiled gradient recalled acquisition at steady state (SPGR ¼ spoiled gradient echo or FLASH ¼ fast low-angle shot) with fat suppression (38,(40)(41)(42)(43)(44)(45)(46)(47) or selective water excitation (we) (48) [Figs 1, 2 and 3(a)], fat-suppressed T 2 -or intermediate (IM) weighted fast spin-echo (FSE) (38,43,(49)(50)(51)(52) [ Fig. 3(b) and (c)] and fat-suppressed driven equilibrium Fourier transform (DEFT) imaging (53).…”

“…Peterfy et al (43) reported cartilage changes and osteophytes to be the most prominent features (>90%) in 19 patients with knee OA [Kellgren Lawrence grade (KLG) 2 and 3] whereas meniscal injury (80%) bone cysts (77%), synovitis (75%), marrow abnormalities (57%), bone attrition (48%) and ligament injuries (8%) were less frequent. In a sample of 372 male and female subjects, aged 26-61 years, knee cartilage defect severity (sagittal fat-suppressed SPGR) was shown to be associated with age and radiographic OA status (45), body mass index (BMI) (46) and C-terminal crosslinking telopeptide of type II collagen (44).…”

Static knee alignment is associated with the risk of unicompartmental knee cartilage defects

“…Interobserver reliability (expressed as ICC) in 50 random MR images was 0.90 for the medial tibiofemoral compartment 0.85 for the lateral tibiofemoral compartment. 13,14 Radiographs and Determining Static Knee Alignment and the Presence of Knee Osteoarthritis Knee angles were measured by a single blinded trained observer from standing AP radiographs using the software program Osiris. 15 Lines were drawn through the middle of the femoral shaft and through the middle of the tibial shaft.…”

Restoration of limited defects of the cartilage with the use of cell-engineered constructs

“…В исследовании МРТ пациентов с повреждения-ми области коленного сустава распространенность дефектов хряща достигала 31% у лиц в возрасте от 45 до 54 лет [6]. В исследовании МРТ с применени-ем томографа 3.0 Тесла у 9 из 20 случайно выбран-ных испытуемых в возрасте 25-45 лет, не имеющих жалоб, выявлены повреждения суставного хряща коленного сустава [7].…”