Magnetic Resonance Imaging–Based Three‐Dimensional Bone Shape of the Knee Predicts Onset of Knee Osteoarthritis: Data From the Osteoarthritis Initiative

Abstract

Objective To examine whether MRI-based 3D bone shape predicts the onset of radiographic knee osteoarthritis (OA). Methods We conducted a case-control study within the Osteoarthritis Initiative by identifying knees that developed incident tibiofemoral radiographic knee OA (case knees) over follow-up, and matching them to two random control knees. Using knee MRI's, we used active appearance modeling of the femur, tibia and patella and linear discriminant analysis to identify vectors that best classified knees having OA vs. not. Vectors were scaled such that -1 and +1 represented the mean non-OA and mean OA shapes, respectively. We examined the relation of 3D bone shape to incident OA (new onset Kellgren and Lawrence (KL) grade ≥2) occurring 12 months later using conditional logistic regression. Results 178 case knees (incident OA) were matched to 353 control knees. The whole joint (i.e., tibia, femur, and patella) 3D bone shape vector had the strongest magnitude of effect, with knees in the highest tertile having 3.0 times higher likelihood of developing incident radiographic knee OA 12 months later compared with those in the lowest tertile (95% CI 1.8-5.0, p<0.0001). The associations were even stronger among knees that showed completely normal radiographs before incidence (KL grade 0) (OR 12.5, 95% CI 4.0-39.3). Bone shape at baseline, often several years before incidence, predicted later OA. Conclusions MRI-based 3D bone shape predicted the later onset of radiographic OA. Further study is warranted to determine whether such methods can detect treatment effects in trials and provide pathophysiologic insight into OA development.

Longitudinal validation of periarticular bone area and 3D shape as biomarkers for knee OA progression? Data from the FNIH OA Biomarkers Consortium

“…Of greater interest, strength of association between bone biomarkers (area and shape) and progression appeared larger for the femur than for the tibia. This is consistent with other recent papers suggesting that femoral bone demonstrates greater change than tibial bone with regard to shape 16 35…”

“…In addition, subtle alterations in joint shape at both the hip and knee may be involved in the pathogenesis of OA 9 15. A recent study found that differences in three-dimensional (3D) shape of the periarticular tibia and femur are associated with the subsequent onset of incident radiographic knee OA 16. Previous studies have suggested that bone area can predict development of cartilage defects,17 is larger in knees with radiographic OA14 and can predict the need for knee joint replacement 17.…”

Imaging research results from the Osteoarthritis Initiative (OAI): a review and lessons learned 10 years after start of enrolment

“…Knees with certain differences in 3-D bone shape were more likely to develop incident ROA 12 months later, and the association was strongest among those with KLG0 prior to incidence 100. OA knees had greater longitudinal increases of bone area than those without OA, and bone area displayed greater sensitivity to change than cartilage thickness or radiographic JSW 99…”

Identifying and Treating Preclinical and Early Osteoarthritis

“…X-ray evidence of OA is a relatively late phenomenon in the structural evolution of this disease. For example, alterations in the shape of the periarticular bones often precedes the development of radiographic disease by 5-10 years (3). MRI abnormalities are present several years before disease development in most cases.…”