Meniscal extrusion or subchondral damage characterize incident accelerated osteoarthritis: Data from the osteoarthritis initiative

Abstract

Introduction Knee osteoarthritis (KOA) is typically a slowly progressive disorder; however, a subset of knees progress with dramatic rapidity. We aimed to describe magnetic resonance imaging (MRI) findings that are associated with accelerated KOA. Materials and Methods We conducted a longitudinal descriptive study in the Osteoarthritis Initiative (OAI) cohort. We selected participants who had no radiographic KOA at baseline with one of the following in the most severe knee: 1) accelerated KOA (progressed to end-stage KOA within 48 months), 2) common KOA, and 3) no KOA at all visits. We enriched the sample by selecting knees with a self-reported or suspected knee injury. A musculoskeletal radiologist blinded to group assignments but not to time sequence performed MRI readings for the visit before and after an injury. Results We assessed 38 participants (knees), 66% were female, mean age 61 (9) years, and mean body mass index 28.5 (4.9) kg/m2. Fifteen of 20 knees with no or common KOA, had no incident findings consistent with acute damage. Among the 18 knees with accelerated KOA most had incident findings: 13 (72%) had incident medial meniscal pathology with extrusion and 5 (28%) knees had subchondral damage. Conclusions Incident MRI findings that are associated with incident accelerated KOA are characterized by structural damage that compromises subchondral bone or the function of the meniscus. Recognizing meniscal extrusion and/or change in shape, lateral meniscal tear, or acute subchondral damage may be vital for identifying individuals at risk for accelerated KOA.

A single recent injury is a potent risk factor for the development of accelerated knee osteoarthritis: data from the osteoarthritis initiative

“…While numerous studies have evaluated AKOA with data from the OAI [1,5,6,3,2,4,10,11] they have all focused on the first four years of the cohort. By studying people with AKOA after the 48-month visit of the OAI, we could explore which modifiable risk factors are consistently present and which risk factors are unique to the timing of incident AKOA.…”

Individuals with incident accelerated knee osteoarthritis have greater pain than those with common knee osteoarthritis progression: data from the Osteoarthritis Initiative

“…Individuals with AKOA may initially be characterized by subtle changes related to knee pain that precede radiographic progression [7,8]. In preliminary analyses, we found that individuals with incident AKOA (n = 18) often have cartilage damage and meniscal pathology before any radiographic evidence of AKOA [8].…”

“…In preliminary analyses, we found that individuals with incident AKOA (n = 18) often have cartilage damage and meniscal pathology before any radiographic evidence of AKOA [8]. Within the OAI, magnetic resonance imaging revealed that individuals with no radiographic osteoarthritis (KL = 0) had a high prevalence of cartilage damage (76%), bone marrow lesions (61%), and meniscal pathology (>20%).…”

Glucose homeostasis influences the risk of incident knee osteoarthritis: Data from the osteoarthritis initiative

“…We recently characterized a group of individuals who develop an accelerated form of knee osteoarthritis, which we defined as a knee without radiographic osteoarthritis that develops incident advance‐stage disease in less than four years and often in just 12 months . Besides an accelerated rate of disease onset, individuals with accelerated knee osteoarthritis are more likely to be older, report greater knee pain, and experience a recent knee injury than their peers who develop a typical (gradual) onset of knee osteoarthritis.…”