Natural History of Knee Cartilage Defects and Factors Affecting Change

Ding, Changhai; Cicuttini, Flavia Maria; Scott, F; Cooley, Helen M; Boon, Catrina; Jones, Graeme

doi:10.1001/archinte.166.6.651

Cited by 152 publications

(186 citation statements)

References 24 publications

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“…Previous studies have shown that cartilage volume loss is a more sensitive and specific marker of cartilage integrity than JSN and possibly the best outcome measure for drug trials looking to preserve cartilage (17). Moreover, cartilage defects have an unstable natural history as they can improve without any intervention depending on the age of the patient, especially in people with less advanced disease (14,26). This is a possible explanation of weaker associations we observed in our study compared to previously available literature.…”

Section: Discussioncontrasting

confidence: 68%

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Correlation Between Changes in Global Knee Structures Assessed by Magnetic Resonance Imaging and Radiographic Osteoarthritis Changes Over Ten Years in a Midlife Cohort

Khan

Chou

Aitken

et al. 2016

Arthritis Care & Research

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Objective. The aim of this study was to describe the correlation between changes in structural abnormalities assessed on magnetic resonance imaging (MRI) and change in radiographic osteoarthritis (OA) over 10 years in a midlife cohort. Methods. A total of 211 participants (mean age 45 years [range 26-61 years], 57% female) were studied at baseline, 2 years, and 10 years. Approximately one-half were adult offspring of subjects who had undergone knee replacement for OA and the remainders were randomly selected controls. Joint space narrowing (JSN) and osteophytes were assessed from radiographs, while cartilage volume, cartilage defects, and meniscal tears/extrusion were assessed from MRI. Spearman ranked correlation analysis was used to describe the correlation between structural changes assessed on MRI and radiographs. Only medial tibiofemoral compartment results are presented, as the lateral compartment had limited change. Results. Over 10 years, change in meniscal tears showed a moderate independent correlation with change in both JSN (r 5 10.37, P < 0.01) and osteophytes (r 5 10.31, P < 0.01) in the adjusted analysis. Meniscal extrusion (r 5 10.22, P < 0.01) and cartilage defects (r 5 10.16, P < 0.04) showed a slightly weaker independent correlation with JSN in the adjusted analysis, whereas cartilage volume loss showed no significant correlation with either of the 2 radiographic outcomes. Conclusion. Change in JSN is correlated with change in meniscal tears and, to a lesser extent, with meniscal extrusion and cartilage defects. In this sample, change in JSN is a composite measure that does not reflect cartilage volume loss, prompting the review of the use of JSN as an outcome measure in chondro-protective drug trials.

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Section: Discussioncontrasting

confidence: 68%

“…MRI. MRI of the right knee was performed as described previously (12)(13)(14). Knees were imaged in the sagittal plane on a 1.5T whole-body MR unit (Picker International), using a commercial transmit-receive extremity coil at the baseline visit and at the 2-year and 10-year followup visits.…”

Section: Significance and Innovationsmentioning

confidence: 99%

Correlation Between Changes in Global Knee Structures Assessed by Magnetic Resonance Imaging and Radiographic Osteoarthritis Changes Over Ten Years in a Midlife Cohort

Khan

Chou

Aitken

et al. 2016

Arthritis Care & Research

Self Cite

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“…[20][21][22] To assess the reproducibility and consistency of our full-thickness injury model, the sections were investigated on the day of the operation. Although the CVs of cartilage thickness, depth of cartilage injury, and crosssectional width were more than 10%, CVs of %depth were all less than 10%.…”

Section: Discussionmentioning

confidence: 99%

An Articular Cartilage Repair Model in Common C57Bl/6 Mice

Matsuoka

Onodera

Sasazawa

et al. 2015

Tissue Engineering Part C: Methods

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To analyze the genetic and biomolecular mechanisms underlying cartilage repair, an optimized mouse model of osteochondral repair is required. Although several models of articular cartilage injury in mice have recently been established, the articular surface in adult C57Bl/6 mice heals poorly. Since C57Bl/6 mice are the most popular strain of genetically manipulated mice, an articular cartilage repair model using C57Bl/6 mice would be helpful for analysis of the mechanisms of cartilage repair. The purpose of this study was to establish a cartilage repair model in C57Bl/6 mice using immature animals. To achieve this goal, fullthickness injuries were generated in 3-week-old (young), 4-week-old (juvenile), and 8-week-old (adult) C57Bl/6 mice. To investigate the reproducibility and consistency of full-thickness injuries, mice were sacrificed immediately after operation, and cartilage thickness at the patellar groove, depth of the cartilage injury, cross-sectional width, and cross-sectional area were compared among the three age groups. The depth of cartilage injury/cartilage thickness ratio (%depth) and the coefficient of variation (CV) for each parameter were also calculated. At 8 weeks postoperatively, articular cartilage repair was assessed using a histological scoring system. With respect to the reproducibility and consistency of full-thickness injuries, cartilage thickness, depth of cartilage injury, and cross-sectional area were significantly larger in young and juvenile mice than in adult mice, whereas cross-sectional width and %depth were almost equal among the three age groups. CVs of %depths were less than 10% in all groups. With respect to articular cartilage repair, young and juvenile mice showed superior results. In conclusion, we established a novel cartilage repair model in C57Bl/6 mice. This model will be valuable in achieving mechanistic insights into the healing process of the joint surface, as it will facilitate the use of genetically modified mice, which are most commonly developed on a C57Bl/6 background.

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“…Cartilage defects in these studies have been assessed by different trained readers who were blinded with regard to clinical data, demonstrating high methodologic quality; for a cartilage defect to be identified it also had to be present on 2 consecutive slices, further reducing measurement error. We have also shown that our method of assessment is sensitive to change over time (8). Additionally, it is convenient and cost-effective to use the same sequences for assessing both cartilage defects and cartilage volume.…”

Section: To the Editormentioning

confidence: 84%

“…It would not result in spurious associations. As is important for any measure, the reproducibility and reliability of our method is high in multiple settings (6)(7)(8)(9), and there is a moderate correlation with histologic findings (10). Most importantly, our measure of cartilage defects has also been shown to be associated with clinically important outcomes such as pain, radiographic OA, cartilage volume loss, cartilage breakdown markers, bone marrow lesions, and knee replacement surgery (11) in multiple cross-sectional and longitudinal studies.…”

Section: To the Editormentioning

confidence: 98%