One year change of knee cartilage morphology in the first release of participants from the Osteoarthritis Initiative progression subcohort: association with sex, body mass index, symptoms and radiographic osteoarthritis status

Abstract

Objective-The Osteoarthritis Initiative (OAI) is a multicentre study targeted at identifying biomarkers for evaluating the progression and risk factors of symptomatic knee OA. Here cartilage loss using 3 Tesla (3 T) MRI is analysed over 1 year in a subset of the OAI, together with its association with various risk factors.Methods-An age-and gender-stratified subsample of the OAI progression subcohort (79 women and 77 men, mean (SD) age 60.9 (9.9) years, body mass index (BMI) 30.3 (4.7)) with both frequent symptoms and radiographic OA in at least one knee was studied. Coronal FLASHwe (fast low angle shot with water excitation) MRIs of the right knee were acquired at 3 T. Seven readers segmented tibial and femoral cartilages blinded to order of acquisition. Segmentations were quality controlled by one expert.Results-The reduction in mean cartilage thickness (ThC) was greater (p = 0.004) in the medial than in the lateral compartment, greater (p = 0.001) in the medial femur (−1.9%) than in the medial tibia (−0.5%) and greater (p = 0.011) in the lateral tibia (−0.7%) than in the lateral femur (0.1%). Multifactorial analysis of variance did not reveal significant differences in the rate of change in ThC by sex, BMI, symptoms and radiographic knee OA status. Knees with Kellgren-Lawrence grade 2 or 3 and with a BMI >30 tended to display greater changes. Conclusions-In this sample of the OAI progression subcohort, the greatest, but overall very modest, rate of cartilage loss was observed in the weight-bearing medial femoral condyle. Knees with radiographic OA in obese participants showed trends towards higher rates of change than those of other participants, but these trends did not reach statistical significance.MRI at 1.5 Tesla (T) can provide valuable information on articular cartilage loss and other structural changes in knee osteoarthritis (OA). The rate and SD of change over time reported, however, has varied substantially between studies. 1-12 These variations may be partly due to differences in study populations, with different profiles of risk factors for progression. The rate and SD of change to be expected for a certain cohort has, however, major implications for powering epidemiological, clinical and pharmacological studies in OA. It is therefore important to identify the factors that drive cartilage loss in OA.Methodologically, it has been shown that 3 T MRI provides a higher signal-and contrast-tonoise ratio 13 and higher test-retest precision of cartilage morphology measurements than 1.5 T MRI. 14 Previous longitudinal studies, have, however, relied on 1.5 T MRI. [1][2][3][4][5][6][7][8][9][10][11][12] There is thus the hope that 3 T MRI may provide a higher sensitivity to change of cartilage morphometry than 1.5 T MRI.The Osteoarthritis Initiative (OAI) is targeted at identifying sensitive biomarkers of symptomatic knee OA, and at characterising risk factors associated with its onset and progression. A total of 4796 participants were recruited between 2004 and 2006: 1389 participants had frequent ...

Intraarticular Sprifermin (Recombinant Human Fibroblast Growth Factor 18) in Knee Osteoarthritis: A Randomized, Double‐Blind, Placebo‐Controlled Trial

“…The primary end point (central subregions of the medial femorotibial compartment) was selected because previous results indicated that the central medial femorotibial compartment shows the greatest rate of change and sensitivity to change in cartilage thickness (20,24,26,42). In light of the previous trials showing more marked treatment effects on the lateral knee compartment as compared to the medial knee compartment (40,41), it is interesting to note that the primary end point of the present trial was not met, while dose-dependent treatment effects were found for the lateral knee compartment (lateral femorotibial compartment).…”

An efficient subset of morphological measures for articular cartilage in the healthy and diseased human knee

“…Metrics of cartilage morphology (volume, thickness, and others) based on MRI have been shown to be reproducible in single (1,3) and multicenter studies (4) and hold promise for evaluating the treatment response of structure/disease-modifying drugs. Several studies have reported the rate and sensitivity to change of cartilage morphology measures in participants with OA (5)(6)(7)(8)(9)(10)(11) and healthy persons (12-15) using 1.5T (1,3,16) or 3T MRI (17)(18)(19). Some of these studies have compared measures of change based on MRI to joint-space narrowing from radiographs (7,10,11,17,20).…”

90°-Flip-angle three-dimensional double-echo steady-state (3D-DESS) magnetic resonance imaging of the knee: Isovoxel cartilage imaging at 3T

“…1). The reasons for using FA-25° 3D-DESS imaging was that the FA-25° setting is the standard imaging condition for 3D-DESS (8,13,14). The sequence parameters were similar to those used in a previous study comparing 3D-DESS and True-FISP (3).…”

“…Accurate and precise analysis of cartilage morphology in the femorotibial joint is reported to be possible with 3D-DESS at 3.0 T (8). 3D-DESS is also used for long-term cartilage evaluation by the Osteoarthritis Initiative (13). However, several reports have suggested that 3D-DESS imaging has lower cartilage-synovial fluid contrast, which makes assessment of cartilage surface lesions more difficult than other sequences (6,7,14).…”