Predicting incident radiographic knee osteoarthritis through quantitative meniscal lesion parameters: the Osteoarthritis Initiative

Abstract

Background: This study investigates the potential of novel meniscal parameters as predictive factors for incident radiographic knee osteoarthritis (ROA) over a span of four years, as part of the Osteoarthritis Initiative (OAI) study. Methods: A subset of 178 knees (from 176 patients ) from the OAI study, with incident ROA (Kellgren Lawrence Grade (KLG) 0 or 1 at baseline (BL), evolving into KLG 2 or above by year 4), were matched for gender, age and radiographic status on a one-to-one basis with 178 control knees (from 178 patients) that did not develop incident ROA (KLG 0 or 1 at BL, KLG<2 by year 4). Mean distance from medial-to-lateral meniscal lesions [Mean(MLD)], mean value of tibial plateau width [Mean(TPW)] and the mean of the relative percentage of the medial to lateral meniscal lesions distance [Mean(RMLD)] were evaluated through coronal T2-weighted turbo spin echo (TSE) MRI. Conditional logistic regression analyses were used to assess the risk of incident ROA associated with novel meniscus parameters after adjustment for covariates. Sensitivity analysis was performed for P-0 (the visit when ROA was identified on radiographs), P-1(one year prior to P-0) and the incidence of ROA at baseline (enrollment period). Results: Mean(MLD) and Mean(RMLD) were significantly greater for incident knees compared to no incident knees at BL P-1and P-0. [Mean(MLD), Mean(RMLD); (42.56-49.73) mean ± (7.70-9.52) mm SD vs (38.14-40.78) mean ± (5.51-7.05)mm SD; (58.61-68.95) mean ± (8.52-11.40) mm SD vs (52.52-56.35) mean ± (6.53-7.85)mm SD, respectively]. The baseline meniscus measurement parameters included Mean(MLD), Mean(TPW), and Mean(RMLD). Baseline Mean(MLD) and Mean(RMLD), [Adjusted OR, 95%CI: 1.11(1.07 to 1.16) and 1.13(1.09 to 1.17), respectively], were associated with incident ROA during 4 years, However, Mean(TPW) [Adjusted OR, 95%CI: 0.98(0.94 to 1.02)] was not associated with incident ROA during 4 years. At baseline, Mean (MLD) and Mean (RMLD) were significantly different between the case and control groups. While Mean(TPW) at P-1 and P-0 was not associated with the risk of incident ROA, Mean(MLD) and Mean(RMLD) at P-1 and P-0 were significantly positively associated with the risk of incident ROA. Conclusions: Compared to the control group, Mean(MLD) and Mean(RMLD) at baseline, P-1 and P-0 were higher in the case group, and significant differentiation of these measures was observed among the groups. These novel meniscus parameters alterations could be an important imaging biomarker to predict the occurrence of ROA.