The Association of Bone Marrow Lesions with Pain in Knee Osteoarthritis

Felson, David T.; Chaisson, Christine E.; Hill, Catherine; Tötterman, S.; Gale, M. Elon; Skinner, Katherine M.; Kazis, Lewis E.; Gale, Daniel

doi:10.7326/0003-4819-134-7-200104030-00007

Cited by 865 publications

(726 citation statements)

References 15 publications

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“…However, the lack of K-L Grade 4 patients in this retrospective case series is due to our general indication for this procedure as we deemed the most advanced grade of osteoarthritis to be a contraindication, as there is little reason to think that treating marrow edema below a bare joint surface would provide durable pain relief or regrow cartilage. In light of other studies [5,6] which have shown that the prevalence of symptomatic bone marrow edema lesions rises with increasing Kellgren-Lawrence Grade, we were not surprised by the negative correlation between K-L Grade and outcome scores. Our small sample size has been discussed as a limitation and we believe further studies with a larger number of study subjects would corroborate our finding.…”

supporting

confidence: 51%

Reply to Letter to the Editor: Subchondral Calcium Phosphate is Ineffective for Bone Marrow Edema Lesions in Adults with Advanced Osteoarthritis

Chatterjee

McGee

Strauss

et al. 2015

Clinical Orthopaedics &Amp; Related Research

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supporting

confidence: 51%

Reply to Letter to the Editor: Subchondral Calcium Phosphate is Ineffective for Bone Marrow Edema Lesions in Adults with Advanced Osteoarthritis

Chatterjee

McGee

Strauss

et al. 2015

Clinical Orthopaedics &Amp; Related Research

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“…Enrollment age for women was older to lessen the chance of inadvertently subjecting a pregnant woman to radiography. The source of subjects for this study has been detailed in other publications (7)(8)(9). Briefly, subjects with knee pain were drawn from 2 cohorts receiving care at Veterans Administration Medical Centers and from the community.…”

Section: Methodsmentioning

confidence: 99%

Cruciate ligament integrity in osteoarthritis of the knee

Hill¹,

Seo²,

Gale³

et al. 2005

Arthritis & Rheumatism

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143

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Objective. To evaluate, using magnetic resonance imaging (MRI), the prevalence of anterior cruciate ligament (ACL) and posterior cruciate ligament (PCL) rupture in knees with symptomatic osteoarthritis (OA) compared with those without OA, and the relationship to pain and recalled injury.Methods. MRI and plain radiography of the knee were performed in a group of 360 subjects with painful knee OA (cases; 66.7% male, mean age 67.1 years) and 73 without knee pain (controls; 57.5% male, mean age 66.1 years). MRIs were read for the presence or absence of complete or partial ACL or PCL tear. Subjects with knee pain were asked to quantify severity of pain on a visual analog scale and to report whether they could recall a significant knee injury (requiring use of a cane or crutches). We compared the prevalence of ACL and PCL rupture in those with and those without knee pain and also evaluated whether, in cases, there was any association with recalled knee injury.Results. The proportion of cases who had complete ACL rupture was 22.8%, compared with 2.7% of controls (P ‫؍‬ 0.0004). PCL rupture was rare both in cases (0.6%) and in controls (0%). Cases with ACL rupture had more severe radiologic OA (P < 0.0001) and were more likely to have medial joint space narrowing (P < 0.0001) than cases with intact ACLs, but did not have higher pain scores. Among cases, only 47.9% of those with complete ACL tears reported a previous knee injury, compared with 25.9% of those without complete ACL tears (P ‫؍‬ 0.003).Conclusion. ACL rupture is more common among those with symptomatic knee OA compared with those without knee OA. Fewer than half of subjects with ACL rupture recall a knee injury, suggesting that this risk factor for knee OA is underrecognized.

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“…Initial reports were extremely enthusiastic about the role of BMLs in knee OA. They suggested that BMLs were associated with knee pain [15], could be predictive of progression [16] especially if they enlarged [17] or were associated with varus or valgus angulation [16]. Later reports, however, were less clear-cut even suggesting that BMLs were not only unassociated with Western Ontario and McMaster Universities index of OA scores (WOMAC™) [18,19] and other measures of patient symptoms but also fluctuated over a period of time, resolving and/or worsening with new lesions coming and going elsewhere in the same joint [20,21].…”

Section: So Where Does the Problem Lie?mentioning

confidence: 99%