Assessment of progression in knee osteoarthritis: results of a 1 year study comparing arthroscopy and MRI.
OBJECTIVE
The objectives of this study were to determine the sensitivity to change of magnetic resonance imaging (MRI) quantification of chondropathy after 1 year in osteoarthritis of the medial tibiofemoral compartment and to assess the predictive value of subchondral bone marrow edema and bone abnormalities on progression of chondropathy.


METHODS
Twenty patients with symptomatic knee osteoarthritis of the medial compartment underwent a prospective, longitudinal study. All patients were evaluated the same day at entry and after 1 year by plain weight-bearing radiographs, MRI with a three-dimensional gradient-echo sequence, using a 0.2-T dedicated MR unit, and arthroscopy. The medial tibiofemoral chondropathy was quantified blindly with MRI and arthroscopy using the French Society of Arthroscopy (SFA) score. Presence of subchondral bone marrow edema and bone abnormalities on initial MRI was recorded in order to evaluate their influence on both unchanged and worsened chondropathy after 1 year.


RESULTS
After 1 year, no statistically significant changes were observed with plain radiographs and arthroscopy. At variance, a statistically significant worsening of chondropathy was found with MRI using the SFA-MR score (P=0.01). SFA-MR score was the most responsive outcome. Absence of subchondral bone abnormalities and bone marrow edema on initial MR assessment predicted absence of worsening of chondropathy after 1 year.


CONCLUSIONS
MRI appears promising for evaluating progression of knee osteoarthritis.
Department of Radiology B, Hôpital Cochin-27, AP-HP, Université Paris V, rue du Faubourg Saint-Jacques, 75679 Paris Cedex 14, France. eric.pessis@cch.ap-hop-paris.fr
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Pessis
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Drapé
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Ravaud
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Chevrot
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Dougados
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Ayral
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001182:Arthroscopy / Q000379:methods*; D001853:Bone Marrow / Q000473:pathology; D001855:Bone Marrow Diseases / Q000473:pathology; D002358:Cartilage, Articular / Q000473:pathology*; D019902:Chondrocytes / Q000473:pathology*; D018450:Disease Progression; D004487:Edema / Q000473:pathology; D005260:Female; D005269:Femur / Q000473:pathology; D006801:Humans; D007719:Knee Joint / Q000473:pathology; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D008875:Middle Aged; D020370:Osteoarthritis, Knee / Q000473:pathology*; D013977:Tibia / Q000473:pathology