title: Knee cartilage defects: association with early radiographic osteoarthritis, decreased cartilage volume, increased joint surface area and type II collagen breakdown.
abstract: OBJECTIVE
  To generate hypotheses regarding the associations between knee cartilage defects and knee radiographic osteoarthritis (ROA), cartilage volume, bone size and type II collagen breakdown in adults.
  
  
  METHODS
  A cross-sectional convenience sample of 372 male and female subjects (mean age 45 years, range 26-61) was studied. Knee cartilage defect score (0-4) and prevalence (a defect score of > or =2), cartilage volume, and bone surface area were determined using T1-weighted fat saturation MRI. Urinary levels of C-terminal crosslinking telopeptide of type II collagen (U-CTX-II) were measured by enzyme-linked immunosorbent assay. Height, weight and ROA were measured by standard protocols.
  
  
  RESULTS
  In multivariate analysis, the severity and prevalence of knee cartilage defects were significantly and independently associated with tibiofemoral osteophytes (regression coefficient (beta): +0.86 to +1.31/unit, odds ratio (OR): 2.97-3.68/unit, all P<0.05 with the exception of OR in lateral tibiofemoral compartment) and tibial bone area (beta: +0.11 to +0.25/cm2; OR: 1.33-1.58/cm2, all P<0.01). Knee cartilage defects were inconsistently associated with joint space narrowing after adjustment for osteophytes but consistently with knee cartilage volume (beta: -0.27 to -0.70/ml; OR: 0.16-0.56/ml, all P<0.01 except for OR at lateral tibial cartilage site P=0.06). Lastly, knee cartilage defect severity was significantly associated with U-CTX-II (Partial r=+0.18, P<0.001 for total cartilage defect score).
  
  
  CONCLUSIONS
  Osteophytes and increasing knee bone size may be causally related to knee cartilage defects. Furthermore, knee cartilage defects may result in increased cartilage breakdown leading to decreased cartilage volume and joint space narrowing suggesting an important role for knee cartilage defects in early knee OA.
authors.affiliation: Menzies Research Institute, University of Tasmania, Hobart, Australia.
authors.forename: Changhai
authors.initials: C
authors.lastname: Ding
authors.forename: Patrick
authors.initials: P
authors.lastname: Garnero
authors.forename: Flavia
authors.initials: F
authors.lastname: Cicuttini
authors.forename: Fiona
authors.initials: F
authors.lastname: Scott
authors.forename: Helen
authors.initials: H
authors.lastname: Cooley
authors.forename: Graeme
authors.initials: G
authors.lastname: Jones
mesh_terms: D000328:Adult; D000886:Anthropometry / Q000379:methods; D002358:Cartilage, Articular / Q000293:injuries / Q000473:pathology*; D024043:Collagen Type II / Q000378:metabolism*; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D007719:Knee Joint / Q000473:pathology*; D008279:Magnetic Resonance Imaging / Q000379:methods; D008297:Male; D008875:Middle Aged; D020370:Osteoarthritis, Knee / Q000378:metabolism / Q000473:pathology*; D010329:Patella / Q000473:pathology; D012720:Severity of Illness Index; D013977:Tibia / Q000473:pathology
chemical_list: D024043:Collagen Type II