The clinical correlates of articular cartilage defects in symptomatic knee osteoarthritis: a prospective study.
OBJECTIVE
To determine whether articular cartilage defects are associated with cartilage loss and joint replacement in subjects with symptomatic knee osteoarthritis (OA).


METHODS
One hundred and seventeen subjects with symptomatic knee OA underwent magnetic resonance imaging of their dominant knee at baseline and 2 yr later. Cartilage defects were identified as prevalent (defect score > or =2) in each knee compartment. Occurrence of joint replacement by 4 yr was documented.


RESULTS
Cartilage defects were present in 81% of medial, 64% of lateral tibiofemoral compartments and 55% of patellar cartilages. Annual patellar cartilage loss was highest in those with defects compared with no defects (5.5% vs 3.2%, P = 0.01). Tibial cartilage loss was not associated with defects in the medial (4.6% vs 5.8%, P = 0.42) or lateral (4.7% vs 6.5%, P = 0.21) tibial cartilages. Higher total cartilage defect scores (8-15) were associated with a 6.0-fold increased risk of joint replacement over 4 yr compared with those with lower scores (2-7) (95% confidence interval 1.6, 22.3), independently of potential confounders.


CONCLUSIONS
Articular cartilage defects are associated with disease severity in knee OA and predict patellar cartilage loss and knee replacement.
Wluka
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Department of Epidemiology and Preventive Medicine, Monash University, Central and Eastern Clinical School, Alfred Hospital, Commercial Road, Melbourne, VIC 3004, Australia.
Ding
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Jones
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Cicuttini
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FM
D000368:Aged; D019645:Arthroplasty, Replacement, Knee; D002358:Cartilage, Articular / Q000293:injuries* / Q000473:pathology; D018450:Disease Progression; D005260:Female; D006801:Humans; D007718:Knee Injuries / Q000150:complications* / Q000473:pathology; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D020370:Osteoarthritis, Knee / Q000150:complications / Q000473:pathology / Q000601:surgery*; D011379:Prognosis; D011446:Prospective Studies; D012307:Risk Factors; D012720:Severity of Illness Index