Tibiofemoral joint osteoarthritis: risk factors for MR-depicted fast cartilage loss over a 30-month period in the multicenter osteoarthritis study.
OBJECTIVE
To assess baseline factors that may predict fast tibiofemoral cartilage loss over a 30-month period.


METHODS
The Multicenter Osteoarthritis (MOST) study is a longitudinal study of individuals who have or who are at high risk for knee osteoarthritis. The HIPAA-compliant protocol was approved by the institutional review boards of all participating centers, and written informed consent was obtained from all participants. Magnetic resonance (MR) images were read according to the Whole-Organ Magnetic Resonance Imaging Score (WORMS) system. Only knees with minimal baseline cartilage damage (WORMS < or = 2.5) were included. Fast cartilage loss was defined as a WORMS of at least 5 (large full-thickness loss, less than 75% of the subregion) in any subregion at 30-month follow-up. The relationships of age, sex, body mass index (BMI), ethnicity, knee alignment, and several MR features (eg, bone marrow lesions, meniscal damage and extrusion, and synovitis or effusion) to the risk of fast cartilage loss were assessed by using a multivariable logistic regression model.


RESULTS
Of 347 knees, 90 (25.9%) exhibited cartilage loss, and only 20 (5.8%) showed fast cartilage loss. Strong predictors of fast cartilage loss were high BMI (adjusted odds ratio [OR], 1.11; 95% confidence interval [CI]: 1.01, 1.23), the presence of meniscal tears (adjusted OR, 3.19; 95% CI: 1.13, 9.03), meniscal extrusion (adjusted OR, 3.62; 95% CI: 1.34, 9.82), synovitis or effusion (adjusted OR, 3.36; 95% CI: 0.91, 12.4), and any high-grade MR-depicted feature (adjusted OR, 8.99; 95% CI: 3.23, 25.1).


CONCLUSIONS
In participants with minimal baseline cartilage damage, the presence of high BMI, meniscal damage, synovitis or effusion, or any severe baseline MR-depicted lesions was strongly associated with an increased risk of fast cartilage loss. Patients with these risk factors may be ideal subjects for preventative or treatment trials.
Roemer
Frank W
FW
Department of Radiology, Boston University Medical Center, 820 Harrison Ave, FGH Building, Third Floor, Boston, MA 02118, USA. frank.roemer@bmc.org
Zhang
Yuqing
Y
Niu
Jingbo
J
Lynch
John A
JA
Crema
Michel D
MD
Marra
Monica D
MD
Nevitt
Michael C
MC
Felson
David T
DT
Hughes
Laura B
LB
El-Khoury
George Y
GY
Englund
Martin
M
Guermazi
Ali
A
D000368:Aged; D002358:Cartilage, Articular / Q000473:pathology*; D005260:Female; D005269:Femur / Q000473:pathology; D006801:Humans; D007090:Image Interpretation, Computer-Assisted / Q000379:methods; D016015:Logistic Models; D008137:Longitudinal Studies; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D008875:Middle Aged; D020370:Osteoarthritis, Knee / Q000473:pathology*; D012307:Risk Factors; D013977:Tibia / Q000473:pathology; D014481:United States / Q000453:epidemiology