title: Cartilage thickening in early radiographic knee osteoarthritis: a within-person, between-knee comparison.
abstract: OBJECTIVE
  To determine whether the presence of definite osteophytes (in the absence of joint space narrowing [JSN]) on radiographs is associated with (subregional) increases in cartilage thickness in a within-person, between-knee cross-sectional comparison of participants in the Osteoarthritis Initiative. Based on previous results, the external weight-bearing medial femoral condyle (ecMF) and external weight-bearing lateral femoral condyle (ecLF) subregions were selected as primary end points.
  
  
  METHODS
  Both knees of 61 Osteoarthritis Initiative participants (n = 4,796) displayed definite tibial or femoral marginal osteophytes and no JSN in 1 knee, and no signs of radiographic osteoarthritis (OA) in the contralateral knee; this was confirmed by an expert central reader. In these participants, cartilage thickness was measured in 16 femorotibial subregions of each knee, based on sagittal double-echo steady-state with water excitation magnetic resonance images. Location-specific joint space width from fixed-flexion radiographs was determined using dedicated software. Location-specific associations of osteophytes with cartilage thickness were evaluated using paired t-tests and mixed-effects models.
  
  
  RESULTS
  Of the 61 participants, 48% had only medial osteophytes, 36% only lateral osteophytes, and 16% bicompartmental osteophytes. The knees with osteophytes had significantly thicker cartilage than contralateral knees without osteophytes in the ecMF (mean ± SD +71 ± 223 μmoles, equivalent to an increase of +5.5%; P = 0.015) and ecLF (mean ± SD +64 ± 195 μmoles, +4.1%; P = 0.013). No significant differences between knees were noted in other subregions or in joint space width. Cartilage thickness in the ecMF and ecLF was significantly associated with tibial osteophytes in the same (medial or lateral) compartment (P = 0.003).
  
  
  CONCLUSIONS
  The knees with early radiographic OA display thicker cartilage than (contralateral) knees without radiographic findings of OA, specifically in the external femoral subregions of compartments with marginal osteophytes.
authors.affiliation: Paracelsus Medical University, Salzburg, Austria.
authors.forename: Sebastian
authors.initials: S
authors.lastname: Cotofana
authors.forename: Robert
authors.initials: R
authors.lastname: Buck
authors.forename: Wolfgang
authors.initials: W
authors.lastname: Wirth
authors.forename: Frank
authors.initials: F
authors.lastname: Roemer
authors.forename: Jeff
authors.initials: J
authors.lastname: Duryea
authors.forename: Michael
authors.initials: M
authors.lastname: Nevitt
authors.forename: Felix
authors.initials: F
authors.lastname: Eckstein
mesh_terms: D000368:Aged; D002358:Cartilage, Articular / Q000000981:diagnostic imaging* / Q000473:pathology*; D003430:Cross-Sectional Studies; D042241:Early Diagnosis; D005260:Female; D005269:Femur / Q000000981:diagnostic imaging / Q000473:pathology; D006801:Humans; D007719:Knee Joint / Q000000981:diagnostic imaging / Q000473:pathology; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D020370:Osteoarthritis, Knee / Q000000981:diagnostic imaging* / Q000473:pathology*; D054850:Osteophyte / Q000000981:diagnostic imaging* / Q000473:pathology*; D011859:Radiography; D013977:Tibia / Q000000981:diagnostic imaging / Q000473:pathology; D016474:Weight-Bearing