title: Co-localisation of non-cartilaginous articular pathology increases risk of cartilage loss in the tibiofemoral joint--the MOST study.
abstract: OBJECTIVE
  To assess risk of cartilage loss in the tibiofemoral joint in relation to baseline damage severity, and to analyse the association of nearby pathologic findings on the risk of subsequent cartilage loss.
  
  
  METHODS
  The Multicenter Osteoarthritis Study is a longitudinal study of individuals with or at high risk for knee osteoarthritis. MRI examinations were assessed according to the Whole Organ MRI Score. Included were all knees with available baseline and 30 months MRIs. Ordinal logistic regression was used to estimate risk of cartilage loss in each subregion in relation to the number of associated articular features including bone marrow lesions, meniscal damage and extrusion and also in regard to baseline damage severity, respectively.
  
  
  RESULTS
  13 524 subregions of 1365 knees were included. 3777 (27.9%) subregions exhibited prevalent cartilage damage at baseline and 1119 (8.3%) subregions showed cartilage loss at 30-month follow-up. Risk of cartilage loss was increased for subregions with associated features (OR 2.53, 95% CI 2.03 to 3.15 for one, 4.32 95% CI 3.42 to 5.47 for two and 5.30 95% CI 3.95 to 7.12 for three associated features; p for trend<0.0001). Subregions with prevalent cartilage damage showed increased risk for further cartilage loss compared to subregions with intact cartilage at baseline with small superficial defects exhibiting highest risk.
  
  
  CONCLUSIONS
  Risk of cartilage loss is increased for subregions with associated pathology and further increased when more than one type of associated feature is present. In addition, prevalent cartilage damage increases risk for subsequent cartilage loss.
authors.affiliation: Department of Radiology, Boston University School of Medicine, Boston, Massachusetts 02118, USA. froemer@bu.edu
authors.forename: Frank W
authors.initials: FW
authors.lastname: Roemer
authors.forename: David T
authors.initials: DT
authors.lastname: Felson
authors.forename: Ke
authors.initials: K
authors.lastname: Wang
authors.forename: Michel D
authors.initials: MD
authors.lastname: Crema
authors.forename: Tuhina
authors.initials: T
authors.lastname: Neogi
authors.forename: Yuqing
authors.initials: Y
authors.lastname: Zhang
authors.forename: Michael C
authors.initials: MC
authors.lastname: Nevitt
authors.forename: Monica D
authors.initials: MD
authors.lastname: Marra
authors.forename: Cora E
authors.initials: CE
authors.lastname: Lewis
authors.forename: James
authors.initials: J
authors.lastname: Torner
authors.forename: Ali
authors.initials: A
authors.lastname: Guermazi
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001855:Bone Marrow Diseases / Q000150:complications / Q000473:pathology*; D002358:Cartilage, Articular / Q000473:pathology*; D018450:Disease Progression; D005260:Female; D006801:Humans; D016015:Logistic Models; D008137:Longitudinal Studies; D008279:Magnetic Resonance Imaging; D008297:Male; D008592:Menisci, Tibial / Q000473:pathology*; D008875:Middle Aged; D016017:Odds Ratio; D020370:Osteoarthritis, Knee / Q000150:complications / Q000473:pathology*; D011446:Prospective Studies