Early pre-radiographic structural pathology precedes the onset of accelerated knee osteoarthritis

BMC Musculoskeletal Disorders

Jincheng Pang¹  Robert J. Ward²  Jeffrey B. Driban³  Julie E. Davis³  Timothy E. McAlindon³  Ming Zhang⁴  Matthew S. Harkey⁵  Lori Lyn Price⁶  Alina C. Stout⁷  Mary F. Barbe⁸  Grace H. Lo⁹  Charles B. Eaton^1,10  James W. MacKay^1,11  Bing Lu^1,12 

[1]0000 0000 8800 7493, grid.410513.2, Pfizer Inc., Cambridge, MA, USA

[2]0000 0000 8934 4045, grid.67033.31, Department of Radiology, Tufts Medical Center, Boston, MA, USA

[3]0000 0000 8934 4045, grid.67033.31, Division of Rheumatology, Allergy, and Immunology, Tufts Medical Center, 800 Washington Street, Box 406, 02111, Boston, MA, USA

[4]0000 0000 8934 4045, grid.67033.31, Division of Rheumatology, Allergy, and Immunology, Tufts Medical Center, 800 Washington Street, Box 406, 02111, Boston, MA, USA

[5]0000 0001 0639 028X, grid.422596.e, Department of Computer Science & Networking, Wentworth Institute of Technology, Boston, MA, USA

[6]0000 0000 8934 4045, grid.67033.31, Division of Rheumatology, Allergy, and Immunology, Tufts Medical Center, 800 Washington Street, Box 406, 02111, Boston, MA, USA

[7]0000 0001 0742 0364, grid.168645.8, Department of Population and Quantitative Health Sciences, University of Massachusetts Medical School, Worcester, MA, USA

[8]0000 0000 8934 4045, grid.67033.31, The Institute for Clinical Research and Health Policy Studies, Tufts Medical Center, Boston, MA, USA

[9]0000 0004 1936 7531, grid.429997.8, Tufts Clinical and Translational Science Institute, Tufts University, Boston, MA, USA

[10]0000 0001 2173 3359, grid.261112.7, Public Health Institute, Northeastern University, Boston, MA, USA

[11]0000 0001 2248 3398, grid.264727.2, Department of Anatomy and Cell Biology, Temple University School of Medicine, Philadelphia, PA, USA

[12]0000 0004 0420 5521, grid.413890.7, Medical Care Line and Research Care Line, Houston Health Services Research and Development (HSR&D) Center of Excellence Michael E. DeBakey VAMC, Houston, TX, USA

[13]0000 0001 2160 926X, grid.39382.33, Section of Immunology, Allergy, and Rheumatology, Baylor College of Medicine, Houston, TX, USA

[14]0000 0004 1936 9094, grid.40263.33, Center for Primary Care and Prevention, Alpert Medical School of Brown University, Pawtucket, RI, USA

[15]0000000121885934, grid.5335.0, Department of Radiology, University of Cambridge School of Clinical Medicine, Cambridge, UK

[16]000000041936754X, grid.38142.3c, Division of Rheumatology, Immunology & Allergy, Brigham & Women’s Hospital and Harvard Medical School, Boston, MA, USA

关键词: Cartilage;    Bone marrow lesion;    Effusion-synovitis;    Meniscus;    Ligament;    Tendons;    Extensor mechanism;    MRI;   

DOI  :  10.1186/s12891-019-2624-y

来源: publisher

【 摘 要 】

BackgroundAccelerated knee osteoarthritis (AKOA) is characterized by more pain, impaired physical function, and greater likelihood to receive a joint replacement compared to individuals who develop the typical gradual onset of disease. Prognostic tools are needed to determine which structural pathologies precede the development of AKOA compared to individuals without AKOA. Therefore, the purpose of this manuscript was to determine which pre-radiographic structural features precede the development of AKOA.MethodsThe sample comprised participants in the Osteoarthritis Initiative (OAI) who had at least one radiographically normal knee at baseline (Kellgren-Lawrence [KL] grade < 1). Participants were classified into 2 groups based on radiographic progression from baseline to 48 months: AKOA (KL grade change from < 1 to > 3) and No AKOA. The index visit was the study visit when participants met criteria for AKOA or a matched timepoint for those who did not develop AKOA. Magnetic resonance (MR) images were assessed for 12 structural features at the OAI baseline, and 1 and 2 years prior to the index visit. Separate logistic regression models (i.e. OAI baseline, 1 and 2 years prior) were used to determine which pre-radiographic structural features were more likely to antedate the development of AKOA compared to individuals not developing AKOA.ResultsAt the OAI baseline visit, degenerative cruciate ligaments (Odds Ratio [OR] = 2.2, 95% Confidence Interval [CI] = 1.3,3.5), infrapatellar fat pad signal intensity alteration (OR = 2.0, 95%CI = 1.2,3.2), medial/lateral meniscal pathology (OR = 2.1/2.4, 95%CI = 1.3,3.4/1.5,3.8), and greater quantitative knee effusion-synovitis (OR = 2.2, 95%CI = 1.4,3.4) were more likely to antedate the development of AKOA when compared to those that did not develop AKOA. These results were similar at one and two years prior to disease onset. Additionally, medial meniscus extrusion at one year prior to disease onset (OR = 3.5, 95%CI = 2.1,6.0) increased the likelihood of developing AKOA.ConclusionsEarly ligamentous degeneration, effusion/synovitis, and meniscal pathology precede the onset of AKOA and may be prognostic biomarkers.

【 授权许可】

CC BY