Accelerated Knee Osteoarthritis is Characterized by Destabilizing Meniscal Tears and Pre-Radiographic Structural Disease Burden

Driban, Jeffrey B., Davis, Julie E, Lu, Bing, Price, Lori Lyn, Ward, Robert J, Mackay, James, Eaton, Charles B, Lo, Grace H., Barbe, Mary F, Zhang, Ming, Pang, Jincheng, Stout, Alina C., Harkey, Matthew S and McAlindon, Timothy E. (2020) Accelerated Knee Osteoarthritis is Characterized by Destabilizing Meniscal Tears and Pre-Radiographic Structural Disease Burden. Arthritis & rheumatology (Hoboken, N.J.), 71 (7). pp. 1089-1100. ISSN 2326-5205

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Abstract

Objective To determine whether accelerated knee osteoarthritis (KOA) is preceded by, and characterized over time by, destabilizing meniscal tears or other pathologic changes. Methods We selected 3 sex-matched groups of subjects from the first 48 months of the Osteoarthritis Initiative, comprising adults who had a knee without KOA (Kellgren/Lawrence [K/L] radiographic grade = 3, those with typical KOA showed increased K/L radiographic scores, and those with no KOA had the same K/L grade over time. An index visit was the visit when the radiographic criteria for accelerated KOA and typical KOA were met (the no KOA group was matched to the accelerated KOA group). The observation period was up to 2 years before and after an index visit. Radiologists reviewed magnetic resonance (MR) images of the index knee and identified destabilizing meniscal tears (root tears, radial tears, complex tears), miscellaneous pathologic features (acute ligamentous or tendinous injuries, attrition, subchondral insufficiency fractures, other incidental findings), and meniscal damage in >2 of 6 regions (3 regions per meniscus: anterior horn, body, posterior horn). In addition, bone marrow lesions (BMLs) and cartilage damage on MR images were quantified. Linear mixed regression models were performed to analyze the results. Results At 1 year before the index visit, >75% of adults with accelerated KOA had meniscal damage in >= 2 regions (odds ratio 3.19 [95% confidence interval 1.70-5.97] versus adults with typical KOA). By the index visit, meniscal damage in >= 2 regions was ubiquitous in adults with accelerated KOA, including 42% of subjects having evidence of a destabilizing meniscal tear (versus 14% of subjects with typical KOA). These changes corresponded to findings of larger BMLs and greater cartilage loss in the accelerated KOA group. Conclusion Accelerated KOA is characterized by destabilizing meniscal tears in a knee compromised by meniscal damage in >2 regions, and also characterized by the presence of large BMLs and greater cartilage loss.

Item Type: Article
Uncontrolled Keywords: aged,diagnostic imaging,diagnostic imaging,disease progression,female,humans,diagnostic imaging,magnetic resonance imaging,male,middle aged,diagnostic imaging,diagnostic imaging
Faculty \ School: Faculty of Medicine and Health Sciences > Norwich Medical School
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Depositing User: LivePure Connector
Date Deposited: 28 Jan 2020 03:52
Last Modified: 11 Jul 2020 23:55
URI: https://ueaeprints.uea.ac.uk/id/eprint/73785
DOI: 10.1002/art.40826

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