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Conservatively treated knee injury is associated with knee cartilage matrix degeneration measured with MRI-based T2 relaxation times: data from the osteoarthritis initiative

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Abstract

Objective

To investigate the association of cartilage degeneration with previous knee injuries not undergoing surgery, determined by morphologic and quantitative 3-T magnetic resonance imaging (MRI).

Materials and methods

We performed a nested cross-sectional study of right knee MRIs from participants in the Osteoarthritis Initiative (OAI) aged 45–79 with baseline Kellgren-Lawrence score of 0–2. Cases were 142 right knees of patients with self-reported history of injury limiting the ability to walk for at least 2 days. Controls were 426 right knees without history of injury, frequency-matched to cases on age, BMI, gender, KL scores and race (1:3 ratio). Cases and controls were compared using covariate-adjusted linear regression analysis, with the outcomes of region-specific T2 mean, laminar analysis and heterogeneity measured by texture analysis to investigate early cartilage matrix abnormalities and the Whole-Organ Magnetic Resonance Imaging Score (WORMS) to investigate morphologic knee lesions.

Results

Compared to control subjects, we found significantly higher mean T2 values in the injury [lateral tibia (28.10 ms vs. 29.11 ms, p = 0.001), medial tibia (29.70 ms vs. 30.40 ms, p = 0.014) and global knee cartilage (32.73 ms vs. 33.29 ms, p = 0.005)]. Injury subjects also had more heterogeneous cartilage as measured by GLCM texture contrast, variance and entropy (p < 0.05 in 14 out of 18 texture parameters). WORMS gradings were not significantly different between the two groups (p > 0.05).

Conclusion

A history of knee injury not treated surgically is associated with higher and more heterogeneous T2 values, but not with morphologic knee abnormalities. Our findings suggest that significant, conservatively treated knee injuries are associated with permanent cartilage matrix abnormalities.

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Acknowledgements

This study was performed with support by the OAI, which is a public-private partnership comprising five contracts (N01-AR-2-2258; N01-AR-2-2259; N01-AR-2-2260; N01-AR-2-2261; N01-AR-2-2262) funded by the National Institutes of Health, which constitutes a branch of the Department of Health and Human Services, and conducted by the OAI Study Investigators. The private funding partners involved are Novartis Pharmaceuticals Corp.; Pfizer, Inc.; Merck Research Laboratories; and GlaxoSmithKline. The private sector funding for the OAI is administered by the Foundation for the National Institutes of Health. Analyses in this study were also funded through grants awarded by the NIH NIAMS (National Institute of Arthritis and Musculoskeletal and Skin Diseases) grants R01AR064771 and P50-AR060752).

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Authors and Affiliations

  1. Musculoskeletal Quantitative Imaging Research Group, Department of Radiology & Biomedical Imaging, University of California San Francisco, 185 Berry Street, Lobby 6, Suite 350, San Francisco, CA, 94107, USA

    Felix C. Hofmann, Jan Neumann, Ursula Heilmeier, Gabby B. Joseph & Thomas M. Link

  2. Department of Radiology, Technical University of Munich, Munich, Germany

    Felix C. Hofmann

  3. Department of Epidemiology and Biostatistics, University of California San Francisco, San Francisco, CA, USA

    Michael C. Nevitt & Charles E. McCulloch

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  1. Felix C. Hofmann
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  2. Jan Neumann
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  4. Gabby B. Joseph
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Correspondence to Felix C. Hofmann or Thomas M. Link.

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The authors declare that they have no conflict of interest.

Ethical approval

The OAI study is HIPAA compliant and approved by the institutional review boards at each clinical site. All study participants signed informed consent forms prior to enrollment.

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Hofmann, F.C., Neumann, J., Heilmeier, U. et al. Conservatively treated knee injury is associated with knee cartilage matrix degeneration measured with MRI-based T2 relaxation times: data from the osteoarthritis initiative. Skeletal Radiol 47, 93–106 (2018). https://doi.org/10.1007/s00256-017-2759-6

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