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Longitudinal MRI structural findings observed in accelerated knee osteoarthritis: data from the Osteoarthritis Initiative

Abstract

Objective

To analyze structural, longitudinal MRI findings during the development of accelerated knee osteoarthritis (AKOA) over 4 years.

Materials and methods

From the Osteoarthritis Initiative (OAI), knees with no radiographic osteoarthritis (KL 0/1) developing advanced-stage osteoarthritis (KL 3/4; AKOA) within a 4-year (y) timeframe were selected. MRIs were graded using the modified Whole-Organ Magnetic Resonance Imaging Score (WORMS) at the beginning of the 4-year timeframe (index visit), at 2-year, and 4-year follow-up. Morphological and clinical findings associated with KL 3/4 onset within 2 years compared to 4 years were assessed using generalized estimating equations.

Results

AKOA was found in 162 knees of 149 subjects (age 63.25 ± 8.3; 103 females; BMI 29.4 ± 3.9). Moderate to severe meniscal lesions WORMS ≥ 3 were present in 25% (41/162) at the index visit, 64% (104/162) at 2-year and 93% (151/162) at 4-year follow-up. Meniscal extrusion was the most prevalent finding (ranging from 18% at the index visit, 45% at 2-year and 94% at 4-year follow-up) and root tears were the most common types of tears (9% at the index visit; 22% at 2 years and 38% at 4 years). Risk factors associated with KL 3/4 onset within 2 years included root tears at the index visit (adjusted OR, 2.82; 95% CI: 1.33, 6.00; p = 0.007) and incident knee injury (42%, 49/116 vs. 24%, 11/46, p = 0.032).

Conclusions

Meniscal abnormalities, in particular extrusion and root tears, were the most prevalent morphological features found in subjects with AKOA. These results suggest that meniscal abnormalities have a significant role in accelerated progression of OA.

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Acknowledgements

The analyses in this study were funded through the NIH/NIAMS (National Institute of Arthritis and Musculoskeletal and Skin Diseases grants R01AR064771 and P50-AR060752). We would like to thank the participants and staff of the Coordinating Center of the OAI for their invaluable assistance with patient selection, statistical analysis, and technical support. The study was supported by the OAI, a public–private partnership comprising five NIH contracts (National Institute of Arthritis and Musculoskeletal and Skin Diseases contracts N01-AR-2-2258, N01-AR-2-2259, N01-AR-2-2260, N01-AR-2-2261, and N01-AR-2-2262), with research conducted by the OAI Study Investigators. The study was also funded in part by the Intramural Research Program of the National Institute on Aging, NIH. Private funding partners include Merck Research, Novartis Pharmaceuticals, GlaxoSmithKline, and Pfizer; the private sector funding for the OAI is managed by the Foundation for the National Institutes of Health.

Funding

The analyses in this study were funded through the NIH/NIAMS (National Institute of Arthritis and Musculoskeletal and Skin Diseases grants R01AR064771 and P50-AR06075).

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Correspondence to Sarah C. Foreman.

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Foreman, S.C., Neumann, J., Joseph, G.B. et al. Longitudinal MRI structural findings observed in accelerated knee osteoarthritis: data from the Osteoarthritis Initiative. Skeletal Radiol 48, 1949–1959 (2019). https://doi.org/10.1007/s00256-019-03242-9

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Keywords

  • Osteoarthritis
  • Magnetic resonance imaging
  • Cartilage