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Bone marrow lesion is associated with disability for activities of daily living in patients with early stage knee osteoarthritis

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Abstract

Osteoarthritis of the knee (knee OA) induces pain, loss of mobility and diminished activities of daily living (ADL). Although an understanding of the pathophysiology of early stage knee OA has been developed, the structural changes associated with disability for ADL in early stage knee OA are still unclear. The aim of the present study was to examine magnetic resonance imaging (MRI)-detected changes associated with disability for ADL in patients with early stage knee OA. One hundred and thirty-two patients with early stage medial knee OA (Kellgren–Lawrence grade ≤ 2) who first visited the outpatient clinic at our university hospital were included. They were also examined by 3.0-Tesla knee MRI. The OA-associated structural changes were scored using the Whole-Organ Magnetic Resonance Imaging Score (WORMS), and clinical manifestations were evaluated by the Japanese Knee Osteoarthritis Measure (JKOM). Median quartile regression was used for the analysis. Cartilage lesion, subchondral bone attrition and osteophytes were observed in all patients. Bone marrow lesions (BMLs) and synovitis were observed in 60% and 55% of the patients, respectively. Subchondral cysts and ligament changes were observed in 6% and 17% of the patients, respectively. Pain severity of the patients was associated with medial cartilage lesions (coefficient 2.50, 95% confidence interval 0.61–4.40, p < 0.01). Disability for ADL of the patients was associated with BMLs in the medial side of the knee joint (0.82, 0.21–1.02, p = 0.04). BMLs in the medial side of the knee joint were associated with disability for ADL of patients with early stage medial knee OA.

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Acknowledgements

We would like to express our deep appreciation to Mr. Tatsuya Miyazaki and his colleagues in Medical Scanning Hospital (Tokyo, Japan) for their help with the MRI analysis.This study was supported by a Grant-in-Aid for Scientific Research from the Japanese Society for the Promotion of Science to M.I. (15K10494, 16H05454 and 18K09082) and H.K. (15K20019 and 18K09083). This study was also funded in part by a High Technology Research Center Grant and the Program for the Strategic Research Foundation at Private Universities (2014–2019) from the Ministry of Education, Culture, Sports, Science and Technology of Japan (MEXT).

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  1. Ryo Sadatsuki

    Present address: Orthopaedic Surgery, Yamanashi Prefectural Central Hospital, Yamanashi, Japan

  2. Ryo Sadatsuki and Muneaki Ishijima contributed equally to this work.

Authors and Affiliations

  1. Department of Medicine for Orthtopaedics and Motor Organ, Juntendo University Graduate School of Medicine, 2-1-1 Hongo Bunkyo-ku, Tokyo, 113-8421, Japan

    Ryo Sadatsuki, Muneaki Ishijima, Haruka Kaneko, Lizu Liu, Ippei Futami, Shinnosuke Hada, Mayuko Kinoshita, Mitsuaki Kubota, Yuji Takazawa, Hiroshi Ikeda & Kazuo Kaneko

  2. Sportoloy Center, Juntendo University Graduate School of Medicine, Tokyo, Japan

    Muneaki Ishijima, Lizu Liu, Takako Aoki & Kazuo Kaneko

  3. Department of Pathophysiology for Locomotive and Neoplastic Diseases, Juntendo University Graduate School of Medicine, Tokyo, Japan

    Yasunori Okada & Kazuo Kaneko

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  1. Ryo Sadatsuki
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Correspondence to Muneaki Ishijima.

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Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. The study protocol, which complied with the principles outlined in the Declaration of Helsinki, was approved by the Ethical Committee Review Board at Juntendo University (approval number: 15-111). Since the studies with the patients with knee OA were categorized as a retrospective study, the Ethical Committee Review Board waived the requirement for patient informed consent for participation because of the anonymous nature of the data.

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Sadatsuki, R., Ishijima, M., Kaneko, H. et al. Bone marrow lesion is associated with disability for activities of daily living in patients with early stage knee osteoarthritis . J Bone Miner Metab 37, 529–536 (2019). https://doi.org/10.1007/s00774-018-0950-z

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