Difference in the joint space of the medial knee compartment between full extension and Rosenberg weight-bearing radiographs

Association of AI-determined Kellgren-Lawrence grade with medial meniscus extrusion and cartilage thickness by AI-based 3D MRI analysis in early knee osteoarthritis

The associations among Kellgren-Lawrence (KL) grade, medial meniscus extrusion (MME), and cartilage thickness in knee osteoarthritis (OA) remain insufficiently understood. Our aim was to determine these associations in early to moderate medial tibiofemoral knee OA. We included 469 subjects with no lateral OA from the Kanagawa Knee Study. KL grade was assessed using artificial intelligence (AI) software. The MME was measured by MRI, and the cartilage thickness was evaluated in 18 subregions of the medial femorotibial joint by another AI system. The median MME width was 1.4 mm in KL0, 1.5 mm in KL1, 2.4 mm in KL2, and 6.0 mm in KL3. Cartilage thinning in the medial femur occurred in the anterior central subregion in KL1, expanded inwardly in KL2, and further expanded in KL3. Cartilage thinning in the medial tibia occurred in the anterior and middle external subregions in KL1, expanded into the anterior and middle central subregions in KL2, and further expanded in KL3. The absolute correlation coefficient between MME width and cartilage thickness increased as the KL grade increased in some subregions. This study provides novel insights into the early stages of knee OA and potentially has implications for the development of early intervention strategies.

Anterior meniscus extrusion is associated with anterior tibial osteophyte width in knee osteoarthritis - The Bunkyo Health Study

Background

In knee osteoarthritis (OA), medial meniscus extrudes both medially and anteriorly. We reported that full-length width of medial tibial osteophyte, which comprises cartilage and bone parts, is directly associated with medial meniscus extrusion in early-stage knee OA and hypothesized that anterior tibial osteophyte (ATO) is also associated with anterior meniscus extrusion (AME). Thus, we aimed to examine their prevalence and relationship.

Methods

Elderly subjects (638 females and 507 males; average 72.9 years old) in the Bunkyo Health Study cohort were enrolled. MRI-detected OA changes were evaluated according to the Whole Organ Magnetic Resonance Imaging Score. ATO was evaluated using the method which can assess both cartilage and bone parts of osteophyte by pseudo-coloring images of proton density-weighted fat-suppressed MRI.

Results

Most subjects showed the Kellgren-Lawrence grade 1/2 of the medial knee OA (88.1%), AME (94.3%, 3.7 ​± ​2.2 ​mm), and ATO (99.6%, 4.2 ​± ​1.5 ​mm). Among the OA changes, AME was most closely associated with full-length width of ATO (multivariable β ​= ​0.877, p ​< ​0.001). The area under the receiver operating characteristic curve for determining the presence of AME as evaluated by ATO width was 0.75 (95% confidence interval 0.60-0.84, p ​< ​0.001). The odds ratio for the presence of AME as evaluated by ATO width at 2.9 ​mm was 7.16 (4.23-12.15, p ​< ​0.001, age, gender, BMI, and K-L adjusted).

Conclusions

AME and ATO were inevitably observed in the elderly subjects and AME was closely associated with full-length width of ATO. Our study provides the first evidence on the close relationship between AME and ATO in knee OA.

Association between knee cartilage thickness determined by magnetic resonance imaging three-dimensional analysis and the International Cartilage Repair Society (ICRS) arthroscopic grade

BACKGROUND

The purpose of this study was to retrospectively investigate whether the average cartilage thickness calculated by magnetic resonance imaging (MRI) three-dimensional (3D) analysis system was correlated with the International Cartilage Repair Society (ICRS) grade at each subregion, as a representative scoring for arthroscopic evaluation.

METHODS

The subjects were 102 patients who underwent arthroscopy for meniscus repair or high tibial osteotomy for medial osteoarthritis of the knee. Cartilage lesions were arthroscopically quantified according to the ICRS grade at each subregion. Fluoroscopy was used to compare the subregions on arthroscopic evaluation with subregions on MRI. The average cartilage thickness at each subregion was also automatically calculated from MRI data using our 3D analysis system. The association between ICRS grade and the average cartilage thickness at 18 subregions in the medial femoral and medial tibial regions was evaluated using Spearman's rank correlation coefficient.

RESULTS

Examination of the fluoroscopic images revealed that the posterior subregions in the medial femoral region did not match the position between arthroscopy and MRI; therefore, those three subregions were excluded. In the medial femoral region, the ICRS grade correlated moderately with cartilage thickness at five subregions and weakly at one subregion. In the medial tibial region, the ICRS grade correlated moderately with cartilage thickness at four subregions and weakly at one subregion, but it did not correlate at the other four subregions.

CONCLUSION

The average cartilage thickness determined by MRI 3D analysis correlated with arthroscopic grade at 11 of 15 subregions in the medial femoral and tibial regions.

CF101 alleviates OA progression and inhibits the inflammatory process via the AMP/ATP/AMPK/mTOR axis

CF101 (IB-MECA) is an adenosine A3 receptor agonist that has anti-inflammatory and pain-relieving properties. Adenosine A3 receptor activation can delay the process of Osteoarthritis(OA) and prevent the occurrence of OA. However, the mechanism of CF101 on OA is still unknown. This study aimed to investigate the effect of CF101 on rats induced by anterior cruciate ligament-transection (ACLT) and rat chondrocytes induced by IL-1ß. ACLT-induced OA rats were administered CF101, and autophagy levels were measured to determine whether CF101 had an autophagy-mediated protective effect on articular cartilage. Furthermore, the mechanism by which CF101 protected articular cartilage in IL-1ß-induced chondrocytes mimicking OA was investigated. In rats treated with ACLT, CF101 was able to delay the progression of OA, as well as reduce inflammation and type II collagen degradation factors. In addition, in vitro experiments revealed that CF101 reduced type II collagen degradation factors in OA chondrocytes. In rats treated with ACLT and OA chondrocytes, CF101 enhanced autophagy and increased the ratio of AMP/ATP and AMPK protein levels while decreasing mTOR expression. Treatment of OA chondrocytes with 3-MA prior to treatment with CF101 resulted in inhibition of autophagy factor levels, as well as increased levels of inflammatory factors and type II collagen degradation compared to the CF101 group. These findings demonstrated that CF101 could protect articular cartilage against OA by enhancing the ratio of ATP/AMP and altering the AMPK/mTOR pathway to enhance autophagy and reduce inflammation. In addition, inhibition of autophagy resulted in a reduced CF101 effect.

Medial Tibial Osteophyte Width Strongly Reflects Medial Meniscus Extrusion Distance and Medial Joint Space Width Moderately Reflects Cartilage Thickness in Knee Radiographs

BACKGROUND

The presence of medial tibial osteophytes on knee radiographs suggests cartilage wear, but may be associated with medial meniscus extrusion (MME). The joint space width of the medial compartment consists anatomically of cartilage and the medial meniscus, but which is most responsible for joint space narrowing remains unclear. Magnetic resonance imaging (MRI) reveals MME and cartilage thickness.

PURPOSES

To determine which radiographic medial tibial osteophyte width correlates better with cartilage thickness or MME distance and which radiographic medial joint space width correlates better with cartilage thickness or MME distance.

STUDY TYPE

Cross-sectional.

POPULATION

Total of 527 subjects, 253 females and 274 males, aged 30-79 years, included in the Kanagawa Knee Study.

FIELD STRENGTH/SEQUENCE

3 T/fat-suppressed spoiled gradient echo and proton density weighted.

ASSESSMENT

The medial tibial osteophyte width and "the minimum joint space width at the medial compartment" (mJSW) were measured from plain radiographs. The cartilage region was automatically extracted from MRI data using software. The medial femoral and tibial cartilage regions were each divided into nine subregions, and the average thickness of the cartilage was determined in each region and subregion. MME was manually measured by two orthopedic surgeons using MRI coronal section images.

STATISTICAL TESTS

Pearson's correlation coefficient and their comparison, with P < 0.05 considered statistically significant.

RESULTS

The absolute values of the correlation coefficients were 0.33 at maximum between osteophyte width and cartilage thickness and 0.76 between osteophyte width and MME; the value was significantly higher with MME than with cartilage thickness (P < 0.001). The absolute values of the correlation coefficients were 0.50 at maximum between mJSW and cartilage thickness and 0.16 between mJSW and MME; the value was significantly higher with cartilage thickness than with MME (P < 0.001).

DATA CONCLUSION

The medial tibial osteophyte width strongly reflected MME and the medial joint space width moderately reflected cartilage thickness.

LEVEL OF EVIDENCE

3 TECHNICAL EFFICACY STAGE: 3.