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Ma C, Zhao G, Luo Z, Ma J, Wang J. Perception of Perioperative Risk for Arthroplasty Patients: A Poll of Chinese Orthopaedic Surgeons. J Arthroplasty 2024:S0883-5403(24)00575-8. [PMID: 38848788 DOI: 10.1016/j.arth.2024.05.090] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/05/2024] [Revised: 05/29/2024] [Accepted: 05/30/2024] [Indexed: 06/09/2024] Open
Abstract
BACKGROUND Informed by the precedent of an American Association of Hip and Knee Surgeons (AAHKS) survey, where 95% of participants reported instigating modifications to preoperative risk factors, this study apprised the approach of Chinese arthroplasty surgeons toward patients who had modifiable risks. METHODS An adaptation of the AAHKS survey tool for a Chinese cohort was undertaken. The survey queried 600 Chinese Society of Hip and Knee Surgeons members on whether the perception of unoptimized medical comorbidities and socioeconomic elements affects the propensity to offer surgical procedures. RESULTS Out of the distributed surveys, 150 responses were received, culminating in a response rate of 25%. The data illustrate that 98.7% of Chinese surgeons practice restrictions on arthroplasty access for patients who have modifiable risk factors, with notable frequencies for malnutrition (93.3%), anemia (91.3%), recent hyaluronic acid injections (HA within one month, 88.7%), and corticosteroid injections (CS within three months, 74.7%). Assessment criteria ahead of surgery included limitations such as a body mass index under 40 (47.3%), requirements for smoking cessation (57.3%), an acceptable hemoglobin A1c level (95.3%), and a dependent fasting blood glucose level (88%). Moreover, 87.3% of respondents endorsed the need for additional interventions for certain socioeconomically disadvantaged patients to achieve successful outcomes. A majority of respondents (94.7%) believed that more equitable access to care, facilitated by better-adjusted payment methodologies, could enhance patient outcomes. Current payment schemes were also perceived by a majority to potentially compromise outcomes for patients who have inadequate social support (80.7%), low socioeconomic status (67.3%), and those lacking insurance (72.7%). CONCLUSION The consistency of the almost 99% response rate in addressing modifiable risk factors prior to arthroplasty aligns closely with the reported practices in the AAHKS survey. These findings underscore the shared valuation of preoperative risk factor optimization by Chinese and American arthroplasty surgeons, notwithstanding divergent healthcare system structures.
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Affiliation(s)
- Chengyuan Ma
- Department of Joint Surgery, Honghui hospital, Xi'An Jiaotong University, No.555 East Youyi Road, Xi'an, Shaanxi, China
| | - Guanghui Zhao
- Department of Joint Surgery, Honghui hospital, Xi'An Jiaotong University, No.555 East Youyi Road, Xi'an, Shaanxi, China
| | - Zifan Luo
- Department of Joint Surgery, Honghui hospital, Xi'An Jiaotong University, No.555 East Youyi Road, Xi'an, Shaanxi, China
| | - Jianbing Ma
- Department of Joint Surgery, Honghui hospital, Xi'An Jiaotong University, No.555 East Youyi Road, Xi'an, Shaanxi, China
| | - Jianpeng Wang
- Department of Joint Surgery, Honghui hospital, Xi'An Jiaotong University, No.555 East Youyi Road, Xi'an, Shaanxi, China.
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2
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Zhu S, Wang Z, Liang Q, Zhang Y, Li S, Yang L, He C. Chinese guidelines for the rehabilitation treatment of knee osteoarthritis: An CSPMR evidence-based practice guideline. J Evid Based Med 2023; 16:376-393. [PMID: 37743650 DOI: 10.1111/jebm.12555] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/23/2023] [Accepted: 09/13/2023] [Indexed: 09/26/2023]
Abstract
BACKGROUND Knee osteoarthritis (KOA) is the most common degenerative joint disease in China, causing a huge economic burden on patients, families, and society. Standardized KOA rehabilitation treatment is an important means to prevent and treat the disease and promote the development of high-quality medical services. This guideline is updated on the basis of the 2016 and 2019 editions. METHODS Clinical questions regarding rehabilitation assessment and treatment were selected through clinical questions screening and deconstruction, and multiple rounds of Delphi questionnaire consultation. The International Classification of Functioning, Disability and Health (ICF) was used as the theoretical framework, and the Grading of Recommendations Assessment, Development and Evaluation (GRADE) method was used to grade the quality of evidence and recommendations. RESULTS The reporting of this guideline followed the standard of Reporting Items for Practice Guidelines in Healthcare (RIGHT). Taking into account patients' preferences and values and the needs of Chinese clinical practice, a total of 11 clinical questions and 28 recommendations were established. The clinical questions were grouped into two categories: KOA assessment (body function, body structure, activity and participation, quality of life, and environmental factors and clinical outcomes assessment, resulting in 9 recommendations) and KOA treatment (health education, therapeutic exercise, therapeutic modalities, occupational therapy, assistive devices, and regenerative rehabilitation approaches, resulting in 19 recommendations). CONCLUSION This is the first evidence-based guideline for KOA rehabilitation in China utilizing the ICF framework. This guideline provides key guidance for developing systematic, standardized, and precise rehabilitation protocols for KOA across various healthcare settings.
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Affiliation(s)
- Siyi Zhu
- Department of Rehabilitation Medicine, West China School of Medicine/West China Hospital, Sichuan University, Chengdu, China
- Rehabilitation Key Laboratory of Sichuan Province, West China Hospital, Sichuan University, Chengdu, China
| | - Zhuo Wang
- Department of Rehabilitation Medicine, West China School of Medicine/West China Hospital, Sichuan University, Chengdu, China
- Rehabilitation Key Laboratory of Sichuan Province, West China Hospital, Sichuan University, Chengdu, China
| | - Qiu Liang
- Department of Rehabilitation Medicine, West China School of Medicine/West China Hospital, Sichuan University, Chengdu, China
| | - Yuting Zhang
- Department of Rehabilitation Medicine, West China School of Medicine/West China Hospital, Sichuan University, Chengdu, China
| | - Sheyu Li
- Department of Endocrinology and Metabolism and Department of Guideline and Rapid Recommendation, Cochrane China Center, MAGIC China Center, Chinese Evidence-Based Medicine Center, West China Hospital, Sichuan University, Chengdu, China
| | - Lin Yang
- Department of Rehabilitation Medicine, West China School of Medicine/West China Hospital, Sichuan University, Chengdu, China
- Rehabilitation Key Laboratory of Sichuan Province, West China Hospital, Sichuan University, Chengdu, China
| | - Chengqi He
- Department of Rehabilitation Medicine, West China School of Medicine/West China Hospital, Sichuan University, Chengdu, China
- Rehabilitation Key Laboratory of Sichuan Province, West China Hospital, Sichuan University, Chengdu, China
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3
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Park SY, Chae DS, Lee JS, Cho BK, Lee NY. Point-of-Care Testing of the MTF1 Osteoarthritis Biomarker Using Phenolphthalein-Soaked Swabs. BIOSENSORS 2023; 13:bios13050535. [PMID: 37232895 DOI: 10.3390/bios13050535] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/31/2023] [Revised: 05/06/2023] [Accepted: 05/08/2023] [Indexed: 05/27/2023]
Abstract
Osteoarthritis (OA) is the most common joint disease, which accompanies pain and inconvenience in daily life owing to degradation of cartilage and adjacent tissues. In this study, we propose a simple point-of-care testing (POCT) kit for the detection of the MTF1 OA biomarker to achieve on-site clinical diagnosis of OA. The kit contains an FTA card for patient sample treatments, a sample tube for loop-mediated isothermal amplification (LAMP), and a phenolphthalein-soaked swab for naked eye detection. The MTF1 gene was isolated from synovial fluids using an FTA card and amplified using the LAMP method at 65 °C for 35 min. A test part of the phenolphthalein-soaked swab was decolorized in the presence of the MTF1 gene due to the pH change after the LAMP, but the color remained pink in the absence of the MTF1 gene. The control part of the swab served as a reference color in relation to the test part. When real-time LAMP (RT-LAMP), gel electrophoresis, and colorimetric detection of the MTF1 gene were performed, the limit of detection (LOD) was confirmed at 10 fg/μL, and the overall processes were completed in 1 h. The detection of an OA biomarker in the form of POCT was reported for the first time in this study. The introduced method is expected to serve as a POCT platform directly applicable by clinicians for easy and rapid identification of OA.
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Affiliation(s)
- So Yeon Park
- Department of BioNano Technology, Gachon University, 1342 Seongnam-daero, Sujeong-gu, Seongnam-si 13120, Republic of Korea
| | - Dong-Sik Chae
- Department of Orthopedic Surgery, College of Medicine, Catholic Kwandong University, Incheon 21431, Republic of Korea
| | - Jae Sun Lee
- Chief Researcher, Healthcontents, Co., Ltd., Cheongju 28119, Republic of Korea
| | - Byung-Ki Cho
- Department of Orthopaedic Surgery, College of Medicine, Chungbuk National University, Cheongju 28644, Republic of Korea
| | - Nae Yoon Lee
- Department of BioNano Technology, Gachon University, 1342 Seongnam-daero, Sujeong-gu, Seongnam-si 13120, Republic of Korea
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4
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Martel-Pelletier J, Paiement P, Pelletier JP. Magnetic resonance imaging assessments for knee segmentation and their use in combination with machine/deep learning as predictors of early osteoarthritis diagnosis and prognosis. Ther Adv Musculoskelet Dis 2023; 15:1759720X231165560. [PMID: 37151912 PMCID: PMC10155034 DOI: 10.1177/1759720x231165560] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2022] [Accepted: 03/23/2023] [Indexed: 05/09/2023] Open
Abstract
Knee osteoarthritis (OA) is a prevalent and disabling disease that can develop over decades. This disease is heterogeneous and involves structural changes in the whole joint, encompassing multiple tissue types. Detecting OA before the onset of irreversible changes is crucial for early management, and this could be achieved by allowing knee tissue visualization and quantifying their changes over time. Although some imaging modalities are available for knee structure assessment, magnetic resonance imaging (MRI) is preferred. This narrative review looks at existing literature, first on MRI-developed approaches for evaluating knee articular tissues, and second on prediction using machine/deep-learning-based methodologies and MRI as input or outcome for early OA diagnosis and prognosis. A substantial number of MRI methodologies have been developed to assess several knee tissues in a semi-quantitative and quantitative fashion using manual, semi-automated and fully automated systems. This dynamic field has grown substantially since the advent of machine/deep learning. Another active area is predictive modelling using machine/deep-learning methodologies enabling robust early OA diagnosis/prognosis. Moreover, incorporating MRI markers as input/outcome in such predictive models is important for a more accurate OA structural diagnosis/prognosis. The main limitation of their usage is the ability to move them in rheumatology practice. In conclusion, MRI knee tissue determination and quantification provide early indicators for individuals at high risk of developing this disease or for patient prognosis. Such assessment of knee tissues, combined with the development of models/tools from machine/deep learning using, in addition to other parameters, MRI markers for early diagnosis/prognosis, will maximize opportunities for individualized risk assessment for use in clinical practice permitting precision medicine. Future efforts should be made to integrate such prediction models into open access, allowing early disease management to prevent or delay the OA outcome.
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Affiliation(s)
- Johanne Martel-Pelletier
- Osteoarthritis Research Unit, University of
Montreal Hospital Research Centre (CRCHUM), 900 Saint-Denis, R11.412B,
Montreal, QC H2X 0A9, Canada
| | - Patrice Paiement
- Osteoarthritis Research Unit, University of
Montreal Hospital Research Centre (CRCHUM), Montreal, QC, Canada
| | - Jean-Pierre Pelletier
- Osteoarthritis Research Unit, University of
Montreal Hospital Research Centre (CRCHUM), Montreal, QC, Canada
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5
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Burfield M, Sayers M, Buhmann R. The association between running volume and knee osteoarthritis prevalence: A systematic review and meta-analysis. Phys Ther Sport 2023; 61:1-10. [PMID: 36809693 DOI: 10.1016/j.ptsp.2023.02.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2022] [Revised: 02/09/2023] [Accepted: 02/10/2023] [Indexed: 02/15/2023]
Abstract
There is conflicting evidence regarding whether regular running is associated with knee osteoarthritis prevalence. Previous evidence reports lower knee osteoarthritis prevalence in recreational runners compared with professionals (with a higher training volume) and controls (who have a lower training volume). The aim of this systematic review and meta-analysis was to determine if weekly running volume is associated with knee osteoarthritis prevalence. Four databases (PubMed, Web of Science, Scopus and SPORTDiscus) were searched from earliest record to November 2021. Included studies must i) recruit participants who ran regularly and recorded weekly running volume; ii) include a control group (running <8 km per week); iii) record knee osteoarthritis prevalence (either by radiological imaging or self-reported diagnosis from a doctor or physiotherapist). Study bias was assessed using the Newcastle-Ottawa Scale (NOS). Pooled effects were estimated using a random effects model. Odds ratios with 95% prediction and confidence intervals are reported. Nine observational case control studies with a total of 12,273 participants (1272 runners) were included in the meta-analysis. Most of the included studies were rated as having a very high (n = 2) or high (n = 3) risk of bias on the Newcastle Ottawa Scale. There was no difference in knee osteoarthritis prevalence between runners and controls (OR = 0.97, 95% CI = 0.56 to 1.68). Runners undertaking 8-32.1 km (OR = 1.17, 95% CI = 0.77 to 1.80), 32.2-48 km (OR = 1.04, 95% CI = 0.48 to 2.31) or > 48 km per week (OR = 0.62, 95% CI = 0.35 to 1.10) did not exhibit higher knee osteoarthritis prevalence compared with controls. It is unclear whether running volume is associated with increased knee osteoarthritis prevalence, future large-scale, high quality prospective studies are required.
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Affiliation(s)
- M Burfield
- School of Health and Behavioural Sciences, Australian Catholic University, Brisbane, Australia
| | - M Sayers
- School of Health and Behaviour Sciences, University of the Sunshine Coast, Maroochydore, Australia
| | - R Buhmann
- School of Health and Behaviour Sciences, University of the Sunshine Coast, Maroochydore, Australia.
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6
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Coburn SL, Crossley KM, Kemp JL, Warden SJ, West TJ, Bruder AM, Mentiplay BF, Culvenor AG. Is running good or bad for your knees? A systematic review and meta-analysis of cartilage morphology and composition changes in the tibiofemoral and patellofemoral joints. Osteoarthritis Cartilage 2023; 31:144-157. [PMID: 36402349 DOI: 10.1016/j.joca.2022.09.013] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/21/2022] [Revised: 09/06/2022] [Accepted: 09/14/2022] [Indexed: 11/18/2022]
Abstract
BACKGROUND The general health benefits of running are well-established, yet concern exists regarding the development and progression of osteoarthritis. AIM To systematically review the immediate (within 20 min) and delayed (20 min-48 h) effect of running on hip and knee cartilage, as assessed using magnetic resonance imaging (MRI). METHOD Studies using MRI to measure change in hip or knee cartilage within 48 h pre- and post-running were identified. Risk of bias was assessed using a modified Newcastle-Ottawa Scale. Percentage change in cartilage outcomes were estimated using random-effects meta-analysis. Certainty of evidence was evaluated with the Grading of Recommendations Assessment, Development and Evaluation tool. RESULTS Twenty-four studies were included, evaluating 446 knees only. One third of studies were low risk of bias. Knee cartilage thickness and volume decreased immediately after running, with declines ranging from 3.3% (95% confidence interval [CI]: 2.6%, 4.1%) for weight-bearing femoral cartilage volume to 4.9% (95% CI: 4.43.6%, 6.2%) for patellar cartilage volume. T1ρ and T2 relaxation times were also reduced immediately after running, with the largest decline being 13.1% (95% CI: -14.4%, -11.7%) in femoral trochlear cartilage. Tibiofemoral cartilage T2 relaxation times recovered to baseline levels within 91 min. Existing cartilage defects were unchanged within 48 h post-run. CONCLUSIONS There is very low certainty evidence that running immediately decreases the thickness, volume, and relaxation times of patellofemoral and tibiofemoral cartilage. Hip cartilage changes are unknown, but knee changes are small and appear transient suggesting that a single bout of running is not detrimental to knee cartilage.
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Affiliation(s)
- S L Coburn
- La Trobe Sport & Exercise Medicine Research Centre, School of Allied Health, Human Services and Sport, La Trobe University, Melbourne, Victoria, Australia.
| | - K M Crossley
- La Trobe Sport & Exercise Medicine Research Centre, School of Allied Health, Human Services and Sport, La Trobe University, Melbourne, Victoria, Australia.
| | - J L Kemp
- La Trobe Sport & Exercise Medicine Research Centre, School of Allied Health, Human Services and Sport, La Trobe University, Melbourne, Victoria, Australia.
| | - S J Warden
- La Trobe Sport & Exercise Medicine Research Centre, School of Allied Health, Human Services and Sport, La Trobe University, Melbourne, Victoria, Australia; Department of Physical Therapy, School of Health & Human Sciences, Indiana University, Indianapolis, IN, USA.
| | - T J West
- La Trobe Sport & Exercise Medicine Research Centre, School of Allied Health, Human Services and Sport, La Trobe University, Melbourne, Victoria, Australia.
| | - A M Bruder
- La Trobe Sport & Exercise Medicine Research Centre, School of Allied Health, Human Services and Sport, La Trobe University, Melbourne, Victoria, Australia.
| | - B F Mentiplay
- La Trobe Sport & Exercise Medicine Research Centre, School of Allied Health, Human Services and Sport, La Trobe University, Melbourne, Victoria, Australia.
| | - A G Culvenor
- La Trobe Sport & Exercise Medicine Research Centre, School of Allied Health, Human Services and Sport, La Trobe University, Melbourne, Victoria, Australia.
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7
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Araújo C, Oliveira RD, Pinto-Ribeiro F, Almeida-Aguiar C. An Insight on the Biomedical Potential of Portuguese Propolis from Gerês. Foods 2022; 11:3431. [PMID: 36360044 PMCID: PMC9656172 DOI: 10.3390/foods11213431] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2022] [Revised: 10/22/2022] [Accepted: 10/26/2022] [Indexed: 09/29/2023] Open
Abstract
Osteoarthritis (OA), a progressive degenerative disease of weight-bearing joints, is the second leading cause of disability in the world. Despite all the advances and research over the last years, none of the proposed strategies has been effective in generating functional and long-lasting tissue. Due to the high prevalence of OA and the urgent need for an effective and successful treatment, interest in natural products as anti-inflammatory agents, such as propolis and its components, has emerged. In this work, we estimate the biomedical potential of Portuguese propolis, evaluating the in vitro antioxidant and anti-inflammatory effects of single hydroalcoholic extracts prepared with propolis from Gerês sampled over a five-year period (2011-2015) (G.EE70 and G.EE35). The in vivo and in vitro anti-inflammatory potential of the hydroalcoholic extract of mixtures of the same samples (mG.EE70 and mG.EE35) was evaluated for the first time too. DPPH• radical scavenging and superoxide anion scavenging assays showed the strong antioxidant potential of both hydroalcoholic extracts, either prepared from single propolis samples or from the mixtures of the same samples. Results also revealed an anti-inflammatory effect of mG.EE35, both in vitro by inhibiting BSA denaturation and in vivo in the OA-induced model by improving mechanical hyperalgesia as well as the gait pattern parameters. Results further support the use of propolis blends as a better and more efficient approach to take full advantage of the bioactive potential of propolis.
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Affiliation(s)
- Carina Araújo
- Biology Department, University of Minho, 4710-057 Braga, Portugal
- Life and Health Sciences Research Institute (ICVS), University of Minho, 4710-057 Braga, Portugal
| | - Rafaela Dias Oliveira
- Biology Department, University of Minho, 4710-057 Braga, Portugal
- Life and Health Sciences Research Institute (ICVS), University of Minho, 4710-057 Braga, Portugal
- ICVS/3B’s—PT Government Associate Laboratory, 4710-057 Braga/4806-909 Guimarães, Portugal
- CBMA—Centre of Molecular and Environmental Biology, University of Minho, 4710-057 Braga, Portugal
| | - Filipa Pinto-Ribeiro
- Life and Health Sciences Research Institute (ICVS), University of Minho, 4710-057 Braga, Portugal
- ICVS/3B’s—PT Government Associate Laboratory, 4710-057 Braga/4806-909 Guimarães, Portugal
| | - Cristina Almeida-Aguiar
- Biology Department, University of Minho, 4710-057 Braga, Portugal
- CBMA—Centre of Molecular and Environmental Biology, University of Minho, 4710-057 Braga, Portugal
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8
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Effect of zoledronic acid with or without methylprednisolone on 3D bone area and bone shape in patients with symptomatic knee osteoarthritis: A post-hoc analysis of the ZAP2 trial. Semin Arthritis Rheum 2022; 56:152054. [DOI: 10.1016/j.semarthrit.2022.152054] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2022] [Revised: 06/14/2022] [Accepted: 06/17/2022] [Indexed: 11/18/2022]
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9
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Fan T, Chen S, Zeng M, Li J, Wang X, Ruan G, Cao P, Zhang Y, Chen T, Ou Q, Wang Q, Wluka AE, Cicuttini F, Ding C, Zhu Z. Osteophytes mediate the associations between cartilage morphology and changes in knee symptoms in patients with knee osteoarthritis. Arthritis Res Ther 2022; 24:217. [PMID: 36076236 PMCID: PMC9454107 DOI: 10.1186/s13075-022-02905-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2022] [Accepted: 08/22/2022] [Indexed: 11/16/2022] Open
Abstract
Aims To investigate whether the associations between cartilage defects and cartilage volumes with changes in knee symptoms were mediated by osteophytes. Methods Data from the Vitamin D Effects on Osteoarthritis (VIDEO) study were analyzed as a cohort. The Western Ontario and McMaster Universities Osteoarthritis Index was used to assess knee symptoms at baseline and follow-up. Osteophytes, cartilage defects, and cartilage volumes were measured using magnetic resonance imaging at baseline. Associations between cartilage morphology and changes in knee symptoms were assessed using linear regression models, and mediation analysis was used to test whether these associations were mediated by osteophytes. Results A total of 334 participants (aged 50 to 79 years) with symptomatic knee osteoarthritis were included in the analysis. Cartilage defects were significantly associated with change in total knee pain, change in weight-bearing pain, and change in non-weight-bearing pain after adjustment for age, sex, body mass index, and intervention. Cartilage volume was significantly associated with change in weight-bearing pain and change in physical dysfunction after adjustment. Lateral tibiofemoral and patellar osteophyte mediated the associations of cartilage defects with change in total knee pain (49–55%) and change in weight-bearing pain (61–62%) and the association of cartilage volume with change in weight-bearing pain (27–30%) and dysfunction (24–25%). Both cartilage defects and cartilage volume had no direct effects on change in knee symptoms. Conclusions The significant associations between cartilage morphology and changes in knee symptoms were indirect and were partly mediated by osteophytes. Supplementary Information The online version contains supplementary material available at 10.1186/s13075-022-02905-8.
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Affiliation(s)
- Tianxiang Fan
- Clinical Research Centre, Zhujiang Hospital, Southern Medical University, Guangzhou, Guangdong, China
| | - Shibo Chen
- Clinical Research Centre, Zhujiang Hospital, Southern Medical University, Guangzhou, Guangdong, China
| | - Muhui Zeng
- Clinical Research Centre, Zhujiang Hospital, Southern Medical University, Guangzhou, Guangdong, China
| | - Jia Li
- Division of Orthopaedic Surgery, Department of Orthopaedics, Nanfang Hospital, Southern Medical University, Guangzhou, Guangdong, China
| | - Xiaoshuai Wang
- Clinical Research Centre, Zhujiang Hospital, Southern Medical University, Guangzhou, Guangdong, China
| | - Guangfeng Ruan
- Clinical Research Centre, Zhujiang Hospital, Southern Medical University, Guangzhou, Guangdong, China
| | - Peihua Cao
- Clinical Research Centre, Zhujiang Hospital, Southern Medical University, Guangzhou, Guangdong, China
| | - Yan Zhang
- Clinical Research Centre, Zhujiang Hospital, Southern Medical University, Guangzhou, Guangdong, China
| | - Tianyu Chen
- Clinical Research Centre, Zhujiang Hospital, Southern Medical University, Guangzhou, Guangdong, China
| | - Qianhua Ou
- Clinical Research Centre, Zhujiang Hospital, Southern Medical University, Guangzhou, Guangdong, China
| | - Qianyi Wang
- Clinical Research Centre, Zhujiang Hospital, Southern Medical University, Guangzhou, Guangdong, China
| | - Anita E Wluka
- Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
| | - Flavia Cicuttini
- Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
| | - Changhai Ding
- Clinical Research Centre, Zhujiang Hospital, Southern Medical University, Guangzhou, Guangdong, China. .,Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, Victoria, Australia. .,Menzies Institute for Medical Research, University of Tasmania, Hobart, Tasmania, Australia. .,Department of Orthopaedics, Zhujiang Hospital, Southern Medical University, Guangzhou, Guangdong, China.
| | - Zhaohua Zhu
- Clinical Research Centre, Zhujiang Hospital, Southern Medical University, Guangzhou, Guangdong, China. .,Department of Orthopaedics, Zhujiang Hospital, Southern Medical University, Guangzhou, Guangdong, China.
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10
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Bonakdari H, Pelletier JP, Abram F, Martel-Pelletier J. A Machine Learning Model to Predict Knee Osteoarthritis Cartilage Volume Changes over Time Using Baseline Bone Curvature. Biomedicines 2022; 10:biomedicines10061247. [PMID: 35740270 PMCID: PMC9220338 DOI: 10.3390/biomedicines10061247] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2022] [Revised: 05/12/2022] [Accepted: 05/19/2022] [Indexed: 01/27/2023] Open
Abstract
The hallmark of osteoarthritis (OA), the most prevalent musculoskeletal disease, is the loss of cartilage. By using machine learning (ML), we aimed to assess if baseline knee bone curvature (BC) could predict cartilage volume loss (CVL) at one year, and to develop a gender-based model. BC and cartilage volume were assessed on 1246 participants using magnetic resonance imaging. Variables included age, body mass index, and baseline values of eight BC regions. The outcome consisted of CVL at one year in 12 regions. Five ML methods were evaluated. Validation demonstrated very good accuracy for both genders (R ≥ 0.78), except the medial tibial plateau for the woman. In conclusion, we demonstrated, for the first time, that knee CVL at one year could be predicted using five baseline BC region values. This would benefit patients at risk of structural progressive knee OA.
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Affiliation(s)
- Hossein Bonakdari
- Osteoarthritis Research Unit, University of Montreal Hospital Research Centre (CRCHUM), Montreal, QC H2X 0A9, Canada; (H.B.); (J.-P.P.)
| | - Jean-Pierre Pelletier
- Osteoarthritis Research Unit, University of Montreal Hospital Research Centre (CRCHUM), Montreal, QC H2X 0A9, Canada; (H.B.); (J.-P.P.)
| | - François Abram
- Medical Imaging Consultant, ArthroLab Inc., Montreal, QC H2X 0A9, Canada;
| | - Johanne Martel-Pelletier
- Osteoarthritis Research Unit, University of Montreal Hospital Research Centre (CRCHUM), Montreal, QC H2X 0A9, Canada; (H.B.); (J.-P.P.)
- Correspondence: ; Tel.: +1-514-890-8000 (ext. 27281); Fax: +1-514-412-7582
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11
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Newman S, Ahmed H, Rehmatullah N. Radiographic vs. MRI vs. arthroscopic assessment and grading of knee osteoarthritis - are we using appropriate imaging? J Exp Orthop 2022; 9:2. [PMID: 34978625 PMCID: PMC8724325 DOI: 10.1186/s40634-021-00442-y] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/18/2021] [Accepted: 12/02/2021] [Indexed: 11/21/2022] Open
Abstract
Purpose Radiographs and MRI scans are commonly used imaging techniques in the assessment of knee osteoarthritis. However, it currently remains uncertain how good a representation of the actual condition of the knee joint these investigations provide. By comparing them against arthroscopic findings the aim of our study was to conclude how accurate these imaging techniques are at grading knee osteoarthritis. Methods This was a retrospective study looking at knee arthroscopies performed at a tertiary centre over a 5 year period. The Outerbridge grade given at arthroscopy was correlated with pre-operative radiograph and MRI scores, so as to assess the reliability of these imaging techniques at predicting the actual severity of knee osteoarthritis seen. Results Kellgren-Lawrence (KL) grading of radiographs was moderately correlated with Outerbridge grades from arthroscopy for the medial compartment of the knee (Spearman’s rho (SR) 0.483, p < 0.001), with a milder correlation in the lateral compartment (SR 0.218, p = 0.003). MRI reporting of knee osteoarthritis was moderately correlated with Outerbridge grades in the medial compartment (SR 0.451, p < 0.001), mildly correlated for both the lateral (SR 0.299, p < 0.001) and patellofemoral joint compartments (SR 0.142, p = 0.054). KL and MRI grading was moderately correlated for the medial compartment (SR 0.475, p < 0.001) and mildly correlated for the lateral compartment (SR 0.277, p < 0.001). Conclusion The ability of radiographs to represent the actual condition of knee osteoarthritis is underestimated. KL grading especially best represents the disease seen in the medial compartment of the knee joint, with a moderate correlation to Outerbridge scores given on arthroscopic assessment. We suggest that whilst MRI is a useful tool in the investigation of knee symptoms, it is often unnecessarily used in patients with OA, when in fact, radiographs alone would be sufficient. Evidence level III
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Affiliation(s)
- Samuel Newman
- Wrightington, Wigan & Leigh NHS Foundation Trust, Wigan Lane, Wigan, WN1 2NN, UK.
| | - Huzefah Ahmed
- Wrightington, Wigan & Leigh NHS Foundation Trust, Wigan Lane, Wigan, WN1 2NN, UK
| | - Nader Rehmatullah
- Wrightington, Wigan & Leigh NHS Foundation Trust, Wigan Lane, Wigan, WN1 2NN, UK
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12
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Han Y, Wu J, Gong Z, Zhou Y, Li H, Wang B, Qian Q. Identification and development of a novel 5-gene diagnostic model based on immune infiltration analysis of osteoarthritis. J Transl Med 2021; 19:522. [PMID: 34949204 PMCID: PMC8705150 DOI: 10.1186/s12967-021-03183-9] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2021] [Accepted: 12/05/2021] [Indexed: 11/27/2022] Open
Abstract
Background Osteoarthritis (OA), which is due to the progressive loss and degeneration of articular cartilage, is the leading cause of disability worldwide. Therefore, it is of great significance to explore OA biomarkers for the prevention, diagnosis, and treatment of OA. Methods and materials The GSE129147, GSE57218, GSE51588, GSE117999, and GSE98918 datasets with normal and OA samples were downloaded from the Gene Expression Omnibus (GEO) database. The GSE117999 and GSE98918 datasets were integrated, and immune infiltration was evaluated. The differentially expressed genes (DEGs) were analyzed using the limma package in R, and weighted gene co-expression network analysis (WGCNA) was used to explore the co-expression genes and co-expression modules. The co-expression module genes were analyzed by Gene Ontology (GO) and Kyoto Encyclopedia of Genes and Genomes (KEGG) analyses. A protein–protein interaction (PPI) network was constructed using the Search Tool for the Retrieval of Interacting Genes/Proteins (STRING) database, and hub genes were identified by the degree, MNC, closeness, and MCC algorithms. The hub genes were used to construct a diagnostic model based on support vector machines. Results The Immune Score in the OA samples was significantly higher than in the normal samples, and a total of 2313 DEGs were identified. Through WGCNA, we found that the yellow module was significantly positively correlated with the OA samples and Immune Score and negatively correlated with the normal samples. The 142 DEGs of the yellow module were related to biological processes such as regulation of inflammatory response, positive regulation of inflammatory response, blood vessel morphogenesis, endothelial cell migration, and humoral immune response. The intersections of the genes obtained by the 4 algorithms resulted in 5 final hub genes, and the diagnostic model constructed with these 5 genes showed good performance in the training and validation cohorts. Conclusions The 5-gene diagnostic model can be used to diagnose OA and guide clinical decision-making. Supplementary Information The online version contains supplementary material available at 10.1186/s12967-021-03183-9.
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Affiliation(s)
- YaGuang Han
- Department of Joint Surgery and Sports Medicine, Shanghai Changzheng Hospital, Second Military Medical University, 415#, Fengyang Road, Huangpu District, Shanghai, 200003, China
| | - Jun Wu
- Department of Joint Surgery and Sports Medicine, Shanghai Changzheng Hospital, Second Military Medical University, 415#, Fengyang Road, Huangpu District, Shanghai, 200003, China.,Department of Orthopaedic Surgery, Nantong Sixth People's Hospital, Nantong Hospital Affiliated To Shanghai University, Nantong, Jiangsu, China
| | - ZhenYu Gong
- Department of Emergency Medicine, Zhongshan Hospital, Fudan University, Shanghai, 200032, China
| | - YiQin Zhou
- Department of Joint Surgery and Sports Medicine, Shanghai Changzheng Hospital, Second Military Medical University, 415#, Fengyang Road, Huangpu District, Shanghai, 200003, China
| | - HaoBo Li
- Department of Joint Surgery and Sports Medicine, Shanghai Changzheng Hospital, Second Military Medical University, 415#, Fengyang Road, Huangpu District, Shanghai, 200003, China
| | - Bo Wang
- Department of Joint Surgery and Sports Medicine, Shanghai Changzheng Hospital, Second Military Medical University, 415#, Fengyang Road, Huangpu District, Shanghai, 200003, China.
| | - QiRong Qian
- Department of Joint Surgery and Sports Medicine, Shanghai Changzheng Hospital, Second Military Medical University, 415#, Fengyang Road, Huangpu District, Shanghai, 200003, China.
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13
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Go DJ, Kim DH, Guermazi A, Crema MD, Hunter DJ, Hwang HS, Kim HA. Metabolic obesity and the risk of knee osteoarthritis progression in elderly community residents: A 3-year longitudinal cohort study. Int J Rheum Dis 2021; 25:192-200. [PMID: 34877797 DOI: 10.1111/1756-185x.14255] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2021] [Revised: 10/29/2021] [Accepted: 11/22/2021] [Indexed: 01/03/2023]
Abstract
OBJECTIVE Metabolic syndrome is a major health problem worldwide associated with obesity, thus drawing attention to its relation to osteoarthritis (OA). However, it is still uncertain whether metabolic syndrome or body fat distribution is associated with knee OA. The aim of this longitudinal study was to elucidate the association between metabolic obesity and adverse structural changes of knee OA assessed by magnetic resonance imaging (MRI). METHODS Participants were recruited from the Hallym Aging Study cohort in Korea. Knee MRI scans, along with dual-energy X-ray absorptiometry, were assessed in 226 participants at baseline and after 3 years. The structural progression in the tibiofemoral joint was evaluated using the semi-quantitative Whole-Organ MRI Score (WORMS) for cartilage morphology and bone marrow lesions (BML). Logistic regression with generalized estimating equation was performed for associations of metabolic risk factors with worsening of WORMS scores at the subregional level. RESULTS In the medial compartment, fat mass in women was associated with cartilage loss, but the statistical significance disappeared after adjusting for body mass index. Metabolic syndrome and each of its components were not associated with cartilage loss or increase of BML. On the other hand, the interaction effects of metabolic syndrome on the association between obesity and knee OA progression were not significant. CONCLUSION In this cohort, metabolic effects of obesity on knee cartilage damage and BML were not demonstrated. Further large-scale studies are required to prove the causal relationship between metabolic obesity and knee OA.
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Affiliation(s)
- Dong Jin Go
- Division of Rheumatology, Department of Internal Medicine, Hallym University Kangnam Sacred Heart Hospital, Hallym University College of Medicine, Seoul, Korea.,Department of Molecular Medicine and Biopharmaceutical Sciences, Graduate School of Convergence Science and Technology, and College of Medicine, Medical Research Institute, Seoul National University, Seoul, Korea
| | - Dong Hyun Kim
- Department of Social and Preventive Medicine, Hallym Research Institute of Clinical Epidemiology, Hallym University, Chuncheon, Korea
| | - Ali Guermazi
- Department of Radiology, Boston University School of Medicine, Boston, Massachusetts, USA
| | - Michel Daoud Crema
- Department of Radiology, Boston University School of Medicine, Boston, Massachusetts, USA
| | - David J Hunter
- Department of Rheumatology, Royal North Shore Hospital and Institute of Bone and Joint Research, University of Sydney, Sydney, New South Wales, Australia
| | - Hyun Sook Hwang
- Division of Rheumatology, Department of Internal Medicine, Hallym University Sacred Heart Hospital, Anyang, Korea.,Institute for Skeletal Aging, Hallym University, Chuncheon, Korea
| | - Hyun Ah Kim
- Division of Rheumatology, Department of Internal Medicine, Hallym University Sacred Heart Hospital, Anyang, Korea.,Institute for Skeletal Aging, Hallym University, Chuncheon, Korea
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14
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Pan F, Tian J, Cicuttini F, Jones G. Prospective Association Between Inflammatory Markers and Knee Cartilage Volume Loss and Pain Trajectory. Pain Ther 2021; 11:107-119. [PMID: 34837639 PMCID: PMC8861228 DOI: 10.1007/s40122-021-00341-1] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2021] [Accepted: 11/10/2021] [Indexed: 01/15/2023] Open
Abstract
Introduction Inflammation has been suggested to be involved in the pathogenesis of osteoarthritis and pain. We sought to explore the associations between inflammatory serum markers and magnetic resonance imaging-defined long-term structural change and pain trajectory. Methods A total of 169 randomly selected participants (mean age 63 years; 47% female) from a prospective cohort study were included in this study. Circulating levels of interleukin 6 (IL-6), tumour necrosis factor alpha (TNF-α) and high-sensitivity C-reactive protein (CRP) were measured at baseline. A knee MRI scan was performed to measure cartilage volume (CV) and bone marrow lesions (BMLs) at baseline and at 10.7 years. Knee pain at four visits was measured by the WOMAC pain questionnaire, and pain trajectories were identified using group-based trajectory modelling. Linear, log-binomial and multi-nominal logistic regression were used for the analyses. Results IL-6 was associated with lateral but not medial tibial CV loss (β = − 0.25% per annum, per standard deviation [SD] log pg/ml; P < 0.05) in the multivariate analysis. IL-6 was also associated with a ‘Moderate pain’ trajectory (relative risk ratio 1.93 per SD log pg/ml; 95% confidence interval 1.02–3.65) relative to the ‘Minimal pain’ trajectory group. There was no significant association of TNF-α and CRP with CV loss and pain trajectory groups with the exception of a beneficial relationship between CRP and medial tibial CV loss (β = 0.20% per annum, per SD log mg/l). No association between inflammatory markers and change in BML size was observed. Conclusions IL-6 was independently associated with compartment-specific CV loss and worse pain trajectory, but the other markers studied were not, suggesting that components of inflammation are implicated in the pathogenesis of cartilage loss and developing a worse pain course. Supplementary Information The online version contains supplementary material available at 10.1007/s40122-021-00341-1.
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Affiliation(s)
- Feng Pan
- Menzies Institute for Medical Research, University of Tasmania, Private Bag 23, Hobart, TAS, 7000, Australia.
| | - Jing Tian
- Menzies Institute for Medical Research, University of Tasmania, Private Bag 23, Hobart, TAS, 7000, Australia
| | - Flavia Cicuttini
- Department of Epidemiology and Preventive Medicine, Monash University Medical School, Commercial Road, Melbourne, VIC, 3181, Australia
| | - Graeme Jones
- Menzies Institute for Medical Research, University of Tasmania, Private Bag 23, Hobart, TAS, 7000, Australia
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15
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Hu N, Zhang J, Wang J, Wang P, Wang J, Qiang Y, Li Z, Wu T, Wang X, Wang Y, Li J, Liu X, Zhang J, Feng X, Ju B, Hao Z, Pu D, Lu X, Wang Q, He L. Biomarkers of joint metabolism and bone mineral density are associated with early knee osteoarthritis in premenopausal females. Clin Rheumatol 2021; 41:819-829. [PMID: 34642881 DOI: 10.1007/s10067-021-05885-3] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2020] [Revised: 07/23/2021] [Accepted: 08/10/2021] [Indexed: 11/28/2022]
Abstract
INTRODUCTION Biomarkers of bone and cartilage metabolism were proposed as early diagnosis indicators for knee osteoarthritis (OA), however, which were influenced by disease stage, age, and menopause state. Accurate diagnosis indicators are eagerly awaited. The current study aims to investigate associations of joint metabolism biomarkers and bone mineral density (BMD) with early knee OA in males and premenopausal females before age 50 years. METHOD A total of 189 patients aged before 50 years with early knee OA and 152 healthy participants were enrolled. Levels of bone biomarkers (PINP, OC, and CTX-I) and cartilage biomarkers (PIIANP, COMP, CTX-II, and MMP-3) were assessed. BMD was measured at the lumbar, femoral neck, and hip. Multivariate regression analyses were performed to evaluate the relationship between biomarkers, BMD, and early knee OA. RESULTS Serum COMP, urine CTX-II and BMD at femoral neck and hip were increased in premenopausal patients as compared to control; with serum PINP and OC reduced. Meanwhile, serum COMP, urine CTX-II, and BMD at femoral neck and hip showed positive associations with premenopausal early knee OA, while serum PINP had negative association. However, in male patients, only serum COMP was higher than control, and no association of biomarkers or BMD was found with early knee OA. CONCLUSIONS The joint metabolism biomarkers and BMD showed multiple associations with early knee OA in premenopausal females, but not in males aged before 50 years. It was suggested that sex differences should be taken into account when evaluating cartilage and bone metabolism in early knee OA. Key Points • The joint metabolism biomarkers and BMD are associated with early knee OA in premenopausal females, but not in males aged before 50 years. • Sex differences should be taken into account when evaluating cartilage and bone metabolism in early knee OA.
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Affiliation(s)
- Nan Hu
- Department of Rheumatology, the First Affiliated Hospital of Xi'an Jiaotong University, 277 West Yan Ta Road, Xi'an, 710061, Shaanxi, China
| | - Jing Zhang
- Department of Rheumatology, the First Affiliated Hospital of Xi'an Jiaotong University, 277 West Yan Ta Road, Xi'an, 710061, Shaanxi, China
| | - Jing Wang
- Department of Rheumatology, the First Affiliated Hospital of Xi'an Jiaotong University, 277 West Yan Ta Road, Xi'an, 710061, Shaanxi, China
| | - Pei Wang
- Department of Rheumatology, the First Affiliated Hospital of Xi'an Jiaotong University, 277 West Yan Ta Road, Xi'an, 710061, Shaanxi, China
| | - Jing Wang
- Department of Radiography, the First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China
| | - Yongqian Qiang
- Department of Radiography, the First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China
| | - Zicheng Li
- Department of Radiography, Shenmu Hospital, Shenmu, China
| | - Tianming Wu
- Clinical Laboratory, Shenmu Hospital, Shenmu, China
| | - Xing Wang
- Physical Examination Center, Shenmu Hospital, Shenmu, China
| | - Yahong Wang
- Physical Examination Center, Shenmu Hospital, Shenmu, China
| | - Jiao Li
- Department of Radiography, Shenmu Hospital, Shenmu, China
| | - Xiaoping Liu
- Department of Orthopaedics, Shenmu Hospital, Middle Section of Guangming Road, Shenmu, 719300, Shaanxi, China
| | - Jirong Zhang
- Department of Radiography, Shenmu Hospital, Shenmu, China
| | - Xiuyuan Feng
- Department of Rheumatology, the First Affiliated Hospital of Xi'an Jiaotong University, 277 West Yan Ta Road, Xi'an, 710061, Shaanxi, China
| | - Bomiao Ju
- Department of Rheumatology, the First Affiliated Hospital of Xi'an Jiaotong University, 277 West Yan Ta Road, Xi'an, 710061, Shaanxi, China
| | - Zhiming Hao
- Department of Rheumatology, the First Affiliated Hospital of Xi'an Jiaotong University, 277 West Yan Ta Road, Xi'an, 710061, Shaanxi, China
| | - Dan Pu
- Department of Rheumatology, the First Affiliated Hospital of Xi'an Jiaotong University, 277 West Yan Ta Road, Xi'an, 710061, Shaanxi, China
| | - Xiaohong Lu
- Department of Rheumatology, the First Affiliated Hospital of Xi'an Jiaotong University, 277 West Yan Ta Road, Xi'an, 710061, Shaanxi, China
| | - Qiang Wang
- Department of Orthopaedics, Shenmu Hospital, Middle Section of Guangming Road, Shenmu, 719300, Shaanxi, China.
| | - Lan He
- Department of Rheumatology, the First Affiliated Hospital of Xi'an Jiaotong University, 277 West Yan Ta Road, Xi'an, 710061, Shaanxi, China.
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16
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Wellsandt E, Emory J, Golightly YM, Dudley AT, Michaud K, Tao MA, Manzer MN, Sajja BR. Individual and cumulative measures of knee joint load associate with T2 relaxation times of knee cartilage in young, uninjured individuals: A pilot study. Knee 2021; 32:19-29. [PMID: 34371371 DOI: 10.1016/j.knee.2021.07.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/21/2020] [Revised: 03/25/2021] [Accepted: 07/18/2021] [Indexed: 02/02/2023]
Abstract
BACKGROUND Articular cartilage structure and chondrocyte health are sensitive and reliant on dynamic joint loading during activities. The purpose of this pilot study was to determine the association between measures of individual and cumulative knee joint loading with T2 relaxation times in the knee cartilage of young individuals without knee injury. METHODS Twelve participants (17-30 years old) without history of knee injury or surgery completed MRI, physical activity (PA), and biomechanical gait testing. T2 relaxation times were calculated in the cartilage within the patella and lateral and medial compartments. Accelerometry was used to measure mean daily step counts, minutes of PA, and % sedentary time over 7 days. Vertical ground reaction force, external knee joint moments and peak knee flexion angle were measured during stance phase of gait using three-dimensional motion capture. Cumulative knee joint loading was calculated as daily step count by external knee joint moment impulse. The relationship between measures of knee joint loading and T2 relaxation times was assessed using Pearson correlations. RESULTS Higher T2 relaxation times in the femoral and tibial cartilage were consistently correlated to greater body mass, daily step counts, moderate and vigorous PA, and peak knee joint moments (r = 0.10-0.84). Greater cumulative knee flexion and adduction loading was associated with higher T2 relaxation times in the femoral and tibial cartilage (r = 0.16-0.65). CONCLUSION Preliminary findings suggest that individual loading factors and cumulative knee joint loading are associated with higher T2 relaxation times in the articular cartilage of young, healthy knees.
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Affiliation(s)
- E Wellsandt
- Division of Physical Therapy Education, University of Nebraska Medical Center, 984420 Nebraska Medical Center, Omaha, NE 98198-4420, United States; Department of Orthopaedic Surgery and Rehabilitation, University of Nebraska Medical Center, 985640 Nebraska Medical Center, Omaha, NE 68198-5640, United States.
| | - J Emory
- College of Medicine, University of Nebraska Medical Center, 985520 Nebraska Medical Center, Omaha, NE 68198-5520, United States
| | - Y M Golightly
- Department of Epidemiology, Gillings School of Global Public Health at The University of North Carolina at Chapel Hill, 135 Dauer Drive, Chapel Hill, NC 27599-7400, United States; Thurston Arthritis Research Center, University of North Carolina at Chapel Hill, 3300 Thurston Bldg., CB#7280, Chapel Hill, NC 27599-7280, United States; Injury Prevention Research Center, University of North Carolina at Chapel Hill, 521 South Greensboro Street, Carboro, NC 27510, United States; Division of Physical Therapy, University of North Carolina at Chapel Hill, Bondurant Hall, CB #7135, Chapel Hill, NC 27599-7135, United States
| | - A T Dudley
- Department of Genetics, Cell Biology and Anatomy, University of Nebraska Medical Center, 985805 Nebraska Medical Center, Omaha, NE 68198-5805, United States
| | - K Michaud
- Department of Internal Medicine, University of Nebraska Medical Center, 983332 Nebraska Medical Center, Omaha, NE 68198-3332, United States; Forward, The National Databank for Rheumatic Diseases, 1035 North Emporia Avenue #288, Wichita, KS 67214, United States
| | - M A Tao
- Division of Physical Therapy Education, University of Nebraska Medical Center, 984420 Nebraska Medical Center, Omaha, NE 98198-4420, United States; Department of Orthopaedic Surgery and Rehabilitation, University of Nebraska Medical Center, 985640 Nebraska Medical Center, Omaha, NE 68198-5640, United States
| | - M N Manzer
- Department of Radiology, University of Nebraska Medical Center, 981045 Nebraska Medical Center, Omaha, NE 68198-1045, United States
| | - B R Sajja
- Department of Radiology, University of Nebraska Medical Center, 981045 Nebraska Medical Center, Omaha, NE 68198-1045, United States
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Fan T, Ruan G, Antony B, Cao P, Li J, Han W, Li Y, Yung SN, Wluka AE, Winzenberg T, Cicuttini F, Ding C, Zhu Z. The interactions between MRI-detected osteophytes and bone marrow lesions or effusion-synovitis on knee symptom progression: an exploratory study. Osteoarthritis Cartilage 2021; 29:1296-1305. [PMID: 34216729 DOI: 10.1016/j.joca.2021.06.008] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/07/2020] [Revised: 06/17/2021] [Accepted: 06/22/2021] [Indexed: 02/02/2023]
Abstract
OBJECTIVES To investigate the longitudinal association between MRI-detected osteophyte scores and progression of knee symptoms, and whether the association was modified in the presence of bone marrow lesions (BMLs) or effusion-synovitis. METHODS Data from Vitamin D Effects on Osteoarthritis (VIDEO) study, a randomized, double-blinded and placebo-controlled clinical trial in symptomatic knee osteoarthritis (OA) patients, were analyzed as an exploratory study. Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) was used to assess knee symptoms. Osteophytes, BMLs and effusion-synovitis were measured using MRI. RESULTS 334 participants with MRI information and WOMAC score (baseline and follow-up) were included in the analyses, with 24.3% of them having knee pain increased 2 years later. Statistically significant interactions were found between MRI-detected osteophytes and BMLs or effusion-synovitis on increased knee symptoms. In participants with BMLs, higher baseline scores of MRI-detected osteophytes in most compartments were significantly associated with increased total knee pain, weight-bearing pain, stiffness, and physical dysfunction, after adjustment for age, sex, body mass index, intervention and effusion-synovitis. In participants with effusion-synovitis, higher baseline scores of MRI-detected osteophytes in almost all the compartments were significantly associated with increased total knee pain, weight-bearing pain, stiffness, and physical dysfunction, after adjustment for age, sex, body mass index, intervention and BMLs. In contrast, MRI-detected osteophyte scores were generally not associated with knee symptom progression in participants without baseline BMLs or effusion-synovitis. CONCLUSIONS MRI-detected OPs are associated with increased total knee pain, weight-bearing knee pain, stiffness and physical dysfunction in participants presenting BMLs or effusion-synovitis, but not in participants lacking BMLs or effusion-synovitis. This suggests they could interact with bone or synovial abnormalities to induce symptoms in knee OA.
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Affiliation(s)
- T Fan
- Clinical Research Centre, Zhujiang Hospital, Southern Medical University, Guangzhou, Guangdong, China.
| | - G Ruan
- Clinical Research Centre, Zhujiang Hospital, Southern Medical University, Guangzhou, Guangdong, China.
| | - B Antony
- Menzies Institute for Medical Research, University of Tasmania, Hobart, Tasmania, Australia.
| | - P Cao
- Clinical Research Centre, Zhujiang Hospital, Southern Medical University, Guangzhou, Guangdong, China.
| | - J Li
- Clinical Research Centre, Zhujiang Hospital, Southern Medical University, Guangzhou, Guangdong, China.
| | - W Han
- Clinical Research Centre, Zhujiang Hospital, Southern Medical University, Guangzhou, Guangdong, China; Department of Orthopaedics, Zhujiang Hospital, Southern Medical University, Guangzhou, Guangdong, China.
| | - Y Li
- Clinical Research Centre, Zhujiang Hospital, Southern Medical University, Guangzhou, Guangdong, China.
| | - S N Yung
- Clinical Research Centre, Zhujiang Hospital, Southern Medical University, Guangzhou, Guangdong, China.
| | - A E Wluka
- Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, Victoria, Australia.
| | - T Winzenberg
- Menzies Institute for Medical Research, University of Tasmania, Hobart, Tasmania, Australia.
| | - F Cicuttini
- Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, Victoria, Australia.
| | - C Ding
- Clinical Research Centre, Zhujiang Hospital, Southern Medical University, Guangzhou, Guangdong, China; Menzies Institute for Medical Research, University of Tasmania, Hobart, Tasmania, Australia; Department of Orthopaedics, Zhujiang Hospital, Southern Medical University, Guangzhou, Guangdong, China; Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, Victoria, Australia.
| | - Z Zhu
- Clinical Research Centre, Zhujiang Hospital, Southern Medical University, Guangzhou, Guangdong, China; Department of Orthopaedics, Zhujiang Hospital, Southern Medical University, Guangzhou, Guangdong, China.
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Ley CJ, Leijon A, Uhlhorn M, Marcelino L, Hansson K, Ley C. Computed tomography is superior to radiography for detection of feline elbow osteoarthritis. Res Vet Sci 2021; 140:6-17. [PMID: 34365276 DOI: 10.1016/j.rvsc.2021.07.025] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2021] [Revised: 06/10/2021] [Accepted: 07/22/2021] [Indexed: 10/20/2022]
Abstract
Elbow osteoarthritis (OA) is common in cats and radiography is typically used for diagnosis. However computed tomography (CT), with its multiplanar three-dimensional characteristics, could have significant advantages for assessment of OA compared to radiography, particularly early in the disease process. The study objectives were to compare radiography and CT to histologic OA changes, investigate the stage of OA that radiography and CT detect, and search for specific changes in CT images strongly predictive for feline elbow OA. Right elbows from 29 cats were evaluated by radiography and CT, and articular cartilage lesions graded histologically and macroscopically. Three further joints were sampled to specifically evaluate the morphology of the anconeal process. Macroscopic, radiographic and CT OA diagnosis were compared to the reference standard histologic OA that was divided into mild, moderate and severe. Osteophytic spurs on the lateral margin of the anconeal process could be reliably measured in CT images (intra-class correlation 0.79) and when ≥0.5 mm had high sensitivity for moderate/severe histologic OA, moderate sensitivity for mild histologic OA and high specificity for all stages of OA. In moderate/severe histologic OA both radiography and CT subjective OA diagnosis had moderate to very high sensitivity. However, in mild histologic OA CT grading had low sensitivity and radiography did not detect OA. In conclusion, CT of the feline elbow including measurement of osteophytes on the anconeal process lateral margin is superior to radiography for OA detection and should be considered for OA diagnosis, particularly when mild OA changes are of interest.
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Affiliation(s)
- Charles J Ley
- Department of Clinical Sciences, Swedish University of Agricultural Sciences, SE-750 07 Uppsala, Sweden..
| | - Alexandra Leijon
- Department of Biomedical Sciences and Veterinary Public Health, Swedish University of Agricultural Sciences, SE-750 07 Uppsala, Sweden
| | - Margareta Uhlhorn
- University Animal Hospital, Swedish University of Agricultural Sciences, SE-750 07 Uppsala, Sweden
| | - Leticia Marcelino
- University Animal Hospital, Swedish University of Agricultural Sciences, SE-750 07 Uppsala, Sweden
| | - Kerstin Hansson
- Department of Clinical Sciences, Swedish University of Agricultural Sciences, SE-750 07 Uppsala, Sweden
| | - Cecilia Ley
- Department of Biomedical Sciences and Veterinary Public Health, Swedish University of Agricultural Sciences, SE-750 07 Uppsala, Sweden.
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Barker T, Rogers VE, Henriksen VT, Trawick RH, Momberger NG, Lynn Rasmussen G. Circulating IL-10 is compromised in patients predisposed to developing and in patients with severe knee osteoarthritis. Sci Rep 2021; 11:1812. [PMID: 33469085 PMCID: PMC7815723 DOI: 10.1038/s41598-021-81382-6] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2020] [Accepted: 01/06/2021] [Indexed: 01/29/2023] Open
Abstract
The purpose of this investigation was to identify if serum interleukin (IL)-10 and tumor necrosis factor (TNF)-α concentrations and their ratio (IL-10/TNF-α) are altered in subjects predisposed to developing knee osteoarthritis following ligamentous injury and in those with severe knee osteoarthritis. Serum IL-10 and TNF-α concentrations were measured in four groups of subjects (n = 218): (1) reportedly-healthy and non-injured control subjects (CON; n = 92), (2) subjects scheduled to undergo anterior cruciate ligament surgery (ACL; n = 42), (3) non-surgical subjects with knee osteoarthritis (OA; n = 60), and (4) subjects with knee osteoarthritis scheduled to undergo total knee arthroplasty (TKA; n = 24). X-ray images were used to grade the severity of knee osteoarthritis. Serum IL-10 and the serum IL-10/TNF-α ratio were significantly lower while serum TNF-α was not significantly perturbed with severe compared to moderate knee osteoarthritis (i.e., Kellgren-Lawrence grade 4 vs. 3, respectively). Serum IL-10 was significantly lower in the absence of serum TNF-α alterations in the ACL group. We conclude that serum IL-10 concentrations are compromised in subjects predisposed to developing knee osteoarthritis following ligamentous trauma and in subjects with radiographic evidence of severe knee osteoarthritis.
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Affiliation(s)
- Tyler Barker
- grid.420884.20000 0004 0460 774XPrecision Genomics, Intermountain Healthcare, 383 W. Vine Street, Suite #300, Murray, UT 84107 USA ,grid.223827.e0000 0001 2193 0096Nutrition and Integrative Physiology, University of Utah, Salt Lake City, UT 84112 USA
| | - Victoria E. Rogers
- grid.416945.b0000 0004 0442 6615The Orthopedic Specialty Hospital, Murray, UT 84107 USA
| | - Vanessa T. Henriksen
- grid.416945.b0000 0004 0442 6615The Orthopedic Specialty Hospital, Murray, UT 84107 USA
| | - Roy H. Trawick
- grid.416945.b0000 0004 0442 6615The Orthopedic Specialty Hospital, Murray, UT 84107 USA ,The Orthopedic Specialty Clinic, Murray, UT 84107 USA
| | - Nathan G. Momberger
- grid.416945.b0000 0004 0442 6615The Orthopedic Specialty Hospital, Murray, UT 84107 USA ,The Orthopedic Specialty Clinic, Murray, UT 84107 USA
| | - G. Lynn Rasmussen
- grid.416945.b0000 0004 0442 6615The Orthopedic Specialty Hospital, Murray, UT 84107 USA ,The Orthopedic Specialty Clinic, Murray, UT 84107 USA
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20
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Lee LS, Chan PK, Fung WC, Chan VWK, Yan CH, Chiu KY. Imaging of knee osteoarthritis: A review of current evidence and clinical guidelines. Musculoskeletal Care 2021; 19:363-374. [PMID: 33387447 DOI: 10.1002/msc.1536] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2020] [Revised: 12/15/2020] [Accepted: 12/15/2020] [Indexed: 12/24/2022]
Abstract
BACKGROUND Knee osteoarthritis (OA) is one of the most common and debilitating degenerative joint diseases worldwide. While radiography is the most commonly used imaging modality, it is associated with drawbacks which newer modalities such as magnetic resonance imaging (MRI) and ultrasound could overcome. Nevertheless, the role of imaging in clinical practice and research in knee OA has not been clearly defined. Furthermore, guidelines on imaging in knee OA from different authoritative bodies have not been compared in previous studies. Therefore, the present review aims to summarise existing evidence and compare guidelines on the use of different imaging modalities in evaluating knee OA. METHODS This is a narrative review based on a search of published clinical guidelines and the PubMed database for articles published between 1 January 1990 and 31 May 2020. RESULTS There is no broad consensus on the value of imaging in patients with typical OA presentation. If imaging is required, current evidence and clinical guidelines support the use of radiography and MRI as first- and second-line diagnostic modalities respectively. Since radiographic OA features have limited sensitivity and do not manifest in early stages, MRI is the preferred option for whole-joint evaluation in OA research. Discrepancies exist regarding the use of alternative imaging modalities including ultrasound, computed tomography and nuclear medicine. CONCLUSION Radiography and MRI are the imaging modalities of choice. Other modalities have their respective advantages, and more research is warranted for the standardisation of image acquisition and interpretation methodology, in order to evaluate their validity, reliability and responsiveness in OA research.
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Affiliation(s)
- Lok Sze Lee
- Department of Orthopaedics and Traumatology, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong SAR, China
| | - Ping Keung Chan
- Department of Orthopaedics and Traumatology, Queen Mary Hospital, Hong Kong SAR, China
| | - Wing Chiu Fung
- Department of Orthopaedics and Traumatology, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong SAR, China
| | - Vincent Wai Kwan Chan
- Department of Orthopaedics and Traumatology, Queen Mary Hospital, Hong Kong SAR, China
| | - Chun Hoi Yan
- Department of Orthopaedics and Traumatology, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong SAR, China
| | - Kwong Yuen Chiu
- Department of Orthopaedics and Traumatology, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong SAR, China
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21
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Hou W, Zhao J, He R, Li J, Ou Y, Du M, Xiong X, Xie B, Li L, Zhou X, Zuo P, Raithel E, Zhang Z, Chen W. Quantitative measurement of cartilage volume with automatic cartilage segmentation in knee osteoarthritis. Clin Rheumatol 2020; 40:1997-2006. [PMID: 33026551 DOI: 10.1007/s10067-020-05388-7] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2020] [Revised: 08/19/2020] [Accepted: 09/01/2020] [Indexed: 11/24/2022]
Abstract
PURPOSE To determine the reproducibility of the automatic cartilage segmentation method using a prototype KneeCaP software (version 1.3; Siemens Healthcare, Erlangen, Germany) and to compare the difference in cartilage volume (CV) between the normal knee joint and knee osteoarthritis (KOA) of different degrees by using the above software. MATERIALS AND METHODS The study included 62 subjects with knee OA and 29 healthy control subjects. The cartilage lesion patients were divided into a mild-to-moderate OA group (n = 29) and severe OA group (n = 33). Automatic cartilage segmentation was performed on all the subjects, and among them, 19 knee cases were randomly selected to also do the manual cartilage segmentation. Statistical significance was determined with one-way analysis of variance (ANOVA), intraclass correlation coefficient (ICC), and Pearson correlation coefficient. Automatic segmentation was compared with the manual one. The relative cartilage volume percentages of the femur, tibia, and patella in the normal control/mild-to-moderate/severe OA groups were assessed. RESULTS Comparing the cartilage volumes derived by manual and automatic segmentation, the ICC value for the knee joint, patella, femur, or tibia was 0.784, 0.815, 0.740, and 0.797. The relative cartilage volume percentages of the femur, tibia, and patella in the normal control/mild-to-moderate/severe OA groups were 57.28%/59.30%/62.45% (femur), 25.35%/23.46%/21.84% (tibia), and 17.37%/17.24%/15.71% (patella), respectively. Compared with the normal control group, the relative tibia cartilage volume percentage was lower in the mild-to-moderate OA group and the severe OA group. Corresponding index showed a similar difference between the mild-to-moderate OA group and the severe OA group (p < 0.001). CONCLUSION This study demonstrated that the relative cartilage volume percentage is correlated with the semi-quantitative systems and may be a preferred outcome measure in clinical studies of OA. Automatic cartilage segmentation using KneeCaP delivered reliable results on high-spatial-resolution 3 T MR images for the healthy, mild-moderate OA patients. Key Points • The cartilage automatic segmentation has excellent reproducibility and was not affected by inter-observer variation. • The relative cartilage volume percentage is correlated with the semi-quantitative systems and may be a preferred outcome measure in clinical studies of OA.
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Affiliation(s)
- Wenjing Hou
- Department of Radiology, Southwest Hospital, Army Medical University (Third Military Medical University), Gaotanyan 30, Shapingba, Chongqing, 400038, People's Republic of China
| | - Jun Zhao
- Department of Radiology, Southwest Hospital, Army Medical University (Third Military Medical University), Gaotanyan 30, Shapingba, Chongqing, 400038, People's Republic of China
| | - Rui He
- Centre of Joint Surgery, Southwest Hospital, Army Medical University (Third Military Medical University), Chongqing, 400038, China
| | - Jing Li
- Department of Radiology, Southwest Hospital, Army Medical University (Third Military Medical University), Gaotanyan 30, Shapingba, Chongqing, 400038, People's Republic of China
| | - Yuan Ou
- Department of Radiology, Southwest Hospital, Army Medical University (Third Military Medical University), Gaotanyan 30, Shapingba, Chongqing, 400038, People's Republic of China
| | - Mingshan Du
- Department of Radiology, Southwest Hospital, Army Medical University (Third Military Medical University), Gaotanyan 30, Shapingba, Chongqing, 400038, People's Republic of China
| | - Xuanqi Xiong
- Department of Radiology, Southwest Hospital, Army Medical University (Third Military Medical University), Gaotanyan 30, Shapingba, Chongqing, 400038, People's Republic of China
| | - Bing Xie
- Department of Radiology, Southwest Hospital, Army Medical University (Third Military Medical University), Gaotanyan 30, Shapingba, Chongqing, 400038, People's Republic of China
| | - Lian Li
- Department of Radiology, Southwest Hospital, Army Medical University (Third Military Medical University), Gaotanyan 30, Shapingba, Chongqing, 400038, People's Republic of China
| | - Xiaoyue Zhou
- MR Collaboration NEA, Siemens Healthcare Ltd., Shanghai, 201318, People's Republic of China
| | - Panli Zuo
- MR Collaboration NEA, Siemens Healthcare Ltd., Shanghai, 201318, People's Republic of China
| | | | - Zhuoli Zhang
- Department of Radiology, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA
| | - Wei Chen
- Department of Radiology, Southwest Hospital, Army Medical University (Third Military Medical University), Gaotanyan 30, Shapingba, Chongqing, 400038, People's Republic of China.
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22
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Cai G, Cicuttini F, Aitken D, Laslett LL, Zhu Z, Winzenberg T, Jones G. Comparison of radiographic and MRI osteoarthritis definitions and their combination for prediction of tibial cartilage loss, knee symptoms and total knee replacement: a longitudinal study. Osteoarthritis Cartilage 2020; 28:1062-1070. [PMID: 32413465 DOI: 10.1016/j.joca.2020.04.017] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/26/2019] [Revised: 04/02/2020] [Accepted: 04/28/2020] [Indexed: 02/02/2023]
Abstract
OBJECTIVE To describe the value of radiographic- and magnetic resonance imaging (MRI)-defined tibiofemoral osteoarthritis (ROA and MRI-OA, respectively) and in combination for predicting tibial cartilage loss, knee pain and disability and total knee replacement (TKR) in a population-based cohort. DESIGN A radiograph and 1.5T MRI of the right knee was performed. ROA and MRI-OA at baseline were defined according to the Osteoarthritis Research Society International atlas and a published Delphi exercise, respectively. Tibial cartilage volume was measured over 2.6 and 10.7 years. Knee pain and disability were assessed at baseline, 2.6, 5.1 and 10.7 years. Right-sided TKRs were assessed over 13.5 years. RESULTS Of 574 participants (mean 62 years, 49% female), 8% had ROA alone, 15% had MRI-OA alone, 13% had both ROA and MRI-OA. Having ROA (vs. no ROA) and MRI-OA (vs. no MRI-OA) predicted greater tibial cartilage loss over 2.6 years (-75.9 and -86.4 mm3/year) and higher risk of TKR over 13.5 years (Risk Ratio [RR]: 15.0 and 10.9). Only MRI-OA predicted tibial cartilage loss over 10.7 years (-7.1 mm3/year) and only ROA predicted onset and progression of knee symptoms (RR: 1.32-1.88). In participants with both MRI-OA and ROA, tibial cartilage loss was the greatest (over 2.6 years: -116.1 mm3/year; over 10.7 years: -11.2 mm3/year), and the onset and progression of knee symptoms (RR: 1.75-2.89) and risk of TKR (RR: 50.9) were the highest. CONCLUSIONS The Delphi definition of MRI-OA is not superior to ROA for predicting structural or symptomatic OA progression but, combining MRI-OA and ROA has much stronger predictive validity.
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Affiliation(s)
- G Cai
- Menzies Institute for Medical Research, University of Tasmania, Hobart, TAS, Australia.
| | - F Cicuttini
- Department of Epidemiology and Preventive Medicine, Monash University Medical School, Melbourne, Australia.
| | - D Aitken
- Menzies Institute for Medical Research, University of Tasmania, Hobart, TAS, Australia.
| | - L L Laslett
- Menzies Institute for Medical Research, University of Tasmania, Hobart, TAS, Australia.
| | - Z Zhu
- Clinical Research Centre, Zhujiang Hospital of Southern Medical University, Guangzhou, Guangdong, China.
| | - T Winzenberg
- Menzies Institute for Medical Research, University of Tasmania, Hobart, TAS, Australia.
| | - G Jones
- Menzies Institute for Medical Research, University of Tasmania, Hobart, TAS, Australia.
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23
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Balogun SA, Graves SE, Lorimer M, Cicuttini F, Scott D, Jones G, Aitken D. Do Older Adults with Low Muscle Mass or Strength, in the Presence of Obesity, Have an Increased Risk of Joint Replacement Over 13 Years? Calcif Tissue Int 2020; 107:10-17. [PMID: 32347321 DOI: 10.1007/s00223-020-00698-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/03/2020] [Accepted: 04/17/2020] [Indexed: 01/19/2023]
Abstract
This study aims to assess whether older adults with low muscle mass or strength, in the presence of obesity, have an increased risk of knee (TKR) and hip replacement (THR) over 13 years. 1082 community-dwelling older adults (51% women; mean age 62.9 ± 7.5 years) were studied at baseline and multiple time points over 13 years. The incidence of TKR and THR was determined by data linkage to National Joint Replacement Registry. Appendicular lean and fat mass were measured using DXA. Lower-limb muscle strength (LMS) was assessed by dynamometer. Low muscle mass and strength were defined as the lowest sex-specific tertiles for appendicular lean mass (adjusted for height and total body fat mass) and lower-limb strength, respectively. Obesity was defined as the highest sex-specific tertile for total body fat mass. Competing risk regression models were used to estimate the sub-distribution hazard ratio (SHR) for TKR and THR. Over 13 years of follow-up, 6.8% (n = 74/1082) of the participants had a TKR and 4.7% (n = 50/1066) had THR. Participants with the combination of obesity and low muscle strength (SHR 3.36, 95% CI 1.50, 7.53) but low muscle mass (SHR 1.11, 95% CI 0.52, 2.40) had a significantly increased risk of TKR, compared to individuals with neither obesity nor low muscle mass/strength. However, obesity with low muscle strength did not lead to a significantly greater risk of TKR compared to having low muscle strength or obesity alone. There was no evidence for an association between obesity with low muscle mass or strength and THR (all p > 0.05). This finding suggests that combining muscle and fat assessments to predict the future risk of TKR is no better than each condition on its own.
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Affiliation(s)
- Saliu A Balogun
- Menzies Institute for Medical Research, University of Tasmania, Hobart, Australia.
- National Centre for Epidemiology and Population Health, Australian National University, Canberra, Australia.
| | - Stephen E Graves
- Australian Orthopaedic Association National Joint Replacement Registry (AOANJRR), Adelaide, SA, Australia
| | - Michelle Lorimer
- South Australian Health and Medical Research Institute (SAHMRI), Adelaide, SA, Australia
| | - Flavia Cicuttini
- Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, VIC, Australia
| | - David Scott
- Menzies Institute for Medical Research, University of Tasmania, Hobart, Australia
- Department of Medicine, School of Clinical Sciences at Monash Health, Monash University, Melbourne, VIC, Australia
- Australian Institute for Musculoskeletal Science, Melbourne Medical School (Western Campus), The University of Melbourne, Melbourne, VIC, Australia
| | - Graeme Jones
- Menzies Institute for Medical Research, University of Tasmania, Hobart, Australia
| | - Dawn Aitken
- Menzies Institute for Medical Research, University of Tasmania, Hobart, Australia
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24
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Laslett LL, Antony B, Wluka AE, Hill C, March L, Keen HI, Otahal P, Cicuttini FM, Jones G. KARAOKE: Krill oil versus placebo in the treatment of knee osteoarthritis: protocol for a randomised controlled trial. Trials 2020; 21:79. [PMID: 31937352 PMCID: PMC6961372 DOI: 10.1186/s13063-019-3915-1] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2019] [Accepted: 11/18/2019] [Indexed: 01/14/2023] Open
Abstract
BACKGROUND Knee osteoarthritis (OA) is a common and important cause of pain and disability, but interventions aimed at modifying structures visible on imaging have been disappointing. While OA affects the whole joint, synovitis and effusion have been recognised as having a role in the pathogenesis of OA. Krill oil reduces knee pain and systemic inflammation and could be used for targeting inflammatory mechanisms of OA. METHODS/DESIGN We will recruit 260 patients with clinical knee OA, significant knee pain and effusion-synovitis present on MRI in five Australian cities (Hobart, Melbourne, Sydney, Adelaide and Perth). These patients will be randomly allocated to the two arms of the study, receiving 2 g/day krill oil or inert placebo daily for 6 months. MRI of the study knee will be performed at screening and after 6 months. Knee symptoms, function and MRI structural abnormalities will be assessed using validated methods. Safety data will be recorded. Primary outcomes are absolute change in knee pain (assessed by visual analog score) and change in size of knee effusion-synovitis over 24 weeks. Secondary outcomes include improvement in knee pain over 4, 8, 12, 16 and 20 weeks. The primary analyses will be intention-to-treat analyses of primary and secondary outcomes. Per protocol analyses adjusting for missing data and for treatment compliance will be performed as the secondary analyses. DISCUSSION This study will provide high-quality evidence to assess whether krill oil 2 g/day reduces pain and effusion-synovitis size in older adults with clinical knee OA and knee effusion-synovitis. If krill oil is effective and confirmed to be safe, we will provide compelling evidence that krill oil improves pain and function, changes disease trajectory and slows disease progression in OA. Given the lack of approved therapies for slowing disease progression in OA, and moderate cost of krill oil, these findings will be readily translated into clinical practice. TRIAL REGISTRATION Australian New Zealand Clinical Trials Registry, ACTRN12616000726459. Registered on 02 June 2016. Universal Trial Number (UTN) U1111-1181-7087.
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Affiliation(s)
- L L Laslett
- Menzies Institute for Medical Research, University of Tasmania, Private Bag 23, Hobart, TAS, 7000, Australia.
| | - B Antony
- Menzies Institute for Medical Research, University of Tasmania, Private Bag 23, Hobart, TAS, 7000, Australia
| | - A E Wluka
- Department of Epidemiology and Preventive Medicine, Monash University, Alfred Hospital, Melbourne, VIC, 3004, Australia
| | - C Hill
- The Queen Elizabeth Hospital, University of Adelaide, Woodville, SA, 5011, Australia.,Discipline of Medicine, University of Adelaide, Adelaide, SA, 5005, Australia
| | - L March
- Royal North Shore Hospital, The University of Sydney, Sydney, NSW, 2006, Australia
| | - H I Keen
- Department of Rheumatology, Fiona Stanley Hospital, Murdoch Drive, Murdoch, WA, 6150, Australia.,Medical School, University of Western Australia, Crawley, 6009, WA, Australia
| | - P Otahal
- Menzies Institute for Medical Research, University of Tasmania, Private Bag 23, Hobart, TAS, 7000, Australia
| | - F M Cicuttini
- Department of Epidemiology and Preventive Medicine, Monash University, Alfred Hospital, Melbourne, VIC, 3004, Australia
| | - G Jones
- Menzies Institute for Medical Research, University of Tasmania, Private Bag 23, Hobart, TAS, 7000, Australia
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25
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Yang X, Ruan G, Xu J, Zheng S, Wang K, Ding C. Associations between suprapatellar pouch effusion-synovitis, serum cartilage oligomeric matrix protein, high sensitivity C-reaction protein, knee symptom, and joint structural changes in patients with knee osteoarthritis. Clin Rheumatol 2020; 39:1663-1670. [PMID: 31897961 DOI: 10.1007/s10067-019-04905-7] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2019] [Revised: 11/30/2019] [Accepted: 12/19/2019] [Indexed: 12/20/2022]
Abstract
OBJECTIVES To investigate the cross-sectional associations between suprapatellar pouch effusion-synovitis and serum levels of cartilage oligomeric matrix protein (COMP), high sensitivity C-reaction protein (hs-CRP), knee symptom, and structural changes in patients with symptomatic knee osteoarthritis (OA). METHOD A total of 173 subjects were included. The osteophytes, joint space narrowing (JSN), and radiographic severity of OA were determined using X-ray. Cartilage defects, bone marrow lesions (BMLs), and suprapatellar pouch effusion-synovitis were assessed using magnetic resonance imaging. Serum levels of COMP and hs-CRP were measured by enzyme-linked immunosorbent assay. The knee joint symptom was self-reported using visual analogue scale. RESULTS In this OA cohort, after adjustment for age, sex, and BMI, the presence of pathological effusion-synovitis was associated with serum levels of COMP (β: 30.98, P = 0.018), and suprapatellar pouch effusion-synovitis maximum areas were associated with serum hs-CRP levels. Both suprapatellar pouch effusion-synovitis maximum area and grade were associated with osteophytes and Kellgren-Lawrence scores (ORs: 1.29-1.54, all P < 0.05). In patients with high tertile of hs-CRP, both suprapatellar pouch effusion-synovitis maximum area and grade were associated with cartilage defects at lateral and medial tibiofemoral sites (ORs: 3.01-8.41, all P < 0.05) after adjustment for covariates. In female patients, the significant associations were present between suprapatellar pouch effusion-synovitis and medial tibiofemoral BMLs (ORs: 1.43-1.53, all P < 0.05) after adjustment for covariates. CONCLUSIONS Suprapatellar pouch effusion-synovitis was associated with serum levels of COMP as well as hs-CRP and knee structural abnormalities in patients with knee OA. These suggested that effusion-synovitis may play a role in knee OA.Key Points• Suprapatellar pouch effusion-synovitis is associated with serum levels of COMP in patients with knee OA.• Suprapatellar pouch effusion-synovitis is associated with cartilage defects in knee OA patients with high systemic inflammation.
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Affiliation(s)
- Xueqing Yang
- Department of Rheumatology and Immunology, The Second Affiliated Hospital of Anhui Medical University, Hefei, China
| | - Guangfeng Ruan
- Department of Rheumatology and Immunology, Arthritis Research Institute, the First Affiliated Hospital of Anhui Medical University, Hefei, China.,Menzies Institute for Medical Research, University of Tasmania, Private Bag 23, Hobart, Tasmania, 7000, Australia
| | - Jianhua Xu
- Department of Rheumatology and Immunology, Arthritis Research Institute, the First Affiliated Hospital of Anhui Medical University, Hefei, China
| | - Shuang Zheng
- Department of Rheumatology and Immunology, Arthritis Research Institute, the First Affiliated Hospital of Anhui Medical University, Hefei, China.,Menzies Institute for Medical Research, University of Tasmania, Private Bag 23, Hobart, Tasmania, 7000, Australia
| | - Kang Wang
- Department of Rheumatology and Immunology, Arthritis Research Institute, the First Affiliated Hospital of Anhui Medical University, Hefei, China.,Menzies Institute for Medical Research, University of Tasmania, Private Bag 23, Hobart, Tasmania, 7000, Australia
| | - Changhai Ding
- Department of Rheumatology and Immunology, Arthritis Research Institute, the First Affiliated Hospital of Anhui Medical University, Hefei, China. .,Menzies Institute for Medical Research, University of Tasmania, Private Bag 23, Hobart, Tasmania, 7000, Australia. .,Clinical Research Centre, Zhujiang Hospital, Southern Medical University, Guangzhou, China.
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26
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Cai G, Jiang M, Cicuttini F, Jones G. Association of age, sex and BMI with the rate of change in tibial cartilage volume: a 10.7-year longitudinal cohort study. Arthritis Res Ther 2019; 21:273. [PMID: 31818318 PMCID: PMC6902563 DOI: 10.1186/s13075-019-2063-z] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2019] [Accepted: 11/13/2019] [Indexed: 01/02/2023] Open
Abstract
Background To describe the association of age, sex and body mass index with the rate of change of tibial knee cartilage volume over 10.7 years in a community-based sample of older adults. Methods Four hundred and eighty-one participants (49% female, mean age 60.8 years [range 51.1–79.7], 49% had knee pain and 58% radiographic osteoarthritis) were included. Tibial cartilage volume of the right knee was assessed on T1-weighted fat-suppressed 1.5 T MRI at baseline and 10.7 years. Data analyses were performed using linear regression models. Results The average rate of loss of cartilage volume was 1.2%/year (range 0.2–3.9%) with all participants losing cartilage volume over the study period. There was a significant association between age and loss of tibial cartilage volume in the medial (0.023%/year, 95% confidence interval [CI] 0.010 to 0.036%, p < 0.001), lateral (0.013%/year, 95% CI 0.003 to 0.023%, p = 0.012) and total tibia (0.018%/year, 95% CI 0.009 to 0.026%, p < 0.001). Higher body mass index at baseline and increases in body mass index over time were associated with a greater tibial cartilage loss at the medial (body mass index at baseline 0.040%/year, 95% CI 0.022 to 0.058%, p < 0.001; increases in body mass index 0.055%/year, 95% CI 0.018 to 0.093%, p = 0.004) but not lateral compartment. No evidence of non-linear relationships was observed. Compared to males, females lost more lateral tibial cartilage with increasing age (0.023%/year, 95% CI 0.003 to 0.043%, p = 0.024 for interaction). Conclusions Tibial cartilage volume declines at a faster rate with increasing age and body mass index in both males and females, particularly in the medial compartment. In contrast to the low rate of change in radiographs, our findings suggest that cartilage loss at the tibia is universal in this age group.
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Affiliation(s)
- Guoqi Cai
- Menzies Institute for Medical Research, University of Tasmania, Private Bag 23, Hobart, TAS, 7001, Australia
| | - Matthew Jiang
- Department of Rheumatology, Royal Hobart Hospital, Hobart, TAS, Australia
| | - Flavia Cicuttini
- Department of Epidemiology and Preventive Medicine, Monash University Medical School, Melbourne, Australia
| | - Graeme Jones
- Menzies Institute for Medical Research, University of Tasmania, Private Bag 23, Hobart, TAS, 7001, Australia.
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27
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Osteoarthritis in the Middle-Aged and Elderly in China: Prevalence and Influencing Factors. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:ijerph16234701. [PMID: 31779104 PMCID: PMC6926632 DOI: 10.3390/ijerph16234701] [Citation(s) in RCA: 80] [Impact Index Per Article: 16.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/25/2019] [Revised: 11/20/2019] [Accepted: 11/22/2019] [Indexed: 01/30/2023]
Abstract
Background: Osteoarthritis is a common joint disease, with the acceleration of the aging process in China, it has troubled the middle-aged and elderly. There have been some epidemiological studies of osteoarthritis conducted in one single site, and most of them were on knee osteoarthritis. The results varied greatly between different surveys. There was still a lack of large-scale and multicenter epidemiological studies of osteoarthritis. This paper aimed to estimate the overall prevalence of lumbar osteoarthritis, cervical osteoarthritis, hand osteoarthritis, knee osteoarthritis, and hip osteoarthritis in the middle-aged and elderly in China by summarizing the existing publications. Methods: We comprehensively searched publications on 1 January 2019 in PubMed, Web of Science, Embase, Cochrane Library, CBM, CNNI, VIP, and Wan Fang. Epidemiological publications on osteoarthritis in the middle-aged and elderly Chinese published from 2000 to 2018 were summarized and analyzed by means of systematic review and meta-analysis. Data of prevalence of osteoarthritis in five joints were extracted from the included publications. The Hoy 2012 tool was used to assess the risk of bias of included studies. Results: After performing a systematic search in eight databases and manually searching, 3058 articles were obtained, and 21 articles were included in the meta-analysis. Lumbar osteoarthritis was the most prevalent with a prevalence of 25.03% (95% CI: 0.1444–0.3562). The prevalence of knee osteoarthritis followed, which was 21.51% (95% CI: 0.1873–0.2429). The prevalence of cervical osteoarthritis was 20.46% (95% CI: 0.1244–0.2849). The prevalence of hand osteoarthritis was 8.99% (95% CI: 0.0435–0.1364). The prevalence of hip osteoarthritis was not pooled due to its lack of data. Higher prevalence of knee, hand, lumbar, and cervical osteoarthritis was seen in the female group and southern regions. The prevalence of knee and hand osteoarthritis increased with age. The prevalence of lumbar and cervical osteoarthritis increased with age. There was also a trend that the prevalence increased with age before 70 years old and slightly decreased in the oldest ages. Conclusions: The lumbar joint was the joint most prevalently affected by osteoarthritis, followed by the prevalence of knee, cervical, hand, and hip joint osteoarthritis. Women, the southern population, and the older population are more susceptible to osteoarthritis. The paucity of epidemiology data of osteoarthritis in China appeals for more population-based surveys being conducted in the future. Based on the relatively high prevalence of osteoarthritis obtained from this review, self-management and community-based management should be considered, which can provide experience from the management of hypertensions and diabetes.
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Han W, Aitken D, Zheng S, Wluka AE, Zhu Z, Blizzard L, Winzenberg T, Cicuttini F, Jones G, Ding C. Association Between Quantitatively Measured Infrapatellar Fat Pad High Signal‐Intensity Alteration and Magnetic Resonance Imaging–Assessed Progression of Knee Osteoarthritis. Arthritis Care Res (Hoboken) 2019; 71:638-646. [DOI: 10.1002/acr.23713] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2017] [Accepted: 07/17/2018] [Indexed: 12/16/2022]
Affiliation(s)
- Weiyu Han
- University of TasmaniaHobart, Tasmania, Australia, and Zhujiang Hospital, Southern Medical University Guangzhou China
| | - Dawn Aitken
- University of Tasmania Hobart Tasmania Australia
| | - Shuang Zheng
- University of Tasmania Hobart Tasmania Australia
| | | | - Zhaohua Zhu
- University of Tasmania Hobart Tasmania Australia
| | | | | | | | - Graeme Jones
- University of Tasmania Hobart Tasmania Australia
| | - Changhai Ding
- University of TasmaniaHobart, Tasmania, and Monash University, Melbourne, Victoria, Australia, and Zhujiang Hospital, Southern Medical University Guangzhou China
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Wang Y, Teichtahl AJ, Wluka AE, Pelletier JP, Abram F, Martel-Pelletier J, Cicuttini FM. Associations of Joint Line Tenderness and Patellofemoral Grind With Long-Term Knee Joint Outcomes: Data From the Osteoarthritis Initiative. Arthritis Care Res (Hoboken) 2019; 72:778-786. [PMID: 31008553 DOI: 10.1002/acr.23906] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2019] [Accepted: 04/16/2019] [Indexed: 11/07/2022]
Abstract
OBJECTIVE To examine whether joint line tenderness and patellofemoral grind from physical examination were associated with cartilage volume loss, worsening of radiographic osteoarthritis, and the risk of total knee replacement. METHODS This study examined 4,353 Osteoarthritis Initiative participants. For each measurement of joint line tenderness and patellofemoral grind, the patterns were defined as no (none at baseline and at 1 year), fluctuating (present at either time point), and persistent (present at both time points). Cartilage volume loss and worsening of radiographic osteoarthritis over 4 years were assessed using magnetic resonance imaging and radiographs, and total knee replacement over 6 years was assessed. RESULTS A total of 35.0% of participants had joint line tenderness, and 15.8% had patellofemoral grind. Baseline patellofemoral grind, but not joint line tenderness, was associated with increased cartilage volume loss (1.08% per year versus 0.96% per year; P = 0.02) and an increased risk of total knee replacement (odds ratio [OR] 1.55 [95% confidence interval (95% CI) 1.11-2.17]; P = 0.01). While the patterns of joint line tenderness were not significantly associated with joint outcomes, participants with persistent patellofemoral grind had an increased rate of cartilage volume loss (1.30% per year versus 0.90% per year; P < 0.001) and an increased risk of total knee replacement (OR 2.10 [95% CI 1.30-3.38]; P = 0.002) compared with those participants without patellofemoral grind. CONCLUSION Patellofemoral grind, but not joint line tenderness, may represent a clinical marker associated with accelerated cartilage volume loss over 4 years and an increased risk of total knee replacement over 6 years. This simple clinical examination may provide clinicians with an inexpensive way to identify those at higher risk of disease progression who should be targeted for surveillance and management.
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Affiliation(s)
- Yuanyuan Wang
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
| | - Andrew J Teichtahl
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
| | - Anita E Wluka
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
| | | | | | | | - Flavia M Cicuttini
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
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Zhu Z, Aitken D, Cicuttini F, Jones G, Ding C. Ambulatory activity interacts with common risk factors for osteoarthritis to modify increases in MRI-detected osteophytes. Osteoarthritis Cartilage 2019; 27:650-658. [PMID: 30654117 DOI: 10.1016/j.joca.2018.12.023] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/29/2018] [Revised: 12/10/2018] [Accepted: 12/24/2018] [Indexed: 02/02/2023]
Abstract
OBJECTIVE To investigate the longitudinal association between objectively measured ambulatory activity (AA) and knee MRI-detected osteophytes (OPs), and to test whether this relationship was modified by common risk factors for OA including sex, obesity, disease severity and knee injury history. METHODS 408 community-dwelling adults aged 51-81 years were assessed at baseline and 2.7 years. T1-weighted fat-suppressed MRI was used to evaluate knee OPs at both time points. AA was assessed at baseline by pedometers and categorized as: less active (≤7499 steps per day), moderately active (7500-9999 steps per day) and highly active (≥10,000 steps per day). RESULTS Statistically significant interactions were detected between knee OA risk factors and AA on increases in MRI-detected OPs (all P < 0.05). In stratified analyses, being moderately active, compared to being less active, was protective against an increase in MRI-detected OPs (score change of ≥1) in females (relative risk (RR) = 0.42, 95%CI, 0.25-0.70, P < 0.01), those who were obese (RR = 0.50, 95%CI, 0.30-0.83, P < 0.01), those with radiographic OA (ROA) (RR = 0.68, 95%CI, 0.47-0.97, P = 0.02) and those with a history of knee injury (RR = 0.27, 95%CI, 0.08-0.88, P = 0.02) in almost every knee compartment, after adjustment for confounders. No statistically significant associations were found in males, non-obese, non-ROA or non-injury groups. CONCLUSIONS Being moderately active is protective against an increase in MRI-detected OPs in females, those with ROA, those who are obese and those with a history of knee injury. These findings suggest that being moderately active is beneficial for individuals who are at higher risk of knee OA.
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Affiliation(s)
- Z Zhu
- Clinical Research Centre, Zhujiang Hospital, Southern Medical University, Guangzhou, Guangdong, China; Menzies Institute for Medical Research, University of Tasmania, Hobart, Tasmania, Australia
| | - D Aitken
- Menzies Institute for Medical Research, University of Tasmania, Hobart, Tasmania, Australia
| | - F Cicuttini
- Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
| | - G Jones
- Menzies Institute for Medical Research, University of Tasmania, Hobart, Tasmania, Australia
| | - C Ding
- Clinical Research Centre, Zhujiang Hospital, Southern Medical University, Guangzhou, Guangdong, China; Menzies Institute for Medical Research, University of Tasmania, Hobart, Tasmania, Australia; Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, Victoria, Australia; Department of Rheumatology and Immunology, Arthritis Research Institute, The First Affiliate Hospital of Anhui Medical University, Hefei, China.
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Gatenholm B, Lindahl C, Brittberg M, Stadelmann VA. Spatially matching morphometric assessment of cartilage and subchondral bone in osteoarthritic human knee joint with micro-computed tomography. Bone 2019; 120:393-402. [PMID: 30529213 DOI: 10.1016/j.bone.2018.12.003] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/09/2018] [Revised: 11/30/2018] [Accepted: 12/06/2018] [Indexed: 01/25/2023]
Abstract
OBJECTIVE The objective of this study was to develop a reproducible and semi-automatic method based on micro computed tomography (microCT) to analyze cartilage and bone morphology of human osteoarthritic knee joints in spatially matching regions of interest. MATERIALS AND METHODS Tibial plateaus from randomly selected patients with advanced osteoarthritis (OA) who underwent total knee arthroplasty surgery were microCT scanned once fresh and once after staining with Hexabrix. The articular surface was determined manually in the first scan. Total articular surface, defect surface and cartilage surface were computed by triangulation of the cartilage surface and the spatially corresponding subchondral bone regions were automatically generated and the standard cortical bone and trabecular bone morphometric indices were computed. RESULTS The method to identify cartilage surface and defects was successfully validated against photographic examinations. The microCT measurements of the cartilage defect were also verified by conventional histopathology using safranin O-stained sections. Cartilage thickness and volume was significantly lower for OA condyle compared with healthy condyle. Bone fraction, bone tissue mineral density, cortical density and trabecular thickness differed significantly depending on the level of cartilage damage. CONCLUSION This new microCT imaging workflow can be used for reproducible quantitative evaluation of articular cartilage damage and the associated changes in subchondral bone morphology in osteoarthritic joints with a relatively high throughput compared to manual contouring. This methodology can be applied to gain better understanding of the OA disease progress in large cohorts.
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Affiliation(s)
- Birgitta Gatenholm
- Department of Orthopaedics, Institute of Clinical Sciences, The Sahlgrenska Academy at the University of Gothenburg, Gothenburg, Sweden; Department of Orthopaedics, Sahlgrenska University Hospital, Mölndal, Sweden
| | - Carl Lindahl
- Department of Clinical Chemistry and Transfusion Medicine, Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Mats Brittberg
- Department of Orthopaedics, Institute of Clinical Sciences, The Sahlgrenska Academy at the University of Gothenburg, Gothenburg, Sweden; Region Halland Orthopaedics, Hallands Sjukhus, Kungsbacka, Sweden
| | - Vincent A Stadelmann
- SCANCO Medical AG, Brüttisellen, Switzerland; Department of Research and Development, Schulthess Klinik, Zürich, Switzerland.
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Everhart JS, Abouljoud MM, Flanigan DC. Lateral cartilage defects and medial subchondral surface ratio are associated with knee-related disability. J Orthop Res 2019; 37:378-385. [PMID: 30478969 DOI: 10.1002/jor.24187] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/17/2018] [Accepted: 11/15/2018] [Indexed: 02/04/2023]
Abstract
We sought to determine the relationship between (i) full-thickness cartilage defects and tibiofemoral subchondral surface ratio (SSR) and (ii) disability and quality of life in patients with mild radiographic osteoarthritis (OA) (Kellgren-Lawrence grade 2) or without radiographic OA (Kellgren-Lawrence grades 0 or 1)? A total of 642 participants from the Osteoarthritis Initiative (OAI) with baseline knee MRIs and a Kellgren-Lawrence grade 2 or less on both bilateral screening radiographs were included. The independent relationship was assessed between (i) full-thickness cartilage defect presence and tibiofemoral SSR and (ii) Knee Injury and Osteoarthritis Outcome Score (KOOS) quality of life (QOL), KOOS function in sports and recreation (KOOS-sport/rec), and Western Ontario and McMaster Universities Arthritis Index (WOMAC) disability score after adjustment for relevant confounders with multivariate regression modeling. The prevalence of medial full-thickness defects was 10.4% (67/642) and lateral was 18.1% (116/642). Lateral defect presence was associated with worse KOOS-QOL (beta -3.61 SE 1.04; p = 0.001), KOOS-sport/rec (beta -4.70 SE 1.38; p = 0.001) and WOMAC-disability scores (beta 0.02 SE 0.01; p = 0.001); these associations were not influenced by defect size. A larger medial compartment SSR was associated with worse KOOS-QOL (beta -27.20 SE 6.80; p < 0.001), KOOS-sports/rec (beta -22.30 SE 9.01; p = 0.01) and WOMAC-disability scores (beta 0.16 SE 0.04; p < 0.001). In older adults with little to no radiographic osteoarthritis, lateral full-thickness cartilage defects, irrespective of size, and a larger medial compartment tibiofemoral SSR are potential sources of knee-related symptoms that are not appreciated on standard radiographs. © 2018 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res 37:378-385, 2019.
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Affiliation(s)
- Joshua S Everhart
- Department of Orthopaedics, The Ohio State University Wexner Medical Center, 2835 Fred Taylor Dr, Columbus, Ohio, 43202
| | - Moneer M Abouljoud
- Department of Orthopaedics, The Ohio State University Wexner Medical Center, 2835 Fred Taylor Dr, Columbus, Ohio, 43202
| | - David C Flanigan
- Department of Orthopaedics, The Ohio State University Wexner Medical Center, 2835 Fred Taylor Dr, Columbus, Ohio, 43202
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MRI-detected osteophytes of the knee: natural history and structural correlates of change. Arthritis Res Ther 2018; 20:237. [PMID: 30352619 PMCID: PMC6235223 DOI: 10.1186/s13075-018-1734-5] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2018] [Accepted: 09/25/2018] [Indexed: 01/08/2023] Open
Abstract
Backgroud The natural history of semi-quantitative magnetic resonance imaging (MRI)-detected osteophytes (MRI-detected OPs) has not been described and it is unknown whether knee structural abnormalities can predict MRI-detected OP change over time. Thus, the aim of current study is to describe the natural history of knee MRI-detected OP, and to determine if knee structural abnormalities are associated with change of MRI-detected OP in a longitudinal study of older adults. Methods Randomly selected older adults (n = 837, mean age 63 years) had MRI at baseline and 413 of them had MRI 2.6 years later to measure MRI-detected OP, cartilage defects, cartilage volume, bone marrow lesions (BMLs), meniscal extrusion, infrapatellar fat pad (IPFP) quality score/maximum area and effusion-synovitis. Results Over 2.6 years, average MRI-detected OP score increased significantly in all compartments. The total MRI-detected OP score remained stable in 53% of participants, worsened (≥ 1-point increase) in 46% and decreased in 1%. Baseline cartilage defects (RR, 1.25–1.35), BMLs (RR, 1.16–1.17), meniscal extrusion (RR, 1.22–1.33) and IPFP quality score (RR, 1.08–1.20) site-specifically and independently predicted an increase in MRI-detected OP (p values all ≤ 0.05), after adjustment for covariates. Presence of IPFP abnormality was significantly associated with increased MRI-detected OPs but became non-significant after adjustment for other structural abnormalities. Total (RR, 1.27) and suprapatellar pouch effusion-synovitis (RR, 1.22) were both associated with increased MRI-detected OPs in the lateral compartment only (both p < 0.04). Conclusion Knee MRI-detected OPs are common in older adults and are likely to progress. The association between baseline structural abnormalities and worsening MRI-detected OPs suggest MRI-detected OP could be a consequence of multiple knee structural abnormalities.
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Xie DX, Wei J, Zeng C, Yang T, Li H, Wang YL, Long HZ, Wu ZY, Qian YX, Li KH, Lei GH. Association between metabolic syndrome and knee osteoarthritis: a cross-sectional study. BMC Musculoskelet Disord 2017; 18:533. [PMID: 29246142 PMCID: PMC5732466 DOI: 10.1186/s12891-017-1890-9] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/18/2017] [Accepted: 12/01/2017] [Indexed: 12/17/2022] Open
Abstract
Background Osteoarthritis (OA) is the most prevalent chronic joint disease in China. The aim of this study was to examine the association between metabolic syndrome (MetS) and knee OA in a population-based Chinese study. Methods Data included in this analysis is from a cross-sectional study, i.e., the Xiangya Hospital Health Management Center Study. MetS was diagnosed according to the criteria defined by the Chinese Diabetes Society. Radiographic knee OA was defined as changes equivalent to Kellgren-Lawrence (K-L) grade 2 or above at least one side. Associations between MetS and its components with OA were evaluated by conducting multivariable adjusted logistic regression. Results A total of 5764 participants were included in the present study. The unadjusted OR (1.27, 95%CI: 1.10–1.47, P = 0.001), age-sex adjusted OR (1.17, 95%CI: 1.01–1.36, P = 0.041) and multivariable adjusted OR (1.17, 95%CI: 1.01–1.36, P = 0.043) all suggested a positive association between MetS and knee OA. Besides, its components (e.g., overweight, hypertension and dyslipidemia) were also associated with the prevalence of radiographic knee OA respectively, after adjusting for some confounding factors. In addition, with the accumulation of MetS components, the prevalence of knee OA increased. Furthermore, MetS as a whole was associated with the prevalence of knee osteophyte (OSP) (OR = 1.72, 95%CI: 1.42–2.09, P < 0.001), but not joint space narrowing (JSN) (OR = 1.06, 95%CI: 0.91–1.23, P = 0.449). Conclusions The findings of the present study indicated that there was a positive association between the prevalence of MetS and knee OA. However, MetS as a whole was associated with the higher prevalence of knee OSP, but not JSN, which should shed light on our understanding the association between MetS and OA.
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Affiliation(s)
- Dong-Xing Xie
- Department of Orthopaedics, Xiangya Hospital, Central South University, #87 Xiangya Road, Changsha, Hunan, 410008, People's Republic of China
| | - Jie Wei
- Health Management Center, Xiangya Hospital, Central South University, Changsha, Hunan Province, 410008, People's Republic of China.,Department of Epidemiology and Health Statistics, Xiangya School of Public Health, Central South University, Changsha, Hunan Province, 410008, People's Republic of China
| | - Chao Zeng
- Department of Orthopaedics, Xiangya Hospital, Central South University, #87 Xiangya Road, Changsha, Hunan, 410008, People's Republic of China
| | - Tuo Yang
- Department of Orthopaedics, Xiangya Hospital, Central South University, #87 Xiangya Road, Changsha, Hunan, 410008, People's Republic of China
| | - Hui Li
- Department of Orthopaedics, Xiangya Hospital, Central South University, #87 Xiangya Road, Changsha, Hunan, 410008, People's Republic of China
| | - Yi-Lun Wang
- Department of Orthopaedics, Xiangya Hospital, Central South University, #87 Xiangya Road, Changsha, Hunan, 410008, People's Republic of China
| | - Hui-Zhong Long
- Department of Orthopaedics, Xiangya Hospital, Central South University, #87 Xiangya Road, Changsha, Hunan, 410008, People's Republic of China
| | - Zi-Ying Wu
- Department of Orthopaedics, Xiangya Hospital, Central South University, #87 Xiangya Road, Changsha, Hunan, 410008, People's Republic of China
| | - Yu-Xuan Qian
- Department of Orthopaedics, Xiangya Hospital, Central South University, #87 Xiangya Road, Changsha, Hunan, 410008, People's Republic of China
| | - Kang-Hua Li
- Department of Orthopaedics, Xiangya Hospital, Central South University, #87 Xiangya Road, Changsha, Hunan, 410008, People's Republic of China
| | - Guang-Hua Lei
- Department of Orthopaedics, Xiangya Hospital, Central South University, #87 Xiangya Road, Changsha, Hunan, 410008, People's Republic of China.
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von Drygalski A, Rappazzo KC, Barnes RFW, Chang EY. Knee Fat Pad Volumes in Patients with Hemophilia and Their Relationship with Osteoarthritis. ARTHRITIS 2017; 2017:1578623. [PMID: 29359047 PMCID: PMC5735625 DOI: 10.1155/2017/1578623] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/10/2017] [Revised: 09/07/2017] [Accepted: 09/17/2017] [Indexed: 12/14/2022]
Abstract
Hemophilic arthropathy is a progressive, disabling condition with poorly understood pathobiology. Since there is an emerging interest to study the role of intra-articular fat pad size and biology in arthritic conditions, we explored fat pad volume changes in hemophilic arthropathy and to what extent they differed from osteoarthritis. We matched a cohort of 13 adult patients with hemophilic arthropathy of the knee with age- and gender-matched cohorts without osteoarthritis ("control cohort") and with the same degree of radiographic osteoarthritis ("OA cohort") in 1 : 2 fashion. Infrapatellar fat pad (IPFP) and suprapatellar fat pad (SPFP) volumes were calculated based on magnetic resonance imaging and differences in fat pad volumes, demographics, height, weight, and osteoarthritis scores were evaluated. Fat pad volumes were positively associated with body size parameters in all three cohorts but were unaffected by the degree of osteoarthritis. While IPFP volumes did not differ between cohorts, SPFP volumes expanded disproportionally with weight in hemophilia patients. Our observations indicate that IPFPs and SPFPs behave biologically differently in response to different arthritic stimuli. The exaggerated expansion of the SPFP in hemophilia patients highlights the importance of further studying the implications of fat pad biology for progression of hemophilic arthropathy.
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Affiliation(s)
- Annette von Drygalski
- Division of Hematology/Oncology, Department of Medicine, University of California San Diego, San Diego, CA, USA
- Department of Molecular and Experimental Medicine, The Scripps Research Institute, La Jolla, CA, USA
| | | | - Richard F. W. Barnes
- Division of Hematology/Oncology, Department of Medicine, University of California San Diego, San Diego, CA, USA
| | - Eric Y. Chang
- Radiology Service, VA San Diego Healthcare System, San Diego, CA, USA
- Department of Radiology, University of California San Diego, San Diego, CA, USA
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Zhu Z, Laslett LL, Han W, Antony B, Pan F, Cicuttini F, Jones G, Ding C. Associations between MRI-detected early osteophytes and knee structure in older adults: a population-based cohort study. Osteoarthritis Cartilage 2017; 25:2055-2062. [PMID: 28935436 DOI: 10.1016/j.joca.2017.09.005] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/03/2017] [Revised: 09/01/2017] [Accepted: 09/11/2017] [Indexed: 02/06/2023]
Abstract
OBJECTIVES To describe prevalence of osteophytes (OPs) detected only by magnetic resonance imaging (MRI) but not by standard X-ray in older adults and to evaluate longitudinal associations with knee structural changes. METHODS 837 participants were randomly selected from the local community and had MRI scans to assess knee OPs and other structures. OPs detected only by MRI but not by standard X-ray were defined as MRI-detected early OPs (MRI-OPs for short). OPs detected by both MRI and X-ray were defined as established-OPs. RESULTS The prevalence of MRI-OPs was 50% while the prevalence of established-OPs was 10% and no-OPs was 40% at total tibiofemoral (TF) compartment at baseline. Compared with no-OPs, participants with MRI-OPs had greater risks of increased cartilage defects in all TF compartments (RR 1.37, 95%CI 1.07-1.74) and bone marrow lesions (BMLs) only in medial TF compartment (RR 1.49, 95%CI 1.06-2.11), after adjustment for age, sex, BMI, cartilage defects, BMLs and/or joint space narrowing; participants with established-OPs had greater cartilage volume loss at total (β -2.02, 95%CI -3.86, -0.17) and lateral tibial sites (β -5.63, 95%CI -9.93, -1.32), greater risks of increased cartilage defects in total (RR 1.66, 95%CI 1.15-2.40) and medial TF compartments (RR 1.49, 95%CI 1.20-1.69) and BMLs in all TF compartments (RR 1.88, 95%CI 1.22-2.89), after adjustment for covariates. CONCLUSION MRI-OPs were associated with changes in knee structures, and the associations were similar but not as prominent as those for established-OPs. These suggest MRI-OPs may have a role to play in knee early-stage osteoarthritic progression.
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Affiliation(s)
- Z Zhu
- Menzies Institute for Medical Research, University of Tasmania, Hobart, Tasmania, Australia
| | - L L Laslett
- Menzies Institute for Medical Research, University of Tasmania, Hobart, Tasmania, Australia
| | - W Han
- Menzies Institute for Medical Research, University of Tasmania, Hobart, Tasmania, Australia; Translational Research Centre, Academy of Orthopaedics, Guangdong Province, China
| | - B Antony
- Menzies Institute for Medical Research, University of Tasmania, Hobart, Tasmania, Australia
| | - F Pan
- Menzies Institute for Medical Research, University of Tasmania, Hobart, Tasmania, Australia
| | - F Cicuttini
- Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
| | - G Jones
- Menzies Institute for Medical Research, University of Tasmania, Hobart, Tasmania, Australia
| | - C Ding
- Menzies Institute for Medical Research, University of Tasmania, Hobart, Tasmania, Australia; Translational Research Centre, Academy of Orthopaedics, Guangdong Province, China; School of Basic Medical Sciences, Southern Medical University, Guangzhou, Guangdong, China; Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, Victoria, Australia.
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Iolascon G, Gimigliano F, Moretti A, de Sire A, Migliore A, Brandi M, Piscitelli P. Early osteoarthritis: How to define, diagnose, and manage. A systematic review. Eur Geriatr Med 2017. [DOI: 10.1016/j.eurger.2017.07.008] [Citation(s) in RCA: 35] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
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Zhu Z, Laslett LL, Jin X, Han W, Antony B, Wang X, Lu M, Cicuttini F, Jones G, Ding C. Association between MRI-detected osteophytes and changes in knee structures and pain in older adults: a cohort study. Osteoarthritis Cartilage 2017; 25:1084-1092. [PMID: 28115233 DOI: 10.1016/j.joca.2017.01.007] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/28/2016] [Revised: 12/14/2016] [Accepted: 01/12/2017] [Indexed: 02/02/2023]
Abstract
OBJECTIVE To describe cross-sectional and longitudinal associations between magnetic resonance imaging (MRI)-detected osteophytes (OPs) and knee structural abnormalities and knee pain in older adults. METHOD A prospective population-based cohort study of 895 participants aged 50-80 years (mean age 62 years, 50% female) was performed. T1-or T2-weighted fat suppressed MRI was used to assess knee OPs, cartilage volume, cartilage defects and bone marrow lesions (BMLs) at baseline and after 2.6 years. Radiographically-detected OPs were scored according to the Osteoarthritis Research Society International (OARSI) atlas. Knee pain was assessed using a self-administered questionnaire at baseline, 2.6 and 5 years later. RESULTS 85% of participants had MRI-detected OPs at baseline, while 10% of participants had radiographically-detected OPs. Cross-sectionally, higher gardes of MRI-detected OPs in all compartments were significantly, independently and site-specifically associated with higher prevalences of cartilage defects and BMLs, lower cartilage volume and higher prevalence of knee pain. Longitudinally, higher gardes of baseline MRI-detected OPs site-specifically predicted greater risks of any increase in cartilage defects or BMLs, and loss of cartilage volume in medial and lateral tibiofemoral (LTF) and total compartments over 2.6 years in multivariable analyses. These significant associations were similar in those without radiographically-detected OPs. MTF and total OP scores were significantly associated with change in total knee pain over 2.6 and 5 years but these became non-significant after adjustment for cartilage defects and BMLs. CONCLUSION MRI-detected knee OPs are common and appear to be clinically relevant to knee structural changes in older adults.
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Affiliation(s)
- Z Zhu
- Menzies Institute for Medical Research, University of Tasmania, Hobart, Tasmania, Australia
| | - L L Laslett
- Menzies Institute for Medical Research, University of Tasmania, Hobart, Tasmania, Australia
| | - X Jin
- Menzies Institute for Medical Research, University of Tasmania, Hobart, Tasmania, Australia
| | - W Han
- Menzies Institute for Medical Research, University of Tasmania, Hobart, Tasmania, Australia; Translational Research Centre, Academy of Orthopedics, Guangdong Province, China; School of Basic Medical Science, Southern Medical University, Guangzhou, Guangdong, China
| | - B Antony
- Menzies Institute for Medical Research, University of Tasmania, Hobart, Tasmania, Australia
| | - X Wang
- Menzies Institute for Medical Research, University of Tasmania, Hobart, Tasmania, Australia
| | - M Lu
- Menzies Institute for Medical Research, University of Tasmania, Hobart, Tasmania, Australia
| | - F Cicuttini
- Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
| | - G Jones
- Menzies Institute for Medical Research, University of Tasmania, Hobart, Tasmania, Australia
| | - C Ding
- Menzies Institute for Medical Research, University of Tasmania, Hobart, Tasmania, Australia; Translational Research Centre, Academy of Orthopedics, Guangdong Province, China; School of Basic Medical Science, Southern Medical University, Guangzhou, Guangdong, China; Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, Victoria, Australia.
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Associations between systemic bone mineral density and early knee cartilage changes in middle-aged adults without clinical knee disease: a prospective cohort study. Arthritis Res Ther 2017; 19:98. [PMID: 28521839 PMCID: PMC5437680 DOI: 10.1186/s13075-017-1314-0] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2017] [Accepted: 05/02/2017] [Indexed: 01/12/2023] Open
Abstract
Background Osteoarthritis has a high prevalence in people with high bone mineral density (BMD). Nevertheless, whether high systemic BMD predates early structural features of knee osteoarthritis is unclear. This study examined the association between systemic BMD and knee cartilage defect progression and cartilage volume loss in middle-aged people without clinical knee disease. Methods Adults (n = 153) aged 25–60 years had total body, lumbar spine, and total hip BMD assessed by dual-energy X-ray absorptiometry at baseline (2005–2008), and tibial cartilage volume and tibiofemoral cartilage defects assessed by magnetic resonance imaging at baseline and follow up (2008–2010). Results Higher spine BMD was associated with increased risk for progression of medial (OR = 1.45, 95% CI 1.10, 1.91) and lateral (OR = 1.30, 95% CI 1.00, 1.67) tibiofemoral cartilage defects. Total hip BMD was also positively associated with the progression of medial (OR = 1.63, 95% CI 1.10, 2.41) and lateral (OR = 1.53, 95% CI 1.08, 2.18) tibiofemoral cartilage defects. Greater total body, spine, and total hip BMD were associated with increased rate of lateral tibial cartilage volume loss (for every 1 g/10 cm2 increase in total body BMD: B = 0.44%, 95% CI 0.17%, 0.71%; spine BMD: 0.17%, 95% CI 0.04%, 0.30%; total hip BMD: 0.29%, 95% CI 0.13%, 0.45%), with no significant associations for medial tibial cartilage volume loss. Conclusion In middle-aged people without clinical knee disease, higher systemic BMD was associated with increased early knee cartilage damage. Further work is needed to clarify the effect of systemic BMD at different stages of the pathway from health through to disease in knee osteoarthritis, as new therapies targeting bone are developed for the management of knee osteoarthritis.
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40
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Podlipská J, Koski JM, Kaukinen P, Haapea M, Tervonen O, Arokoski JP, Saarakkala S. Structure-symptom relationship with wide-area ultrasound scanning of knee osteoarthritis. Sci Rep 2017; 7:44470. [PMID: 28295049 PMCID: PMC5353612 DOI: 10.1038/srep44470] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2016] [Accepted: 02/09/2017] [Indexed: 12/13/2022] Open
Abstract
The aetiology of knee pain in osteoarthritis (OA) is heterogeneous and its relationship with structural changes and function is unclear. Our goal was to determine the prevalence of wide-area scanned ultrasound-defined knee OA structural features and their association with pain and functional impairment in 79 symptomatic and 63 asymptomatic subjects. All subjects underwent ultrasound knee wide-area scanning and the severity of articular cartilage degeneration, the presence and size of osteophytes, and meniscal extrusion were evaluated. Subjects filled in a self-administrated questionnaire on present knee pain, and Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) on clinical symptoms and function over the past week. Cartilage changes were the most prevalent followed by lateral meniscal extrusion, osteophytes and medial meniscal extrusion. The global femoral cartilage grade associated strongly with pain and the WOMAC index. Site-specifically, early medial cartilage changes and thinning in sulcus and lateral site were associated with symptoms. The presence of femoral lateral osteophytes was also associated with both outcomes. Using the novel wide-area ultrasound scanning technique, we were able to confirm the negative impact of femoral cartilage OA changes on clinical symptoms. Presence, not necessarily size, of lateral femoral osteophytes was also associated with increased pain and disability.
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Affiliation(s)
- Jana Podlipská
- Research Unit of Medical Imaging, Physics and Technology, University of Oulu, Oulu, Finland
| | - Juhani M Koski
- Department of Internal Medicine, Mikkeli Central Hospital, Mikkeli, Finland
| | - Päivi Kaukinen
- Institute of Clinical Medicine, University of Eastern Finland, Kuopio, Kuopio, Finland.,Department of Physical and Rehabilitation Medicine, Kuopio University Hospital, Kuopio, Finland
| | - Marianne Haapea
- Department of Diagnostic Radiology, Oulu University Hospital, Oulu, Finland.,Medical Research Center, University of Oulu and Oulu University Hospital, Oulu, Finland.,Center for Life Course Health Research, University of Oulu, Oulu, Finland
| | - Osmo Tervonen
- Research Unit of Medical Imaging, Physics and Technology, University of Oulu, Oulu, Finland.,Department of Diagnostic Radiology, Oulu University Hospital, Oulu, Finland.,Medical Research Center, University of Oulu and Oulu University Hospital, Oulu, Finland
| | - Jari P Arokoski
- Department of Physical and Rehabilitation Medicine, University of Helsinki, Finland.,Helsinki University Hospital, Helsinki, Finland
| | - Simo Saarakkala
- Research Unit of Medical Imaging, Physics and Technology, University of Oulu, Oulu, Finland.,Department of Diagnostic Radiology, Oulu University Hospital, Oulu, Finland.,Medical Research Center, University of Oulu and Oulu University Hospital, Oulu, Finland
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41
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Carbone A, Rodeo S. Review of current understanding of post-traumatic osteoarthritis resulting from sports injuries. J Orthop Res 2017; 35:397-405. [PMID: 27306867 DOI: 10.1002/jor.23341] [Citation(s) in RCA: 118] [Impact Index Per Article: 16.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/15/2016] [Accepted: 06/14/2016] [Indexed: 02/04/2023]
Abstract
Certain types of joint injuries, common in athletes, are known to have a high association with the development of osteoarthritis (OA). Post-traumatic osteoarthritis (PTOA) is especially debilitating due to its earlier onset than traditional OA, and its predisposition to affect a younger and more active population. Five common athletic injuries have been demonstrated to be risk factors for the development of OA. These include ACL rupture, meniscus tear, glenohumeral instability, patellar dislocation, and ankle instability. Though the mechanisms responsible for the development of PTOA are not entirely clear, certain kinematic, biologic, and mechanical factors have been implicated. In addition, there has been an increased emphasis on development of new methods to detect early OA changes in patients with known risk factors, as early intervention may prevent the development of end-stage OA. New imaging modalities as well as the identification of specific biomarkers may allow earlier detection. Though these developments hold promise, it is not entirely known what steps we can take today to prevent the future development of OA, even with early detection. © 2016 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res 35:397-405, 2017.
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Affiliation(s)
- Andrew Carbone
- Department of Orthopaedics, Rutgers New Jersey Medical School, Newark, New Jersey
| | - Scott Rodeo
- Soft Tissue Research Laboratory, Hospital for Special Surgery, 535 E. 70th St., New York, 10021, New York
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Pan F, Blizzard L, Tian J, Cicuttini F, Winzenberg T, Ding C, Jones G. The interaction between weight and family history of total knee replacement with knee cartilage: a 10-year prospective study. Osteoarthritis Cartilage 2017; 25:227-233. [PMID: 27789341 DOI: 10.1016/j.joca.2016.10.013] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/07/2016] [Revised: 10/11/2016] [Accepted: 10/17/2016] [Indexed: 02/02/2023]
Abstract
OBJECTIVE Although being overweight or obese is an important risk factor for the development of knee osteoarthritis (OA), the interplay between weight and genetic factors remains unclear. This study aimed to examine the associations between weight and knee cartilage volume/defects over 10 years in offspring having at least one parent with a total knee replacement (TKR) for primary knee OA and in controls without a knee OA family history. METHOD 367 participants (183 offspring and 184 controls) aged from 26 to 61 years were recruited at baseline, and followed at 2 and 10 years later. T1-weighted magnetic resonance imaging (MRI) of the right knee was used to measure cartilage volume/defects at each time-point. Mixed-effects models were used with adjustment for potential confounders. RESULTS Study participants were middle-age adults (mean age 45 years, mean weight 77.5 kg at baseline). In multivariable analysis, increasing body weight was deleteriously associated with medial tibiofemoral cartilage volume (β = -0.28 ml, per 1 SD increase, 95% CI -0.49 to -0.07) and presence of medial tibiofemoral cartilage defects (RR = 1.27, per 1 SD increase, 95% CI 1.07 to 1.51) in offspring over 10 years. Similar associations were observed for lateral tibiofemoral cartilage volume (β = -0.19 ml, P = 0.059), and defects (RR = 1.24, P = 0.049). However, there were no statistically significant associations between weight and cartilage volume or defects in controls. CONCLUSION The adverse effects of increasing weight are stronger in the offspring of people with knee replacement for knee OA suggesting genetics-environment interaction with regard to overweight/obesity in the pathogenesis of knee OA particularly in the early stages.
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Affiliation(s)
- F Pan
- Menzies Institute for Medical Research, University of Tasmania, Private Bag 23, Hobart, Tasmania 7000, Australia.
| | - L Blizzard
- Menzies Institute for Medical Research, University of Tasmania, Private Bag 23, Hobart, Tasmania 7000, Australia.
| | - J Tian
- Menzies Institute for Medical Research, University of Tasmania, Private Bag 23, Hobart, Tasmania 7000, Australia.
| | - F Cicuttini
- Department of Epidemiology and Preventive Medicine, Monash University Medical School, Commercial Road, Melbourne 3181, Australia.
| | - T Winzenberg
- Menzies Institute for Medical Research, University of Tasmania, Private Bag 23, Hobart, Tasmania 7000, Australia.
| | - C Ding
- Menzies Institute for Medical Research, University of Tasmania, Private Bag 23, Hobart, Tasmania 7000, Australia.
| | - G Jones
- Menzies Institute for Medical Research, University of Tasmania, Private Bag 23, Hobart, Tasmania 7000, Australia.
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Wise BL, Niu J, Guermazi A, Liu F, Heilmeier U, Ku E, Lynch JA, Zhang Y, Felson DT, Kwoh CK, Lane NE. Magnetic resonance imaging lesions are more severe and cartilage T2 relaxation time measurements are higher in isolated lateral compartment radiographic knee osteoarthritis than in isolated medial compartment disease - data from the Osteoarthritis Initiative. Osteoarthritis Cartilage 2017; 25:85-93. [PMID: 27539891 PMCID: PMC5182174 DOI: 10.1016/j.joca.2016.08.002] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/02/2016] [Revised: 07/02/2016] [Accepted: 08/09/2016] [Indexed: 02/02/2023]
Abstract
OBJECTIVE Isolated lateral compartment tibiofemoral radiographic osteoarthritis (IL-ROA) is an understudied form of knee osteoarthritis (OA). The objective of the present study was to characterize Magnetic Resonance Imaging (MRI) abnormalities and MR-T2 relaxation time measurements associated with IL-ROA and with isolated medial compartment ROA (IM-ROA) compared with knees without OA. METHOD 200 case subjects with IL-ROA (Kellgren/Lawrence (K/L) grade≥2 and joint space narrowing (JSN) > 0 in the lateral compartment but JSN = 0 in the medial compartment) were randomly selected from the Osteoarthritis Initiative baseline visit. 200 cases with IM-ROA and 200 controls were frequency matched to the IL-ROA cases. Cases and controls were analyzed for odds of having a subregion with >10% cartilage area affected, with ≥25% bone marrow lesions (BML), with meniscal tear or maceration, and for association with cartilage T2 values. RESULTS IL-ROA was more strongly associated with ipsilateral MRI knee pathologies than IM-ROA (IL-ROA: OR = 135.2 for size of cartilage lesion, 95% CI 42.7-427.4; OR = 145.4 for large size BML, 95% CI 41.5-509.5; OR = 176 for meniscal tears, 95% CI 59.8-517.7; IM-ROA: OR = 28.4 for size of cartilage lesion, 95% CI 14.7-54.7; OR = 38.1 for size of BML, 95% CI 12.7-114; OR = 37.0 for meniscal tears, 95% CI 12-113.6). Cartilage T2 values were higher in both tibial and medial femoral compartments in IL-ROA, but in IM-ROA were only significantly different from controls in the medial femur. CONCLUSION IL-ROA knees show a greater prevalence and severity of MRI lesions and higher cartilage T2 values than IM-ROA knees compared with controls.
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Affiliation(s)
- Barton L. Wise
- Center for Musculoskeletal Health, University of California, Davis School of
Medicine, 4625 2 Avenue, Suite 2002, Sacramento, CA 95817
| | - Jingbo Niu
- Boston University School of Medicine, Boston, MA
| | - Ali Guermazi
- Boston University School of Medicine, Boston, MA
| | - Felix Liu
- University of California, San Francisco School of Medicine
| | | | - Eric Ku
- University of California, San Francisco School of Medicine
| | - John A. Lynch
- University of California, San Francisco School of Medicine
| | - Yuqing Zhang
- Boston University School of Medicine, Boston, MA
| | | | - C. Kent Kwoh
- University of Arizona College of Medicine, Tuscon, AZ
| | - Nancy E. Lane
- University of California, Davis School of Medicine, Sacramento, CA
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Stachowiak G, Wolski M, Woloszynski T, Podsiadlo P. Detection and prediction of osteoarthritis in knee and hand joints based on the X-ray image analysis. BIOSURFACE AND BIOTRIBOLOGY 2016. [DOI: 10.1016/j.bsbt.2016.11.004] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
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Lu M, Chen Z, Han W, Zhu Z, Jin X, Hunter DJ, Ding C. A novel method for assessing signal intensity within infrapatellar fat pad on MR images in patients with knee osteoarthritis. Osteoarthritis Cartilage 2016; 24:1883-1889. [PMID: 27327783 DOI: 10.1016/j.joca.2016.06.008] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/08/2015] [Revised: 05/18/2016] [Accepted: 06/11/2016] [Indexed: 02/02/2023]
Abstract
PURPOSE To assess reliability and validity of a semi-automated quantitative method to measure infrapatellar fat pad (IPFP) signal intensity in patients with knee osteoarthritis (OA). METHODS Hundred patients with knee OA were selected. Sagittal planes of fat-saturated T2-weighted images obtained on 1.5-T magnetic resonance imaging (MRI) were utilized to assess IPFP signal intensity using MATLAB. Knee structural abnormalities including cartilage defects, bone marrow lesions (BML) and radiographic OA (ROA) were evaluated. Clinical construct validity and concurrent validity were examined through describing associations of IPFP measurements with knee structural abnormalities and a semi-quantitative scoring method, respectively. The reliability was examined by calculating the intra- and inter-observer correlation coefficients. RESULTS Significantly positive associations were found between standard deviation of IPFP signal intensity [sDev (IPFP)], clustering factor (H) and all knee structural abnormalities. The volume of high signal intensity regions [Volume (H)] and the ratio of Volume (H) to volume of whole IPFP [Percentage (H)] were positively associated with cartilage defects and ROA, but not with BMLs. The median value [Median (H)] and upper quartile value [UQ (H)] of high signal intensity were only significantly associated with quartiles of cartilage defect score. Significant correlations were found between all quantitative measurements and semi-quantitative scores (All P < 0.001). Intraclass and interclass correlation coefficients for these quantitative measures were high (>0.90). CONCLUSIONS A novel and efficient method to segment IPFP and calculate its signal intensity on T2-weighted MRI images is documented. This method is reproducible, and has concurrent and clinical construct validity, but its predictive validity needs to be examined by future longitudinal studies.
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Affiliation(s)
- M Lu
- Menzies Institute for Medical Research, University of Tasmania, Hobart, Tasmania, Australia; Department of Orthopaedics, 1st Affiliated Hospital, Anhui Medical University, Hefei, Anhui, China; Arthritis Research Institute, 1st Affiliated Hospital, Anhui Medical University, Hefei, Anhui, China
| | - Z Chen
- Menzies Institute for Medical Research, University of Tasmania, Hobart, Tasmania, Australia; School of Engineering, Southeast University, Nanjing, China
| | - W Han
- Menzies Institute for Medical Research, University of Tasmania, Hobart, Tasmania, Australia
| | - Z Zhu
- Menzies Institute for Medical Research, University of Tasmania, Hobart, Tasmania, Australia; Arthritis Research Institute, 1st Affiliated Hospital, Anhui Medical University, Hefei, Anhui, China
| | - X Jin
- Menzies Institute for Medical Research, University of Tasmania, Hobart, Tasmania, Australia
| | - D J Hunter
- Institute of Bone and Joint Research, Kolling Institute, University of Sydney; Rheumatology Department, Royal North Shore Hospital, Sydney, NSW, Australia
| | - C Ding
- Menzies Institute for Medical Research, University of Tasmania, Hobart, Tasmania, Australia; Arthritis Research Institute, 1st Affiliated Hospital, Anhui Medical University, Hefei, Anhui, China; Institute of Bone and Joint Research, Kolling Institute, University of Sydney; Rheumatology Department, Royal North Shore Hospital, Sydney, NSW, Australia.
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Han W, Aitken D, Zhu Z, Halliday A, Wang X, Antony B, Cicuttini F, Jones G, Ding C. Hypointense signals in the infrapatellar fat pad assessed by magnetic resonance imaging are associated with knee symptoms and structure in older adults: a cohort study. Arthritis Res Ther 2016; 18:234. [PMID: 27729069 PMCID: PMC5059934 DOI: 10.1186/s13075-016-1130-y] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2016] [Accepted: 09/20/2016] [Indexed: 02/07/2023] Open
Abstract
Background There are few clinical and epidemiological studies reporting the association between abnormal changes within the IPFP and knee osteoarthritic changes. This study aims to describe the associations between hypointense signals in the infrapatellar fat pad (IPFP) and knee structural change and symptoms in older adults. Methods Participants (n = 874) were selected randomly from local community and followed up 2.7 years later (range 2.6–3.3 years). T1- or T2-weighted fat-suppressed magnetic resonance imaging (MRI) was assessed for IPFP hypointense signal, cartilage volume, cartilage defects, and bone marrow lesions (BMLs). Knee pain was assessed by self-administered Western Ontario and McMaster Osteoarthritis Index (WOMAC) questionnaire. Radiographic osteoarthritis was assessed using the OARSI atlas. Results Cross-sectionally, hypointense signals in the IPFP were significantly associated with a higher risk of knee cartilage defects at all sites, tibiofemoral BMLs and knee pain in multivariable analyses. Longitudinally, baseline signal abnormalities were significantly and positively associated with increases in knee cartilage defects (OR: 2.27, 95 % CI: 1.61–3.21), BMLs (OR: 1.91, 95 % CI: 1.39–2.62), and knee pain (OR: 1.36, 95 % CI: 1.05–1.76) in multivariable analyses. The associations with cartilage defects remained significant after adjustment for BMLs, but the associations with BMLs and knee pain decreased in magnitude or became non-significant after further adjustment for cartilage defects. Conclusions Hypointense signals in the IPFP were associated primarily with increased knee cartilage defects and also with BMLs and knee symptoms in cross-sectional and longitudinal analyses, suggesting the abnormality represented by this signal has a potentially important role in osteoarthritis progression. Electronic supplementary material The online version of this article (doi:10.1186/s13075-016-1130-y) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Weiyu Han
- Menzies Institute for Medical Research, University of Tasmania, Private Bag 23, Hobart, TAS, 7000, Australia.,Department of Orthopedics, 3rd Affiliated Hospital of Southern Medical University, Guangzhou, China
| | - Dawn Aitken
- Menzies Institute for Medical Research, University of Tasmania, Private Bag 23, Hobart, TAS, 7000, Australia
| | - Zhaohua Zhu
- Menzies Institute for Medical Research, University of Tasmania, Private Bag 23, Hobart, TAS, 7000, Australia.,Arthritis Research Institute, 1st Affiliated Hospital, Anhui Medical University, Hefei, Anhui, China
| | - Andrew Halliday
- Department of Radiology, Royal Hobart Hospital, Hobart, TAS, Australia
| | - Xia Wang
- Menzies Institute for Medical Research, University of Tasmania, Private Bag 23, Hobart, TAS, 7000, Australia
| | - Benny Antony
- Menzies Institute for Medical Research, University of Tasmania, Private Bag 23, Hobart, TAS, 7000, Australia
| | - Flavia Cicuttini
- Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, VIC, Australia
| | - Graeme Jones
- Menzies Institute for Medical Research, University of Tasmania, Private Bag 23, Hobart, TAS, 7000, Australia
| | - Changhai Ding
- Menzies Institute for Medical Research, University of Tasmania, Private Bag 23, Hobart, TAS, 7000, Australia. .,Arthritis Research Institute, 1st Affiliated Hospital, Anhui Medical University, Hefei, Anhui, China. .,Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, VIC, Australia.
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Patellofemoral Bone Marrow Lesions: Natural History and Associations With Pain and Structure. Arthritis Care Res (Hoboken) 2016; 68:1647-1654. [DOI: 10.1002/acr.22871] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2015] [Revised: 01/13/2016] [Accepted: 02/16/2016] [Indexed: 11/07/2022]
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48
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Antony B, Venn A, Cicuttini F, March L, Blizzard L, Dwyer T, Cross M, Jones G, Ding C. Association of Body Composition and Hormonal and Inflammatory Factors With Tibial Cartilage Volume and Sex Difference in Cartilage Volume in Young Adults. Arthritis Care Res (Hoboken) 2016; 68:517-25. [PMID: 26386243 DOI: 10.1002/acr.22715] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2014] [Revised: 08/11/2015] [Accepted: 08/18/2015] [Indexed: 12/24/2022]
Abstract
OBJECTIVE To describe the associations between body composition and hormonal and inflammatory factors measured 5 years prior and tibial cartilage volume in young adults, and to explore if these factors contribute to the sex difference in tibial cartilage volume. METHODS Subjects broadly representative of the young adult Australian population (n = 328, ages 31-41 years, 47.3% women) were selected. They underwent T1-weighted fat-suppressed magnetic resonance imaging (MRI) of their knees. Tibial cartilage volume was measured from MRI. Sex hormone binding globulin (SHBG) and testosterone in a subset of women and C-reactive protein (CRP) level and fibrinogen in both sexes were measured 5 years prior. Body mass index (BMI), fat mass, and lean mass were calculated from height, weight, and skinfolds. RESULTS In multivariable analyses, correlates of tibial cartilage volume included lean body mass (β = 26.4 mm(3) ; 95% confidence interval [95% CI] 13.6, 39.1), fat mass (β = -11.8 mm(3) ; 95% CI -22.2, -1.4), and fibrinogen (β = -146.4 mm(3) ; 95% CI -276.4, -16.4), but not BMI, testosterone, or CRP level. In women, SHBG was positively associated with tibial cartilage volume (β = 0.67 mm(3) ; 95% CI 0.14, 1.20) and Free Androgen Index was negatively associated with lateral tibial cartilage volume (β = -0.04 mm(3) ; 95% CI -0.07, 0.00). Men had 13% more tibial cartilage volume (500 mm(3) ) than women. The magnitude of this association decreased by 38%, 20%, and 37% after adjustment for lean body mass, fat mass, and fibrinogen, respectively. CONCLUSION Body composition, sex hormones, and fibrinogen correlate with knee cartilage volume in young adult life. Sex difference in knee cartilage volume is contributed largely by variations in body composition and/or fibrinogen.
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Affiliation(s)
- Benny Antony
- Menzies Institute for Medical Research, University of Tasmania, Hobart, Australia
| | - Alison Venn
- Menzies Institute for Medical Research, University of Tasmania, Hobart, Australia
| | | | - Lyn March
- Institute of Bone and Joint Research, University of Sydney, Sydney, Australia
| | - Leigh Blizzard
- Menzies Institute for Medical Research, University of Tasmania, Hobart, Australia
| | - Terence Dwyer
- Murdoch Children's Research Institute, Melbourne, Australia
| | - Marita Cross
- Institute of Bone and Joint Research, University of Sydney, Sydney, Australia
| | - Graeme Jones
- Menzies Institute for Medical Research, University of Tasmania, Hobart, Australia
| | - Changhai Ding
- Menzies Institute for Medical Research, Tasmania, Hobart, Australia, and Monash University, Melbourne, Australia
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Ijaz Khan H, Chou L, Aitken D, McBride A, Ding C, Blizzard L, Pelletier JP, Martel-Pelletier J, Cicuttini F, Jones G. Correlation Between Changes in Global Knee Structures Assessed by Magnetic Resonance Imaging and Radiographic Osteoarthritis Changes Over Ten Years in a Midlife Cohort. Arthritis Care Res (Hoboken) 2016; 68:958-64. [DOI: 10.1002/acr.22778] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2015] [Revised: 09/10/2015] [Accepted: 10/27/2015] [Indexed: 12/12/2022]
Affiliation(s)
- Hussain Ijaz Khan
- Menzies Institute for Medical Research, University of Tasmania, Hobart; Tasmania Australia
| | - Louisa Chou
- Menzies Institute for Medical Research, University of Tasmania, Hobart; Tasmania Australia
| | - Dawn Aitken
- Menzies Institute for Medical Research, University of Tasmania, Hobart; Tasmania Australia
| | - Andrew McBride
- Menzies Institute for Medical Research, University of Tasmania, Hobart; Tasmania Australia
| | - Changhai Ding
- Menzies Institute for Medical Research, University of Tasmania, Hobart; Tasmania Australia
| | - Leigh Blizzard
- Menzies Institute for Medical Research, University of Tasmania, Hobart; Tasmania Australia
| | | | | | | | - Graeme Jones
- Menzies Institute for Medical Research, University of Tasmania, Hobart; Tasmania Australia
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Prediction of medial tibiofemoral compartment joint space loss progression using volumetric cartilage measurements: Data from the FNIH OA biomarkers consortium. Eur Radiol 2016; 27:464-473. [PMID: 27221563 DOI: 10.1007/s00330-016-4393-4] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2015] [Revised: 04/28/2016] [Accepted: 05/02/2016] [Indexed: 12/18/2022]
Abstract
OBJECTIVES Investigating the association between baseline cartilage volume measurements (and initial 24th month volume loss) with medial compartment Joint-Space-Loss (JSL) progression (>0.7 mm) during 24-48th months of study. METHODS Case and control cohorts (Biomarkers Consortium subset from the Osteoarthritis Initiative (OAI)) were defined as participants with (n=297) and without (n=303) medial JSL progression (during 24-48th months). Cartilage volume measurements (baseline and 24th month loss) were obtained at five knee plates (medial-tibial, lateral-tibial, medial-femoral, lateral-femoral and patellar), and standardized values were analysed. Multivariate logistic regression was used with adjustment for known confounders. Artificial-Neural-Network analysis was conducted by Multi-Layer-Perceptrons (MLPs) including baseline determinants, and baseline (1) and interval changes (2) in cartilage volumes. RESULTS Larger baseline lateral-femoral cartilage volume was predictive of medial JSL (OR: 1.29 (1.01-1.64)). Greater initial 24th month lateral-femoral cartilage volume-loss (OR: 0.48 (0.27-0.84)) had protective effect on medial JSL during 24-48th months of study. Baseline and interval changes in lateral-femoral cartilage volume, were the most important estimators for medial JSL progression (importance values: 0.191(0.177-0.204), 0.218(0.207-0.228)) in the ANN analyses. CONCLUSIONS Cartilage volumes (both at baseline and their change during the initial 24 months) in the lateral femoral plate were predictive of medial JSL progression. KEY POINTS • Baseline lateral femoral cartilage volume is directly associated with medial JSL progression. • 24-month lateral femoral cartilage loss is inversely associated with medial JSL progression. • Lateral femoral cartilage volume is most important in association with medial JSL progression.
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