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Accelerated Knee Osteoarthritis Is Characterized by Destabilizing Meniscal Tears and Preradiographic Structural Disease Burden.

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cam.issuedOnline2019-05-21
dc.contributor.authorDriban, Jeffrey B
dc.contributor.authorDavis, Julie E
dc.contributor.authorLu, Bing
dc.contributor.authorPrice, Lori Lyn
dc.contributor.authorWard, Robert J
dc.contributor.authorMacKay, James W
dc.contributor.authorEaton, Charles B
dc.contributor.authorLo, Grace H
dc.contributor.authorBarbe, Mary F
dc.contributor.authorZhang, Ming
dc.contributor.authorPang, Jincheng
dc.contributor.authorStout, Alina C
dc.contributor.authorHarkey, Matthew S
dc.contributor.authorMcAlindon, Timothy E
dc.contributor.orcidDriban, Jeffrey B [0000-0001-6098-4273]
dc.contributor.orcidDavis, Julie E [0000-0002-1327-484X]
dc.contributor.orcidLo, Grace H [0000-0003-3142-1839]
dc.contributor.orcidHarkey, Matthew S [0000-0002-3480-3173]
dc.date.accessioned2019-01-10T00:30:55Z
dc.date.available2019-01-10T00:30:55Z
dc.date.issued2019-07
dc.description.abstractOBJECTIVE: To determine whether accelerated knee osteoarthritis (KOA) is preceded by, and characterized over time by, destabilizing meniscal tears or other pathologic changes. METHODS: We selected 3 sex-matched groups of subjects from the first 48 months of the Osteoarthritis Initiative, comprising adults who had a knee without KOA (Kellgren/Lawrence [K/L] radiographic grade <2) at baseline. Subjects in the accelerated KOA group developed KOA of K/L grade ≥3, those with typical KOA showed increased K/L radiographic scores, and those with no KOA had the same K/L grade over time. An index visit was the visit when the radiographic criteria for accelerated KOA and typical KOA were met (the no KOA group was matched to the accelerated KOA group). The observation period was up to 2 years before and after an index visit. Radiologists reviewed magnetic resonance (MR) images of the index knee and identified destabilizing meniscal tears (root tears, radial tears, complex tears), miscellaneous pathologic features (acute ligamentous or tendinous injuries, attrition, subchondral insufficiency fractures, other incidental findings), and meniscal damage in >2 of 6 regions (3 regions per meniscus: anterior horn, body, posterior horn). In addition, bone marrow lesions (BMLs) and cartilage damage on MR images were quantified. Linear mixed regression models were performed to analyze the results. RESULTS: At 1 year before the index visit, >75% of adults with accelerated KOA had meniscal damage in ≥2 regions (odds ratio 3.19 [95% confidence interval 1.70-5.97] versus adults with typical KOA). By the index visit, meniscal damage in ≥2 regions was ubiquitous in adults with accelerated KOA, including 42% of subjects having evidence of a destabilizing meniscal tear (versus 14% of subjects with typical KOA). These changes corresponded to findings of larger BMLs and greater cartilage loss in the accelerated KOA group. CONCLUSION: Accelerated KOA is characterized by destabilizing meniscal tears in a knee compromised by meniscal damage in >2 regions, and also characterized by the presence of large BMLs and greater cartilage loss.
dc.format.mediumPrint-Electronic
dc.identifier.doi10.17863/CAM.35074
dc.identifier.eissn2326-5205
dc.identifier.issn2326-5191
dc.identifier.urihttps://www.repository.cam.ac.uk/handle/1810/287758
dc.languageeng
dc.language.isoeng
dc.publisherWiley
dc.publisher.urlhttp://dx.doi.org/10.1002/art.40826
dc.subjectAged
dc.subjectBone Marrow
dc.subjectCartilage, Articular
dc.subjectDisease Progression
dc.subjectFemale
dc.subjectHumans
dc.subjectJoint Instability
dc.subjectMagnetic Resonance Imaging
dc.subjectMale
dc.subjectMiddle Aged
dc.subjectOsteoarthritis, Knee
dc.subjectTibial Meniscus Injuries
dc.titleAccelerated Knee Osteoarthritis Is Characterized by Destabilizing Meniscal Tears and Preradiographic Structural Disease Burden.
dc.typeArticle
dcterms.dateAccepted2018-12-20
prism.endingPage1100
prism.issueIdentifier7
prism.publicationDate2019
prism.publicationNameArthritis Rheumatol
prism.startingPage1089
prism.volume71
rioxxterms.licenseref.startdate2019-07
rioxxterms.licenseref.urihttp://www.rioxx.net/licenses/all-rights-reserved
rioxxterms.typeJournal Article/Review
rioxxterms.versionAM
rioxxterms.versionofrecord10.1002/art.40826

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