Periarticular bone predicts knee osteoarthritis progression: Data from the Osteoarthritis Initiative☆
Section snippets
Study design
This is a 12–18 months longitudinal observational cohort study of enrollees into the Osteoarthritis Initiative (OAI) Bone Ancillary Study with complete longitudinal follow-up of knee dual-energy x-ray absorptiometry (DXA), trabecular MR imaging, and knee X-rays read for radiographic medial joint space narrowing (JSN) scores.
Sample selection/setting
The OAI is a multi-center observational study of knee OA with a progression subcohort selected to have symptomatic radiographic knee OA [17]. The four OAI clinical sites
Results
In total, 629 participants were originally enrolled into the bone study. Of these, 144 had missing or insufficient quality trabecular morphometry MRIs, 34 had missing radiographs, 4 had missing DXAs, 1 had an artifact on DXA, 1 had knee arthroplasty by month 48, and 31 had a medial JSN score of 3 by the 36-month visit. This resulted in a final sample comprised 444 participants, among whom there was a slight predominance of men and Caucasian race (Table 1). Comparing those that were included and
Discussion
This study shows that cross-sectional and most longitudinal measures of periarticular bone, with a higher medial:lateral ratio, greater bone volume fracture, trabecular thickness and number, and lower trabecular spacing in knees of people with OA are associated with loss of medial tibiofemoral radiographic joint space. Interestingly, femoral neck BMD, a measure of systemic bone, both cross-sectionally and longitudinally are not associated with loss of medial tibiofemoral radiographic joint
Significance and innovation
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This study shows that periarticular health in knees in people with OA associate with loss of radiographic joint space over a relatively short time frame.
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The close participation of the periarticular bone with joint space loss in the pathogenesis of OA suggests that bone could be a target for therapeutic intervention.
Sources of funding
The ole of Bone in Knee Osteoarthritis Progression was sponsored by NIH/NIAMS (grant R01 AR054938). Periarticular Bone Density as a Biomarker for Early Knee OA was sponsored by NIH/NIAMS (grant R01 AR060718). Dr. Lo is supported by K23 AR062127, an NIH/NIAMS funded mentored award. This work was supported in part with resources at the VA HSR&D Center for Innovations in Quality, Effectiveness and Safety (#CIN 13-413), at the Michael E. DeBakey VA Medical Center, Houston, TX. The OAI is a
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2022, Osteoarthritis and CartilageCitation Excerpt :Additionally, higher signal intensity of the infrapatellar fat pad was related to progression of knee OA on MRI over 2 years, as noted by greater loss of tibial cartilage volume, larger increases in tibiofemoral cartilage defects, and increases in tibiofemoral bone marrow lesions125. Periarticular bone measures (i.e., higher medial:lateral ratio, greater bone volume fracture, trabecular thickness and number, lower trabecular spacing) were strongly related to progression of radiographic medial tibiofemoral joint space narrowing over 12 months126. There is great interest in understanding and defining OA phenotypes that involve combinations of disease characteristics.
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2020, Osteoarthritis and CartilageCitation Excerpt :Compared to systemic BMD, fewer studies have evaluated the role of subchondral BMD in the progression of OA. High subchondral BMD2526 and the medial-to-lateral ratio of subchondral BMD22 were consistently associated with joint space narrowing and cartilage defects over 1–2.7 years. However, one study indicated that high subchondral BMD was associated with reduced loss of cartilage thickness over 2.7 years, suggesting it was protective.18
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2020, Osteoarthritis and CartilageCitation Excerpt :Studies have investigated potential risk factors for the progression of knee OA. Factors found to be associated with the progression of tibiofemoral OA include frontal plane malalignment on X-rays29,30, decreased bone mineral density on DXA31, effusion and synovitis32–34, mucinous changes in the anterior cruciate ligament (ACL)35, bone marrow edema lesions34, elevated cartilage T2 relaxation time34, trabecular microstructure deterioration31, and increased thigh muscle fat36 on MRI, quadriceps muscle weakness37, hip abductor muscle weakness38, and knee pain39. Factors found to be associated with the progression of patellofemoral OA include frontal plane malalignment on X-rays29, patella alta40, tibia tuberosity to trochlear groove distance41, superolateral Hoffa's fat fad edema42, and meniscus tear and extrusion43 on MRI, and quadriceps muscle weakness44.
Osteoarthritis year in review 2018: imaging
2019, Osteoarthritis and CartilageCitation Excerpt :These findings support the hypothesis that local vascular abnormalities may be responsible for degenerative articular changes, and indicate a possible gender-specific pathogenesis60. Lo et al.61 evaluated the ability of periarticular bone features (from DXA, MRI and X-rays) to predict the structural progression of knee OA over 12–18 months in the OAI dataset. Several measures of trabecular bone obtained from the medial tibia plateau, including higher medial-to-lateral ratio, bone volume fracture, and trabecular thickness and number and lower trabecular spacing were strongly associated to knee OA progression.
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The views expressed in this article are those of the author(s) and do not necessarily represent the views of the Department of Veterans Affairs or the National Institutes of Health.