Department of Imaging & Functional Musculoskeletal Research, Institute of Anatomy & Cell Biology, Paracelsus Medical University, Salzburg, Austria.
Chondrometrics GmbH, Ainring, Germany.
Cartilage. 2021 Dec;13(1_suppl):685S-693S. doi: 10.1177/1947603520980157. Epub 2020 Dec 24.
OBJECTIVE: Cartilage damage diagnosed by magnetic resonance imaging (MRI) is highly prevalent in the population. In this article, we explore whether such cartilage damage is associated with greater longitudinal change in 3D cartilage thickness and knee function in subjects without (risk factors of) knee osteoarthritis. DESIGN: Eighty-two knees of Osteoarthritis Initiative healthy reference cohort participants had baseline and 4-year follow-up MRI and knee function data. Baseline presence of semiquantitatively assessed MRI-based cartilage damage (MOAKS [MRI Osteoarthritis Knee Score] ≥ grade 1.0) was recorded by an experienced radiologist. Longitudinal femorotibial cartilage thickness change was determined after segmentation, using location-independent methodology. Knee function was evaluated by patient-reported outcomes and functional performance measures. Statistical comparisons included analysis of covariance adjusting for age, sex, and body mass index. RESULTS: Forty-five percent of the participants had cartilage damage in at least one femorotibial subregion; the cartilage thickness change score was 15% greater in participants with than in those without damage (1216 ± 434 vs. 1058 ± 277 µm). This difference reached borderline statistical significance with and without adjustment for age, sex, and body mass index ( = 0.05). No significant differences in the change of patient-reported outcomes of knee function (PASE [physical activity score of the elderly] and WOMAC [Western Ontario McMaster Osteoarthritis Index]) or chair stand test results were detected. Of those without femorotibial damage, 58% had cartilage damage in at least one femoropatellar subregion; these had a 9% greater femorotibial cartilage change score than those without femoropatellar or femorotibial damage (difference not statistically significant). CONCLUSIONS: In the absence of osteoarthritis risk factors, semiquantitatively assessed MRI-based cartilage damage appears to be associated with greater longitudinal location-independent femorotibial cartilage thickness changes, but not with greater functional deteriorations.
目的：磁共振成像（MRI）诊断的软骨损伤在人群中非常普遍。本文探讨了在无膝关节骨关节炎（OA）风险因素的人群中，这种软骨损伤是否与 3D 软骨厚度的更大纵向变化和膝关节功能相关。
设计：82 例 Osteoarthritis Initiative 健康参考队列参与者的膝关节在基线和 4 年随访时均有 MRI 和膝关节功能数据。由有经验的放射科医生记录基线时半定量评估的基于 MRI 的软骨损伤（MOAKS[MRI 骨关节炎膝关节评分]≥1.0 级）的存在情况。使用位置独立的方法进行分割后，确定股骨胫骨软骨厚度的纵向变化。通过患者报告的结果和功能表现测量来评估膝关节功能。统计学比较包括调整年龄、性别和体重指数的协方差分析。
结果：45%的参与者至少有一个股骨胫骨亚区的软骨损伤；有损伤的参与者的软骨厚度变化评分比无损伤的参与者高 15%（1216±434μm vs. 1058±277μm）。调整年龄、性别和体重指数后，差异具有统计学意义（ = 0.05）。在膝关节功能的患者报告结果（PASE[老年人体力活动评分]和 WOMAC[西部安大略省麦克马斯特骨关节炎指数]）或坐站测试结果的变化方面，未发现显著差异。在没有股骨胫骨损伤的人群中，58%的人至少有一个股骨髌区的软骨损伤；这些人的股骨胫骨软骨变化评分比没有股骨髌或股骨胫骨损伤的人高 9%（差异无统计学意义）。
结论：在没有 OA 风险因素的情况下，半定量评估的基于 MRI 的软骨损伤似乎与更大的纵向位置独立的股骨胫骨软骨厚度变化相关，但与更大的功能恶化无关。
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