Two-year prospective longitudinal study exploring the factors associated with change in femoral cartilage volume in a cohort largely without knee radiographic osteoarthritis 1

Menzies Research Institute, University of Tasmania, Hobart, Australia.
Osteoarthritis and Cartilage (Impact Factor: 4.17). 04/2008; 16(4):443-9. DOI: 10.1016/j.joca.2007.08.009
Source: PubMed

ABSTRACT To identify factors associated with change in femoral cartilage volume over 2 years in a cohort largely without knee radiographic osteoarthritis.
A total of 252 subjects (mean 45 years, range 28-60) were used for this study. T1-weighted fat saturation magnetic resonance imaging was performed at baseline and approximately 2 years later. Knee femoral condyle cartilage volume, femoral cartilage defect (0-4 scale) and tibial bone size were determined.
The total femoral cartilage volume loss was 6.3% for the 2.3-year period. Factors associated with this annual change were female gender (females vs males: -1.69%, P<0.01), age (over vs under 40 years: -0.96%, P=0.01), smoking (beta: -0.04% per pack-years, P<0.01), as well as lower limb muscle strength (r: +0.32, P<0.01) and its change (beta: +0.34% per quartile, P<0.05). Structural factors associated with change included baseline femoral cartilage volume (beta: -0.36% per ml, P<0.01), femoral cartilage defects (beta: +1.07% per grade, P<0.01), tibial bone area (beta: +0.13% per cm(2), P<0.05), lateral osteophytes (beta: -1.91% per grade, P<0.01) and change in femoral cartilage defects (beta: -0.8% per grade, P<0.001).
This study provides evidence confirming that significant risk factors are associated with femoral cartilage loss and these include gender (female), age, smoking, and severity of lower limb muscle weakness. It also supports the hypothesis that femoral cartilage swelling reflected by an increased baseline cartilage volume could be a predictor of disease progression. Our findings also provide interesting clues to implement preventive measures that can possibly prevent or reduce knee cartilage loss.

10 Reads
  • Source
    • "All measurements in men, but only those of RLC and RMC in women decreased with age and BMI did not correlate with any of the measurements in either group. It is well established that age and female gender are strong risk factors for OA; therefore the absence of some of the correlations in females might possibly be attributed to femoral cartilage swelling that precedes cartilage erosions in early OA [28]. "
    [Show abstract] [Hide abstract]
    ABSTRACT: Background and objectives: Measurement of the femoral cartilage thickness by using in-vivo musculoskeletal ultrasonography (MSUS) has been previously shown to be a valid and reliable method in previous studies; however, to our best notice, normative data has not been provided before in the healthy population.The aim of our study was to provide normative data regarding femoral cartilage thicknesses of healthy individuals with collaborative use of MSUS. Methods: This is across-sectional study run at Physical and Rehabilitation Medicine Departments of 18 Secondary and Tertiary Centers in Turkey. 1544 healthy volunteers (aged between 25-40 years) were recruited within the collaboration of TURK-MUSCULUS (Turkish Musculoskeletal Ultrasonography Study Group). Subjects who had a body mass index value of less than 30 and who did not have signs and symptoms of any degenerative/inflammatory arthritis or other rheumatic diseases, history of knee trauma and previous knee surgery were enrolled. Ultrasonographic measurements were performed axially from the suprapatellar window by using linear probes while subjects' knees were in maximum flexion. Three (mid-point) measurements were taken from both knees (lateral condyle, intercondylar area, medial condyle). Results: A total of 2876 knees (of 817 M, 621 F subjects) were taken into analysis after exclusion of inappropriate images. Mean cartilage thicknesses were significantly lower in females than males (all p< 0.001). Thickness values negatively correlated with age; negatively (females) and positively (males) correlated with smoking. Men who regularly exercised had thicker cartilage than who did not exercise (all p < 0.05). Increased age (in both sexes) and absence of exercise (males) were found to be risk factors for decreased cartilage thicknesses. Conclusion: Further data pertaining to other countries would be interesting to uncover whether ethnic differences also affect cartilage thickness. Collaborative use of MSUS seems to be promising in this regard.
    Journal of Back and Musculoskeletal Rehabilitation 11/2013; 27(2). DOI:10.3233/BMR-130441 · 0.71 Impact Factor
  • Source
    • "Cartilage defects at baseline (visual scoring) appeared to be associated with longitudinal measurement of quantitative cartilage loss in the same compartment in OA subjects [137, 138], although the second of the two above studies [138] only found a significant relationship in the femoro-patellar but not in the femoro-tibial joint. Other studies reported that the presence of cartilage defects predicted knee cartilage loss also in asymptomatic individuals without radiographic knee OA [139, 140]. It was hypothesized that tibial subchondral bone area expansion may lead to the development of knee cartilage defects (which are associated with future cartilage loss) and is predictive of the need for knee joint replacement in subjects with knee OA, independent of radiographic change [141]. "
    [Show abstract] [Hide abstract]
    ABSTRACT: Quantitative measures of cartilage morphology (i.e., thickness) represent potentially powerful surrogate endpoints in osteoarthritis (OA). These can be used to identify risk factors of structural disease progression and can facilitate the clinical efficacy testing of structure modifying drugs in OA. This paper focuses on quantitative imaging of articular cartilage morphology in the knee, and will specifically deal with different cartilage morphology outcome variables and regions of interest, the relative performance and relationship between cartilage morphology measures, reference values for MRI-based knee cartilage morphometry, imaging protocols for measurement of cartilage morphology (including those used in the Osteoarthritis Initiative), sensitivity to change observed in knee OA, spatial patterns of cartilage loss as derived by subregional analysis, comparison of MRI changes with radiographic changes, risk factors of MRI-based cartilage loss in knee OA, the correlation of MRI-based cartilage loss with clinical outcomes, treatment response in knee OA, and future directions of the field.
    01/2011; 2011(2090-1984):475684. DOI:10.1155/2011/475684
  • Source
    • "Increased muscle strength and tendon stiffness secondary to PRT [9] facilitates a strong balanced co-contraction of knee extensor and flexor muscles, and may thus improve joint stability and reduce varus and valgus instability [27-29]. In the first pathway by improving knee joint stability, abnormal loading and harmful forces generated during walking may be reduced; helping to protect and prevent further cartilage degeneration [3,30]. In the second pathway, the moderate controlled loading of PRT may stimulate cartilage synthesis [31], offsetting or delaying the changes usually seen in OA. "
    [Show abstract] [Hide abstract]
    ABSTRACT: This article provides the rationale and methodology, of the first randomised controlled trial to our knowledge designed to assess the efficacy of progressive resistance training on cartilage morphology in women with knee osteoarthritis.Development and progression of osteoarthritis is multifactorial, with obesity, quadriceps weakness, joint malalignment, and abnormal mechanical joint forces particularly relevant to this study. Progressive resistance training has been reported to improve pain and disability in osteoarthritic cohorts. However, the disease-modifying potential of progressive resistance training for the articular cartilage degeneration characteristic of osteoarthritis is unknown. Our aim was to investigate the effect of high intensity progressive resistance training on articular cartilage degeneration in women with knee osteoarthritis. Our cohort consisted of women over 40 years of age with primary knee osteoarthritis, according to the American College of Rheumatology clinical criteria. Primary outcome was blinded measurement of cartilage morphology via magnetic resonance imaging scan of the tibiofemoral joint. Secondary outcomes included walking endurance, balance, muscle strength, endurance, power, and velocity, body composition, pain, disability, depressive symptoms, and quality of life.Participants were randomized into a supervised progressive resistance training or sham-exercise group. The progressive resistance training group trained muscles around the hip and knee at 80% of their peak strength and progressed 3% per session, 3 days per week for 6 months. The sham-exercise group completed all exercises except hip adduction, but without added resistance or progression. Outcomes were repeated at 3 and 6 months, except for the magnetic resonance imaging scan, which was only repeated at 6 months. Our results will provide an evaluation of the disease-modifying potential of progressive resistance training for osteoarthritis. ANZCTR Reference No. 12605000116628.
    BMC Geriatrics 02/2009; 9(1):1. DOI:10.1186/1471-2318-9-1 · 1.68 Impact Factor
Show more