Knee cartilage loss in symptomatic knee OA over 4.5 years

Department of Epidemiology and Preventive Medicine, Monash University-Central and Eastern Clinical School, Alfred Hospital, Commercial Road, Melbourne, VIC 3004, Australia.
Arthritis research & therapy (Impact Factor: 3.75). 02/2006; 8(4):R90. DOI: 10.1186/ar1962
Source: PubMed


The objective of this study was to describe the rate of change in knee cartilage volume over 4.5 years in subjects with symptomatic knee osteoarthritis (OA) and to determine factors associated with cartilage loss. One hundred and five subjects were eligible for this longitudinal study. Subjects' tibial cartilage volume was assessed by magnetic resonance imaging (MRI) at baseline, at 2 years and at 4.5 years. Of 105 subjects, 78 (74%) completed the study. The annual percentage losses of medial and lateral tibial cartilage over 4.5 years were 3.7 +/- 4.7% (mean +/- SD; 95% confidence interval 2.7 to 4.8%) and 4.4 +/- 4.7% (mean +/- SD; 95% confidence interval 3.4 to 5.5%), respectively. Cartilage volume in each individual seemed to track over the study period, relative to other study participants. After multivariate adjustment, annual medial tibial cartilage loss was predicted by lesser severity of baseline knee pain but was independent of age, body mass index and structural factors. No factors specified a priori were associated with lateral cartilage volume rates of change. Tibial cartilage declines at an average rate of 4% per year in subjects with symptomatic knee OA. There was evidence to support the concept that tracking occurs in OA. This may enable the prediction of cartilage change in an individual. The only significant factor affecting the loss of medial tibial cartilage was baseline knee pain, possibly through altered joint loading.

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    • "Estimates of tibial cartilage loss over two years were suggested to be correlated with those over 4.5 years, albeit the authors did not report the consistency of the longitudinal changes in the second versus the first observation period [86]. More importantly, however, the rate of change in VC over 2 years was significantly associated with total knee arthroplasty (TKA) at year 4 [150]. "
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    • "In addition, the damage it purports to measure may be as much in the meniscus as in the hyaline cartilage (Hunter et al. 2006). More recently magnetic resonance imaging (MRI) measurements of medial tibiofemoral cartilage thickness and volume have been shown in several centres (Eckstein et al. 2006; Wluka et al. 2006) to decline typically by 4% per annum in OA patients. Reproducibility varies between different centres and in different settings, but coefficients of variation of 2–4% are typical (Eckstein et al. 2006). "
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