Felix Eckstein1, Robert Boudreau2, Zhijie Wang3, Michael J Hannon3, Jeff Duryea4, Wolfgang Wirth5, Sebastian Cotofana5, Ali Guermazi6, Frank Roemer6,7, Michael Nevitt8, Markus R John9, Christoph Ladel10, Leena Sharma11, David J Hunter12, C Kent Kwoh13. 1. Institute of Anatomy, Paracelsus Medical University Salzburg & Nuremberg Austria & Chondrometrics GmbH, Ainring, Germany. felix.eckstein@pmu.ac.at. 2. Department of Epidemiology, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, PA, USA. 3. Division of Rheumatology and Clinical Immunology, University of Pittsburgh and Pittsburgh VAHS, Pittsburgh, PA, USA. 4. Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA. 5. Institute of Anatomy, Paracelsus Medical University Salzburg & Nuremberg Austria & Chondrometrics GmbH, Ainring, Germany. 6. Boston University School of Medicine and Boston Imaging Core Lab (BICL), LLC, Boston, MA, USA. 7. Department of Radiology, University of Erlangen-Nuremberg, Erlangen, Germany. 8. OAI Coordinating Ctr., UCSF, San Francisco, CA, USA. 9. Novartis Pharma AG, Basel, Swizerland. 10. Merck KGaA, Darmstadt, Germany. 11. Department of Medicine, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA. 12. Royal North Shore Hospital & Institute of Bone and Joint Research, Kolling Institute, University Sydney, Sydney, NSW, Australia. 13. Division of Rheumatology and the University of Arizona Arthritis Center, University of Arizona, Tucson, AZ, USA.
Abstract
OBJECTIVE: To evaluate whether change in fixed-location measures of radiographic joint space width (JSW) and cartilage thickness by MRI predict knee replacement. METHODS: Knees replaced between 36 and 60 months' follow-up in the Osteoarthritis Initiative were each matched with one control by age, sex and radiographic status. Radiographic JSW was determined from fixed flexion radiographs and subregional femorotibial cartilage thickness from 3 T MRI. Changes between the annual visit before replacement (T0) and 2 years before T0 (T-2) were compared using conditional logistic regression. RESULTS: One hundred and nineteen knees from 102 participants (55.5 % women; age 64.2 ± 8.7 [mean ± SD] years) were studied. Fixed-location JSW change at 22.5 % from medial to lateral differed more between replaced and control knees (case-control [cc] OR = 1.57; 95 % CI: 1.23-2.01) than minimum medial JSW change (ccOR = 1.38; 95 % CI: 1.11-1.71). Medial femorotibial cartilage loss displayed discrimination similar to minimum JSW, and central tibial cartilage loss similar to fixed-location JSW. Location-independent thinning and thickening scores were elevated prior to knee replacement. CONCLUSIONS: Discrimination of structural progression between knee pre-placement cases versus controls was stronger for fixed-location than minimum radiographic JSW. MRI displayed similar discrimination to radiography and suggested greater simultaneous cartilage thickening and loss prior to knee replacement. KEY POINTS: • Fixed-location JSW predicts surgical knee replacement more strongly than minimum JSW. • MRI predicts knee replacement with similar accuracy to radiographic JSW. • MRI reveals greater cartilage thinning and thickening prior to knee replacement.
OBJECTIVE: To evaluate whether change in fixed-location measures of radiographic joint space width (JSW) and cartilage thickness by MRI predict knee replacement. METHODS: Knees replaced between 36 and 60 months' follow-up in the Osteoarthritis Initiative were each matched with one control by age, sex and radiographic status. Radiographic JSW was determined from fixed flexion radiographs and subregional femorotibial cartilage thickness from 3 T MRI. Changes between the annual visit before replacement (T0) and 2 years before T0 (T-2) were compared using conditional logistic regression. RESULTS: One hundred and nineteen knees from 102 participants (55.5 % women; age 64.2 ± 8.7 [mean ± SD] years) were studied. Fixed-location JSW change at 22.5 % from medial to lateral differed more between replaced and control knees (case-control [cc] OR = 1.57; 95 % CI: 1.23-2.01) than minimum medial JSW change (ccOR = 1.38; 95 % CI: 1.11-1.71). Medial femorotibial cartilage loss displayed discrimination similar to minimum JSW, and central tibial cartilage loss similar to fixed-location JSW. Location-independent thinning and thickening scores were elevated prior to knee replacement. CONCLUSIONS: Discrimination of structural progression between knee pre-placement cases versus controls was stronger for fixed-location than minimum radiographic JSW. MRI displayed similar discrimination to radiography and suggested greater simultaneous cartilage thickening and loss prior to knee replacement. KEY POINTS: • Fixed-location JSW predicts surgical knee replacement more strongly than minimum JSW. • MRI predicts knee replacement with similar accuracy to radiographic JSW. • MRI reveals greater cartilage thinning and thickening prior to knee replacement.
Entities:
Keywords:
Clinical validation; Knee osteoarthritis; Magnetic resonance imaging; Measurement performance; Radiographic joint space width (JSW)
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