Quantitative MRI measures of cartilage predict knee replacement: A case-control study from the Osteoarthritis Initiative

Felix Eckstein, Chian K Kwoh, Robert M. Boudreau, Zhijie Wang, Michael J. Hannon, Sebastian Cotofana, Martin I. Hudelmaier, Wolfgang Wirth, Ali Guermazi, Michael C. Nevitt, Markus R. John, David J. Hunter

Research output: Contribution to journalArticle

62 Citations (Scopus)

Abstract

Objective: Knee osteoarthritis commonly requires joint replacement, substantially reduces quality of life and increases healthcare utilisation and costs. This study aimed to identify whether quantitative measures of articular cartilage structure predict knee replacement, and to establish their utility as outcomes in clinical trials of disease-modifying therapy. Methods: A nested case-control study was performed in Osteoarthritis Initiative participants, a multicentre observational cohort of 4796 participants with or at risk of knee osteoarthritis. 127 knees were replaced between baseline and 4 years follow-up, and one control knee per case matched for baseline radiographic disease stage (Kellgren-Lawrence grade; KLG), gender and age. Quantitative cartilage measures were obtained from 3 T magnetic resonance images at the exam before knee replacement, and longitudinal change during the previous 12 months when available (n=110). Results: Cartilage thickness loss in the central and total medial femorotibial compartment ( primary and secondary predictor variables) was significantly greater in case than control knees (AUC=0.59/0.58). Differences in cartilage loss were greater at earlier than later radiographic disease stages (p<0.01 for interaction with KLG). Cartilage thickness loss in the central tibia was the most predictive longitudinal measure (AUC=0.64). Denuded bone areas in the medial femur were the most predictive and discriminatory cross-sectional measure between case and control knees (AUC=0.66). Conclusions: This study demonstrates the predictive value of quantitative, MRI-based measures of cartilage for the clinically relevant endpoint of knee replacement, providing support for their utility in clinical trials to evaluate the effectiveness of structure-modifying intervention.

Original languageEnglish (US)
Pages (from-to)707-714
Number of pages8
JournalAnnals of the Rheumatic Diseases
Volume72
Issue number5
DOIs
StatePublished - May 2013
Externally publishedYes

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Knee prostheses
Cartilage
Osteoarthritis
Magnetic resonance imaging
Case-Control Studies
Knee
Area Under Curve
Knee Osteoarthritis
Replacement Arthroplasties
Clinical Trials
Magnetic resonance
Articular Cartilage
Tibia
Bone
Health Care Costs
Femur
Magnetic Resonance Spectroscopy
Quality of Life
Bone and Bones
Costs

ASJC Scopus subject areas

  • Rheumatology
  • Immunology
  • Biochemistry, Genetics and Molecular Biology(all)
  • Immunology and Allergy

Cite this

Quantitative MRI measures of cartilage predict knee replacement : A case-control study from the Osteoarthritis Initiative. / Eckstein, Felix; Kwoh, Chian K; Boudreau, Robert M.; Wang, Zhijie; Hannon, Michael J.; Cotofana, Sebastian; Hudelmaier, Martin I.; Wirth, Wolfgang; Guermazi, Ali; Nevitt, Michael C.; John, Markus R.; Hunter, David J.

In: Annals of the Rheumatic Diseases, Vol. 72, No. 5, 05.2013, p. 707-714.

Research output: Contribution to journalArticle

Eckstein, F, Kwoh, CK, Boudreau, RM, Wang, Z, Hannon, MJ, Cotofana, S, Hudelmaier, MI, Wirth, W, Guermazi, A, Nevitt, MC, John, MR & Hunter, DJ 2013, 'Quantitative MRI measures of cartilage predict knee replacement: A case-control study from the Osteoarthritis Initiative', Annals of the Rheumatic Diseases, vol. 72, no. 5, pp. 707-714. https://doi.org/10.1136/annrheumdis-2011-201164
Eckstein, Felix ; Kwoh, Chian K ; Boudreau, Robert M. ; Wang, Zhijie ; Hannon, Michael J. ; Cotofana, Sebastian ; Hudelmaier, Martin I. ; Wirth, Wolfgang ; Guermazi, Ali ; Nevitt, Michael C. ; John, Markus R. ; Hunter, David J. / Quantitative MRI measures of cartilage predict knee replacement : A case-control study from the Osteoarthritis Initiative. In: Annals of the Rheumatic Diseases. 2013 ; Vol. 72, No. 5. pp. 707-714.
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AU - Kwoh, Chian K

AU - Boudreau, Robert M.

AU - Wang, Zhijie

AU - Hannon, Michael J.

AU - Cotofana, Sebastian

AU - Hudelmaier, Martin I.

AU - Wirth, Wolfgang

AU - Guermazi, Ali

AU - Nevitt, Michael C.

AU - John, Markus R.

AU - Hunter, David J.

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N2 - Objective: Knee osteoarthritis commonly requires joint replacement, substantially reduces quality of life and increases healthcare utilisation and costs. This study aimed to identify whether quantitative measures of articular cartilage structure predict knee replacement, and to establish their utility as outcomes in clinical trials of disease-modifying therapy. Methods: A nested case-control study was performed in Osteoarthritis Initiative participants, a multicentre observational cohort of 4796 participants with or at risk of knee osteoarthritis. 127 knees were replaced between baseline and 4 years follow-up, and one control knee per case matched for baseline radiographic disease stage (Kellgren-Lawrence grade; KLG), gender and age. Quantitative cartilage measures were obtained from 3 T magnetic resonance images at the exam before knee replacement, and longitudinal change during the previous 12 months when available (n=110). Results: Cartilage thickness loss in the central and total medial femorotibial compartment ( primary and secondary predictor variables) was significantly greater in case than control knees (AUC=0.59/0.58). Differences in cartilage loss were greater at earlier than later radiographic disease stages (p<0.01 for interaction with KLG). Cartilage thickness loss in the central tibia was the most predictive longitudinal measure (AUC=0.64). Denuded bone areas in the medial femur were the most predictive and discriminatory cross-sectional measure between case and control knees (AUC=0.66). Conclusions: This study demonstrates the predictive value of quantitative, MRI-based measures of cartilage for the clinically relevant endpoint of knee replacement, providing support for their utility in clinical trials to evaluate the effectiveness of structure-modifying intervention.

AB - Objective: Knee osteoarthritis commonly requires joint replacement, substantially reduces quality of life and increases healthcare utilisation and costs. This study aimed to identify whether quantitative measures of articular cartilage structure predict knee replacement, and to establish their utility as outcomes in clinical trials of disease-modifying therapy. Methods: A nested case-control study was performed in Osteoarthritis Initiative participants, a multicentre observational cohort of 4796 participants with or at risk of knee osteoarthritis. 127 knees were replaced between baseline and 4 years follow-up, and one control knee per case matched for baseline radiographic disease stage (Kellgren-Lawrence grade; KLG), gender and age. Quantitative cartilage measures were obtained from 3 T magnetic resonance images at the exam before knee replacement, and longitudinal change during the previous 12 months when available (n=110). Results: Cartilage thickness loss in the central and total medial femorotibial compartment ( primary and secondary predictor variables) was significantly greater in case than control knees (AUC=0.59/0.58). Differences in cartilage loss were greater at earlier than later radiographic disease stages (p<0.01 for interaction with KLG). Cartilage thickness loss in the central tibia was the most predictive longitudinal measure (AUC=0.64). Denuded bone areas in the medial femur were the most predictive and discriminatory cross-sectional measure between case and control knees (AUC=0.66). Conclusions: This study demonstrates the predictive value of quantitative, MRI-based measures of cartilage for the clinically relevant endpoint of knee replacement, providing support for their utility in clinical trials to evaluate the effectiveness of structure-modifying intervention.

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