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Comparison of radiographic and MRI osteoarthritis definitions and their combination for prediction of tibial cartilage loss, knee symptoms and total knee replacement: a longitudinal study

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Cai, G, Cicuttini, F, Aitken, D ORCID: 0000-0001-5685-7634, Laslett, LL ORCID: 0000-0002-4336-0095, Zhu, Z, Winzenberg, T ORCID: 0000-0002-4112-3491 and Jones, G ORCID: 0000-0002-9814-0006 2020 , 'Comparison of radiographic and MRI osteoarthritis definitions and their combination for prediction of tibial cartilage loss, knee symptoms and total knee replacement: a longitudinal study' , Osteoarthritis and Cartilage , pp. 1-9 , doi: 10.1016/j.joca.2020.04.017.

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Abstract

Objective: To describe the value of radiographic- and magnetic resonance imaging (MRI)-defined tibiofemoral osteoarthritis (ROA and MRI-OA, respectively) and in combination for predicting tibial cartilage loss, knee pain and disability and total knee replacement (TKR) in a population-based cohort. Design: A radiograph and 1.5T MRI of the right knee was performed. ROA and MRI-OA at baseline were defined according to the Osteoarthritis Research Society International atlas and a published Delphi exercise, respectively. Tibial cartilage volume was measured over 2.6 and 10.7 years. Knee pain and disability were assessed at baseline, 2.6, 5.1 and 10.7 years. Right-sided TKRs were assessed over 13.5 years. Results: Of 574 participants (mean 62 years, 49% female), 8% had ROA alone, 15% had MRI-OA alone, 13% had both ROA and MRI-OA. Having ROA (vs. no ROA) and MRI-OA (vs. no MRI-OA) predicted greater tibial cartilage loss over 2.6 years (-75.9 and -86.4 mm3/year) and higher risk of TKR over 13.5 years (Risk Ratio [RR]: 15.0 and 10.9). Only MRI-OA predicted tibial cartilage loss over 10.7 years (-7.1 mm3/year) and only ROA predicted onset and progression of knee symptoms (RR: 1.32-1.88). In participants with both MRI-OA and ROA, tibial cartilage loss was the greatest (over 2.6 years: -116.1 mm3/year; over 10.7 years: -11.2 mm3/year), and the onset and progression of knee symptoms (RR: 1.75-2.89) and risk of TKR (RR: 50.9) were the highest. Conclusions: The Delphi definition of MRI-OA is not superior to ROA for predicting structural or symptomatic OA progression but, combining MRI-OA and ROA has much stronger predictive validity.

Item Type: Article
Authors/Creators:Cai, G and Cicuttini, F and Aitken, D and Laslett, LL and Zhu, Z and Winzenberg, T and Jones, G
Keywords: cartilage volume, knee osteoarthritis, MRI, pain, radiograph, total knee replacement
Journal or Publication Title: Osteoarthritis and Cartilage
Publisher: W B Saunders Co Ltd
ISSN: 1063-4584
DOI / ID Number: 10.1016/j.joca.2020.04.017
Copyright Information:

© 2020 Osteoarthritis Research Society International. Published by Elsevier Ltd. All rights reserved.

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