Brief Report: Cartilage Thickness Change as an Imaging Biomarker of Knee Osteoarthritis Progression: Data From the Foundation for the National Institutes of Health Osteoarthritis Biomarkers Consortium

Abstract

Objective: To investigate the association of cartilage thickness change over 24 months, as determined by magnetic resonance imaging (MRI), with knee osteoarthritis (OA) progression at 24-48 months.

Methods: This nested case-control study included 600 knees with a baseline Kellgren/Lawrence (K/L) grade of 1-3 from 600 Osteoarthritis Initiative (OAI) participants. Case knees (n = 194) had both medial tibiofemoral radiographic joint space loss (≥0.7 mm) and a persistent increase in the Western Ontario and McMaster Universities Osteoarthritis Index pain score (≥9 on a 0-100 scale) 24-48 months from baseline. Control knees (n = 406) included 200 with neither radiographic nor pain progression, 103 with radiographic progression only, and 103 with pain progression only. Medial and lateral femorotibial cartilage was segmented from sagittal 3T MRIs at baseline, 12 months, and 24 months. Logistic regression was used to assess the association of change in cartilage thickness, with a focus on the central medial femorotibial compartment, and OA progression.

Results: Central medial femorotibial compartment thickness loss was significantly associated with case status, with an odds ratio (OR) of 1.9 (95% confidence interval [95% CI] 1.6-2.3) (P < 0.0001). Association with case status reached P < 0.05 for both the central femur (OR 1.8 [95% CI 1.5-2.2]) and the central tibia (OR 1.6 [95% CI 1.3-1.9]). Lateral femorotibial compartment cartilage thickness loss, in contrast, was not significantly associated with case status. A reduction in central medial femorotibial compartment cartilage thickness was strongly associated with radiographic progression (OR 4.0 [95% CI 2.9-5.3]; P < 0.0001) and only weakly associated with pain progression (OR 1.3 [95% CI 1.1-1.6]; P < 0.01).

Conclusion: Our findings indicate that loss of medial femorotibial cartilage thickness over 24 months is associated with the combination of radiographic and pain progression in the knee, with a stronger association for radiographic progression.

Trial registration: ClinicalTrials.gov NCT00080171.

Conflict of interest statement

DISCLOSURE OF INTEREST

1. Felix Eckstein is CEO/CMO and co-owner of Chondrometrics GmbH, a company providing MR image analysis services to academic researchers and to industry. He has provided consulting services to Merck Serono and Mariel Therapeutics, and has received speaker honoraria from Medtronic. Chondrometrics GmbH has received funding from the FNIH Biomarker Consortium for the quantitative analysis of cartilage data from this study.

2. Jamie Collins has no conflict of interest to report

3. Michael Nevitt has received support from the FNIH OA Biomarkers Consortium

4. John Lynch has no conflict of interest to report

5. Virginia Kraus has received support from the FNIH OA Biomarkers Consortium

6. Jeffrey N. Katz has no conflict of interest to report

7. Elena Losina has received support from the FNIH OA Biomarkers Consortium and is additionally funded additionally by grants from NIAMS R01 AR064320, K24 AR057827, P60 AR47782.

8. Wolfgang Wirth is a part time employee and co-owner of Chondrometrics GmbH; he has provided consulting services to Merck Serono and to Ampio Pharmaceuticals

9. Ali Guermazi is President of Boston Imaging Core Lab, LLC (BICL), a company providing MRI reading services to academic researchers and to industry. He has provided consulting services to Merck Serono, Genzyme, OrthoTrophix and TissueGene. BICL has received funding from the FNIH Biomarker Consortium for semi-quantitative analysis of MRI data from this study.

10. Frank Roemer Frank Roemer is CMO and co-owner of BICL.

11. David Hunter has received support from the FNIH OA Biomarkers Consortium.

© 2015, American College of Rheumatology.