| Objective: Meniscal extrusion may can impair the normal mechanical function of the meniscus and is associated with OA-related knee structural changes and symptoms.The purpose of this study was to determine the MRI-based diagnostic threshold of medial meniscal extrusion for progression of knee pain and knee articular cartilage destruction within 4 years.Methods: 235 knee joints from 235 subjects were randomly selected from the OAI database.Medial meniscal extrusion was measured at baseline.Individuals with increased WOMAC pain score during the 48 months follow up were defined as subjects with knee pain progression.Knee cartilage destruction were assessed using WORMS score and progression of cartilage destruction for global knee,medial compartment,medial femoral condyle and medial tibial plateau were classified as follows: cartilage destruction progression,present of new full thickness defects,present of new full thickness defects or enlargement of preexisting full thickness defects.Univariate and multivariate binary logistic regression were used to analyze the association between baseline MME distance and progression of knee pain and cartilage damage,adjusting for age,gender,and BMI.ROC curves were used to calculate the cut off values.Results: The study persons had mean age of 59.8±8.0 years,63% were women and the mean BMI was 29.6±4.8 kg/m2.In univariate regression analyses,MME measurements were significantly associated with progression of knee pain(P < 0.001)as well as progression of cartilage damage for global knee(P = 0.009),medial compartment(P = 0.003),medial femoral condyle(P = 0.017),and medial tibial plateau(P = 0.001)over a 48 months period.In global knee assessments,the MME measurements were also found to be significantly associated with present of new full thickness defects(P = 0.013)as well as present of new full thickness defects or enlargement of preexisting full thickness defects(P = 0.002).The above correlations remained significant after adjusting for gender,baseline age,and baseline BMI.The AUC of MME measurement for predicting knee pain progression was 0.658(0.580 ~ 0.735,95% CI),with a cut off value of 3.26 mm.The AUC and cut off values for predicting cartilage destruction progression of global knee(cartilage destruction progression,present of new full thickness defects,present of new full thickness defects or enlargement of preexisting full thickness defects),medial compartment,medial femoral condyle and medial tibial plateau were 0.603(0.527 ~ 0.679),2.43 mm;0.605(0.526 ~ 0.684),2.68mm;0.620(0.543 ~ 0.697),2.68mm;0.617(0.541 ~ 0.693),2.73mm;0.610(0.529 ~ 0.692),2.73mm;0.654(0.560 ~ 0.747),3.14 mm,respectively.Conclusions: This study demonstrated that MME was significantly associated with progression of knee pain and cartilage destruction over a 48-month period and identified MRI-based MME thresholds for progression of knee pain and articular cartilage degeneration.This MME measurement method is simple and reproducible,which could be used as a method for screening progression of knee pain and cartilage damage.Objective: Metabolic disorders presenting in HIV-infected patients on antiretroviral therapy(ART)may increase the risk of osteoarthritis.However,structural changes of the knee in HIV infected subjects are understudied.The aim of this study is to investigate knee cartilage degeneration and knee structural changes over 8 years in subjects with and without HIV infection determined based on the use of ART.Methods: We studied 10 participants from the Osteoarthritis Initiative who received ART at baseline and 20 controls without ART,frequency matched for age,sex,race,baseline body mass index(BMI)and Kellgren & Lawrence grade.Knee abnormalities were assessed using the whole-organ magnetic resonance imaging score(WORMS)and cartilage T2 including laminar and texture analyses were analyzed using multislice-multiecho spin-echo sequence.Signal abnormalities of the infrapatellar fat pad(IPFP)and suprapatellar fat pad(SPFP)were assessed separately using a semi-quantitative scoring system.Linear regression models were used in the cross-sectional analysis to compare the differences between ART/HIV subjects and controls in T2(regular and laminar T2 values,texture parameters)and morphologic parameters(subscores of WORMS,scores for signal alterations of IPFP and SPFP).Mixed effects models were used in the longitudinal analysis to compare the rate of change in T2 and morphological parameters between groups over 8 years.All analyses were adjusted for baseline age,sex,race,baseline BMI and K&L grades.Results: At baseline,individuals on ART had significantly greater size of IPFP signal abnormalities(P = 0.008),higher signal intensities of SPFP(P = 0.015),higher effusion scores(P = 0.009),and lower subchondral cysts sum scores(P = 0.003)compared to the controls.No significant differences were found between the groups in T2-based cartilage parameters and WORMS scores for cartilage,meniscus,bone marrow edema patterns and ligaments(P > 0.05).Longitudinally,the HIV cohort had significantly higher global knee T2 entropy values(P = 0.047),more severe effusion(P = 0.001)but less severe subchondral cysts(P = 0.002)on average over 8 years.Conclusions: Knees of individuals with HIV on ART had a more heterogeneous cartilage matrix,more severe synovitis and abnormalities of the IPFP and SPFP,which may increase the risk of incident knee osteoarthritis. |
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