From the Journals

OA progresses equally with new focal partial- or full-thickness cartilage damage


 

FROM ARTHRITIS & RHEUMATOLOGY

A small, partial-thickness focal cartilage defect in the tibiofemoral joint compartment has the same impact on osteoarthritis disease progression – defined as new cartilage damage – as does a full-thickness lesion, according to an analysis of data from the Multicenter Osteoarthritis Study.

Ali Guermazi, MD, PhD, of Boston University, and his associates used MRI to show that both full- and partial-thickness small focal defects (less than 1 cm) in the tibiofemoral compartment contributed significantly to the risk of incident cartilage damage 30 months later in other tibiofemoral compartment subregions (adjusted odds ratio, 1.62; 95% confidence interval, 1.06-2.47, for partial-thickness defects and aOR, 1.92; 95% CI, 1.00-3.66, for full-thickness defects) when compared with subregions with no baseline cartilage damage, defined as a Kellgren-Lawrence grade of 0-1.

An older man bends over in pain with his hands on his left knee. ©KatarzynaBialasiewicz/Thinkstock
However, there was no difference between partial- and full-thickness lesions in the tibiofemoral compartment on the risk of incident damage in other subregions when there were partial- and full-thickness lesions present at baseline. The results did not change when the investigators excluded people with Kellgren-Lawrence grades 3-4.

The results indicate that “partial-thickness and full-thickness defects are similarly relevant in regard to cartilage damage development in knee osteoarthritis,” the investigators wrote.

They studied 374 compartments (359 knees), of which 140 knees (39%) had radiographic osteoarthritis defined as a Kellgren-Lawrence grade of 2 or higher).

“It is potentially important to detect focal cartilage defects early as there are various options for repair of focal cartilage defects ... [and it could be possible to use MRI] to screen persons with early-stage osteoarthritis or those at high risk of osteoarthritis and initiate treatment for focal cartilage defects,” they wrote.

Read the full study in Arthritis & Rheumatology (2016 Oct 27. doi: 10.1002/art.39970).

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