The natural history of cartilage defects in people with knee osteoarthritis

Davies-Tuck MLW, A. E.; Wang, Y.; Teichtahl, A. J.; Jones, G.; Ding, C.; Cicuttini, F. M. (2008) The natural history of cartilage defects in people with knee osteoarthritis. Osteoarthritis Cartilage 16:337-342

OBJECTIVES: Cartilage defects are highly prevalent in subjects with knee osteoarthritis (OA). Although they are associated with increased cartilage loss and joint replacement, there is little data on the natural history of cartilage defects. The aim of this study was to examine the progression of cartilage defects over 2 years in people with knee OA and to identify factors associated with progression. METHODS: One hundred and seventeen subjects with OA underwent magnetic resonance imaging of their dominant knee at baseline and follow-up. Cartilage defects were scored (0-4) at four sites. Bone size of the medial and lateral tibial plateau was determined. Height, weight, body mass index and physical activity were measured by standard protocols. RESULTS: The mean cartilage defect score increased significantly over the 2-year study period in all tibiofemoral compartments (all P<0.001), except="" the="" lateral="" tibial="" compartment="" with="" age="" and="" tibial="" plateau="" bone="" area="" at="" baseline="" being="" predictors="" of="" progression.="" however,="" there="" was="" heterogeneity="" with="" 81%="" progressing="" at="" any="" site,="" 15%="" remaining="" stable="" and="" 4%="" decreasing.="" conclusion:="" over="" 2="" years,="" cartilage="" defects="" tend="" to="" progress="" in="" people="" with="" symptomatic="" oa,="" with="" only="" a="" small="" percentage="" decreasing="" in="" severity.="" increasing="" age="" and="" increased="" bone="" area="" are="" risk="" factors="" for="" progression.="" interventions="" aimed="" at="" preventing="" cartilage="" defects="" from="" occurring="" and="" reducing="" their="" severity="" may="" result="" in="" a="" reduction="" in="" the="" severity="" of="" oa,="" by="" reducing="" loss="" of="" articular="" cartilage="" and="" subsequent="" requirement="" for="" knee="" joint="">