Do rates of femorotibial cartilage loss in Kellgren-Lawrence 2 and 3 knees differ between those with mild-moderate vs. severe patellofemoral structural damage? – Data from the FNIH and IMI-APPROACH cohorts

IF 9 2区医学 Q1 ORTHOPEDICS

Osteoarthritis and Cartilage Pub Date : 2026-05-01 Epub Date: 2025-10-12 DOI:10.1016/j.joca.2025.10.003

Frank W. Roemer , Mylène Jansen , Susanne Maschek , Simon Mastbergen , Anna Wisser , Harrie H. Weinans , Francisco J. Blanco , Francis Berenbaum , Margreet Kloppenburg , Ida K. Haugen , David J. Hunter , Ali Guermazi , Wolfgang Wirth

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引用次数: 0

Abstract

Background

The aim was to assess whether rates of quantitative femorotibial (FT) cartilage loss are increased for knees with semiquantitatively (sq)-defined severe patellofemoral (PF) cartilage damage and/or large bone marrow lesions (BMLs) vs. those without over a period of 24 months.

Methods

626 knees with Kellgren-Lawrence 2 and 3 from the FNIH and IMI-APPROACH studies were included. MRI assessment was performed using the MRI Osteoarthritis Knee Score (MOAKS) instrument. Baseline FT cartilage damage severity was defined as mild, moderate, or severe. PF cartilage damage was defined as mild-moderate vs. severe. A 2nd definition was based on the presence or absence of large BMLs. Quantitative cartilage thickness loss (defined as the difference from baseline to follow-up in mean cartilage thickness in the medial and in the lateral femorotibial joint, which were computed by summing the cartilage thickness measures observed in the respective cartilage plates) was derived from baseline and 24-month manual segmentations. Between-group comparisons were performed using analysis of covariance (ANCOVA) adjusting for age, sex and body mass index.

Results

410 (65%) knees were categorized as mild, 92 (15%) as moderate, and 124 (20%) as severe medial FT cartilage damage. For almost all categories of FT cartilage damage, the difference in quantitative medial FT cartilage loss was not statistically significant. Only for the category of knees with moderate medial FT cartilage damage, statistically higher rates of FT cartilage loss were observed for those with large PF BMLs compared to those without (mean adjusted difference −0.128 mm, 95% confidence interval [-0.238, −0.018], p=0.023).

Conclusions

Screening for PF cartilage damage and BMLs does not appear to be required in a disease-modifying OA drug trial.

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轻度-中度髌骨-股骨结构损伤与重度髌骨-股骨结构损伤相比，Kellgren-Lawrence 2型和3型膝关节的股胫软骨丢失率是否不同？-数据来自FNIH和IMI-APPROACH队列。

研究背景：研究目的是评估在24个月的时间里，有半定量（sq）定义的严重髌骨股骨（PF）软骨损伤和/或大骨髓病变（BMLs）的膝关节，与没有严重髌骨股骨（PF）软骨损伤的膝关节相比，定量股胫（FT）软骨损失的发生率是否增加。方法纳入626例来自FNIH和IMI-APPROACH研究的kelgren - lawrence 2和3膝关节。采用MRI骨关节炎膝关节评分（MOAKS）仪进行MRI评估。基线FT软骨损伤严重程度定义为轻度、中度或重度。PF软骨损伤分为轻、中度和重度。第二个定义是基于是否存在大型bml。定量软骨厚度损失（定义为从基线到随访期间股骨胫骨内侧和外侧关节平均软骨厚度的差异，通过将各自软骨板中观察到的软骨厚度测量值相加来计算）来源于基线和24个月的手工分割。采用协方差分析（ANCOVA）进行组间比较，调整年龄、性别和体重指数。结果410例膝关节（65%）为轻度，92例（15%）为中度，124例（20%）为重度内侧FT软骨损伤。对于几乎所有类型的FT软骨损伤，内侧FT软骨定量损失的差异无统计学意义。仅在膝关节内侧有中度FT软骨损伤的类别中，PF骨密度大的患者的FT软骨损失率高于无损伤的患者（调整后平均差为-0.128 mm， 95%可信区间[-0.238,-0.018],p=0.023）。结论：在改善疾病的OA药物试验中，似乎不需要筛选PF软骨损伤和bls。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Osteoarthritis and Cartilage 医学-风湿病学

CiteScore

11.70

自引率

7.10%

发文量

802

审稿时长

52 days

期刊介绍： Osteoarthritis and Cartilage is the official journal of the Osteoarthritis Research Society International. It is an international, multidisciplinary journal that disseminates information for the many kinds of specialists and practitioners concerned with osteoarthritis.