Rheumatology Advance Access originally published online on July 19, 2005
Rheumatology 2005 44(10):1311-1316; doi:10.1093/rheumatology/kei018
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The clinical correlates of articular cartilage defects in symptomatic knee osteoarthritis: a prospective study
Department of Epidemiology and Preventive Medicine, Monash University Medical School, Melbourne, Victoria and 1 Menzies Research Institute, University of Tasmania, Hobart, Tasmania, Australia.
Correspondence: F. M. Cicuttini, Department of Epidemiology and Preventive Medicine, Monash University, Central and Eastern Clinical School, Alfred Hospital, Commercial Road, Melbourne, VIC 3004, Australia. E-mail: flavia.cicuttini{at}med.monash.edu.au
Objectives. To determine whether articular cartilage defects are associated with cartilage loss and joint replacement in subjects with symptomatic knee osteoarthritis (OA).
Methods. One hundred and seventeen subjects with symptomatic knee OA underwent magnetic resonance imaging of their dominant knee at baseline and 2 yr later. Cartilage defects were identified as prevalent (defect score 
2) in each knee compartment. Occurrence of joint replacement by 4 yr was documented.
Results. Cartilage defects were present in 81% of medial, 64% of lateral tibiofemoral compartments and 55% of patellar cartilages. Annual patellar cartilage loss was highest in those with defects compared with no defects (5.5% vs 3.2%, P = 0.01). Tibial cartilage loss was not associated with defects in the medial (4.6% vs 5.8%, P = 0.42) or lateral (4.7% vs 6.5%, P = 0.21) tibial cartilages. Higher total cartilage defect scores (8–15) were associated with a 6.0-fold increased risk of joint replacement over 4 yr compared with those with lower scores (2–7) (95% confidence interval 1.6, 22.3), independently of potential confounders.
Conclusions. Articular cartilage defects are associated with disease severity in knee OA and predict patellar cartilage loss and knee replacement.
KEY WORDS: Articular cartilage, Cartilage defect, Joint replacement, Osteoarthritis, Progression
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