Rheumatology Advance Access originally published online on September 27, 2005
Rheumatology 2006 45(1):79-84; doi:10.1093/rheumatology/kei108
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Factors affecting progression of knee cartilage defects in normal subjects over 2 years
1 Department of Epidemiology and Preventive Medicine, Monash University, Central and Eastern Clinical School, Alfred Hospital, Melbourne, 2 Graduate School of Integrative Medicine, Swinburne University of Technology, Hawthorn, Victoria, 3 Menzies Research Institute, University of Tasmania, Hobart, Tasmania, 4 The Baker Heart Research Institute, Melbourne, 5 Women's Program, Department of Medicine, Monash University, Melbourne and 6 Departments of Diabetes and Endocrinology, and Medicine, University of Melbourne, Royal Melbourne Hospital, Parkville, Victoria, Australia.
Correspondence to: F. Cicuttini, Department of Epidemiology and Preventive Medicine, Monash University, Central and Eastern Clinical School, Alfred Hospital, Melbourne, Vic. 3004, Australia. E-mail: flavia.cicuttini{at}med.monash.edu.au
Objectives. Cartilage defects are present in subjects with knee osteoarthritis (OA). Although they are often present in healthy subjects, there is little data on the natural history of cartilage defects. The aim of this study was to examine the change in cartilage defects over 2 yr and to identify factors associated with this change.
Methods. One hundred and twenty-four healthy subjects underwent magnetic resonance imaging of their dominant knee at baseline and follow-up. Cartilage defects were scored (0–4) at five sites. Bone size was determined at medial and lateral tibial plateau and patella. Height, weight, body mass index and physical activity were measured by standard protocols.
Results. Eighty-six subjects completed the study. The mean cartilage defect score of each tibiofemoral compartment increased over time. However, medial and lateral tibiofemoral defect score decreased in 5% of the subjects. Cartilage defects were more likely to progress in males than females in each individual compartment (P<0.001 for medial tibiofemoral, P=0.005 for lateral tibiofemoral and P=0.01 for patellar cartilage). Baseline cartilage defect score was negatively associated with the progression of cartilage defects in each compartment (all P<0.001).
Conclusion. Although knee cartilage defects progressed over time in the majority of normal subjects, those of the highest severity tended to regress. Male gender and baseline cartilage defect score were the main factors associated with the progression of cartilage defects. Larger studies will be required to identify factors associated with the progression and regression of lesions.
KEY WORDS: Cartilage defects, Knee, Magnetic resonance imaging (MRI), Normal, Progression
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