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Rheumatology Advance Access published online on July 19, 2005
Rheumatology, doi:10.1093/rheumatology/kei018
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© The Author 2005. Published by Oxford University Press on behalf of the British Society for Rheumatology. All rights reserved. For Permissions, please email: journals.permissions@oupjournals.org
Received March 10, 2005
Accepted May 27, 2005

Original Papers

The clinical correlates of articular cartilage defects in symptomatic knee osteoarthritis: a prospective study

A. E. Wluka 1, C. Ding 2, G. Jones 2, and F. M. Cicuttini 1*

1 Department of Epidemiology and Preventive Medicine, Monash University Medical School, Melbourne, Victoria, Australia
2 Menzies Research Institute, University of Tasmania, Hobart, Tasmania, Australia

* To whom correspondence should be addressed.
F. M. Cicuttini, E-mail: flavia.cicuttini{at}med.monash.edu.au


  Abstract

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.

Keywords: Articular cartilage; Cartilage defect; Joint replacement; Osteoarthritis; Progression.
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