Does Baseline Cartilage T2 Predict Incident and Worsening of Structural Morphological Damage of the Radiographically Normal Knee Joint Over 3 Years?

Introduction Our purpose was to analyze whether knees with morphological cartilage and bone marrow lesion (BML) development or worsening at 3 years exhibit elevated cartilage T2 in the same plate at baseline.

Material and Methods We included 141 knees from the Osteoarthritis Initiative without radiographic osteoarthritis (ROA) (K-L 0). Cartilage damage and subchondral BMLs were assessed for year 1 (Y1) and year 4 (Y4) using the magnetic resonance imaging osteoarthritis knee score scoring system. Y1 deep and superficial layer cartilage T2 was computed from sagittal multi-echo spin-echo magnetic resonance (MR) images. Statistical analyses were performed joint on a plate level, that is, medial femur (MF), medial tibia (MT), lateral femur, and lateral tibia (LT), using the UNIANOVA procedure.

Results A total of 141 participants were included. Worsening of femorotibial (FT) cartilage lesions from Y1 to Y4 were seen in 7% medially and 15% in the lateral FT compartment. Incident FT cartilage lesions were seen in knees in 11.5% medially and 6% laterally. Deep layer T2 showed prolongation in the LT in knees with incident LT cartilage lesions (n = 8; 34.5 versus 32.7 ms; p = 0.02) and for MF in knees with MF cartilage lesion worsening (n = 9; 47.6 versus 41.4 ms; p = 0.01) and MF BML incidence (n = 6; 45.4 versus 41.6 ms; p = 0.000). Superficial T2 showed prolongation in the MT only in those knees with MT cartilage lesion worsening (n = 2; 47.3 versus 43.4 ms; p = 0.03).

Conclusion For knees without ROA, baseline deep layer T2 prolongation was seen for those who developed incident cartilage damage in the LT at Y4 and those with worsening cartilage damage and incident BMLs in the MF, respectively. Superficial T2 showed prolongation only in the MT for those with MT cartilage lesion worsening.