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Arthritis Care Res (Hoboken). 2019 Apr 1. doi: 10.1002/acr.23891. [Epub ahead of print]

Early MRI-based Changes in Patients with Meniscal Tear and Osteoarthritis.

Author information

1
Orthopedic and Arthritis Center for Outcomes Research, Department of Orthopedic Surgery, Brigham and Women's Hospital, Boston, MA.
2
Harvard Medical School, Boston, MA.
3
Weill Cornell Medicine, Hospital for Special Surgery, New York, NY.
4
Quantitative Imaging Center, Department of Radiology, Boston University School of Medicine, Boston, MA.
5
Department of Radiology, Mercy Catholic Medical Center, Darby, PA.
6
Department of Orthopaedic Surgery, Cleveland Clinic, Cleveland, OH.
7
Department of Orthopedic Surgery, Mayo Clinic, Rochester, MN.
8
Department of Orthopedic Surgery, Massachusetts General Hospital, Boston, MA.
9
Department of Orthopaedic Surgery, Washington University School of Medicine, St. Louis, MO.

Abstract

OBJECTIVE:

To evaluate changes in knee MRI findings over the course of 18 months in subjects with osteoarthritic change (OA) and meniscal tear (MT) treated with arthroscopic partial meniscectomy (APM) or non-operatively with physical therapy (PT).

METHODS:

We used 18-month follow up data from the Meniscal Tear in Osteoarthritis Research (MeTeOR) Trial. MRIs were read using the MRI OA Knee Score (MOAKS). We focused on 18-month change in bone marrow lesions (BMLs), cartilage thickness, cartilage surface area, osteophytes size, effusion-synovitis, and Hoffa-synovitis. We used multinomial logistic regression to assess associations between MRI-based changes in each feature and treatment type.

RESULTS:

351 subjects were randomized and 225 had both baseline and 18-month MRI. In both treatment groups, patients experienced substantial changes in several MRI-based markers. In 60% of the APM group, vs. 33% of the PT group, cartilage surface area damage advanced in ≥2 subregions (adjusted odds ratio (OR) 4.2 (95% CI 2.0, 9.0). Patients who underwent APM also had greater advancement in scores for osteophytes and effusion-synovitis. We did not find significant associations between treatment type and change in cartilage thickness, BMLs, or Hoffa-synovitis.

CONCLUSION:

This cohort with meniscal tear and OA had marked advancement in MRI-based features over 18 months. Those treated with APM had more advancement in some features compared to those treated non-operatively. The clinical relevance of these early findings is unknown and requires further study. This article is protected by copyright. All rights reserved.

PMID:
30932360
DOI:
10.1002/acr.23891

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