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Baseline Values and Change in Superficial and Deep Layer Cartilage T2 Times in External Femoral Subregions do not Differ Between Knees With and Without Osteophytes – Data From The Osteoarthritis Initiative
S248
Abstracts / Osteoarthritis and Cartilage 25 (2017) S76eS444
Results: The presence of ACL injury was significantly (p¼0.05) related to lateral tibial plateau cartilage volume decrease over 24 months; b¼56.7 (95% confidence interval¼112.62, 0.72). Alignment (p¼0.02) and presence of ACL injury (p¼0.01) were significantly related to increased BML volume at the medial tibial plateau at 72 months; varus alignment b¼2.9 (95% confidence interval¼0.55, 5.29), ACL injury b¼2.9 (95% confidence interval¼0.66, 5.15). Presence of ACL injury, alignment, or interaction between these factors did not impact cartilage or BML changes for the remaining regions over both 24 and 72 months including at the lateral femoral condyles. The small sample size likely accounted for some of the nonsignificant findings. Conclusions: Considering the interactions between ACL injury and alignment were not significant for predicting cartilage or BML volume changes, alignment had a similar impact on OA progression in both participants with and without evidence of ACL injury. However, ACL injury and alignment did impact structural progression in distinct locations. Following ACL injury, previous studies have demonstrated more frequent damage to the lateral compartment including cartilage matrix degradation. These changes likely contribute to OA initiation, and the current findings indicate these changes continue to impact OA progression, specifically at the lateral tibial plateau. In regards to the BML changes, varus alignment increases the load distribution on the medial compartment. This led to further structural damage as indicated by the increase in medial tibial plateau BML. ACL injury also resulted in increased BML over time at this location. Changes in joint kinematics after ACL injury could lead to a modified loading environment accounting for this structural progression. 388 BASELINE VALUES AND CHANGE IN SUPERFICIAL AND DEEP LAYER CARTILAGE T2 TIMES IN EXTERNAL FEMORAL SUBREGIONS DO NOT DIFFER BETWEEN KNEES WITH AND WITHOUT OSTEOPHYTES e DATA FROM THE OSTEOARTHRITIS INITIATIVE W. Wirth y, z, S. Maschek y, z, F. Roemer x, k, F. Eckstein y, z. y Paracelsus Med. Univ. Salzburg & Nuremberg, Salzburg, Austria; z Chondrometrics GmbH, Ainring, Germany; x Boston Imaging Core Lab, Boston, MA, USA; k Univ. of Erlangen, Erlangen, Germany Purpose: We previously reported significantly greater cartilage thickness in external femoral subregions of knees with osteophytes (OPs) but without joint space narrowing (JSN), compared to contralateral knees without any signs of radiographic knee osteoarthritis (neither OP nor JSN). The results of this between-knee, within-person comparison were hypothesized to reflect cartilage swelling or hypertrophy. Cartilage transverse relaxation time (T2) mapping has been shown to be sensitive to cartilage hydration, collagen content and collagen orientation, and to also reflect mechanical cartilage properties. The objective of the current study was therefore to explore whether compositional cartilage changes can be observed in external femoral regions of these knees using laminar (deep/superficial layer) cartilage T2 times. Methods: From 4796 Osteoarthritis Initiative (OAI) participants, 84 had OPs but no JSN in one of their knees and no signs of radiographic OA (OPs or JSN) in the contralateral knee. Sagittal 3T multi-echo spin echo MRIs were only acquired in one of both knees (resolution: 0.31x0.31x3mm, repetition time: 2700ms, echo time: 10, 20, 30, 40, 50, 60, 70ms, 1st echo excluded from analysis) , whereas sagittal DESS MRIs for cartilage morphometry were available for both knees, Baseline MESE
MRIs were available in 32 knees with OPs (age: 60.2 ± 10.0 years, BMI: 27.6 ± 4.6, 56% female) and in 28 knees without OPs (age: 61.1 ± 9.4 years, BMI: 28.0 ± 5.0, 50% female) of the above cohort. One-year follow-up MESE MRIs were available in 24 knees with, and in 26 knees without OPs. Deep and superficial cartilage layer T2 times (each 50% of the cartilage thickness) were computed using a non-linear curve-fitting in external medial and lateral femoral subregions (ecMF/ecLF), in which greater cartilage thickness was previously reported in OP vs. non-OP knees based on the sagittal DESS MRIs. Baseline values and change in cartilage T2 times in the ecMF and ecLF were compared using t-tests. Results: The T2 times in the ecMF were slightly longer in the superficial and deep cartilage layer in knees with than in knees without OPs (Table), but the differences were not statistically significant (p0.18). Further, no significant differences (p0.88) were observed in the superficial or deep ecLF layer (Table). The one-year longitudinal change in superficial T2 in the ecLF differed significantly (p¼0.01) between knees with and without osteophytes; yet, this difference was primarily driven by a T2 decrease in knees without OPs (Table). The longitudinal T2 change in the ecMF tended to differ between knees with OPs (decrease) vs. those without OPs (increase), but again the difference failed to reach the significance level (p0.06, Table). Conclusions: T2 times in ecMF and the ecLF cartilage did not differ significantly between knees with early signs of radiographic OA (OPs, but no JSN) and those without signs of radiographic OA (no OPs and no JSN). Although the study had a limited sample size, the current results do not support the hypothesis that thicker cartilage in external (medial and lateral) femoral subregions of knees with early radiographic OA is associated with compositional cartilage alterations that can be detected using T2 relaxation time analyses. 389 QUANTITATIVE CARTILAGE THICKNESS CHANGE SURGICAL AND VIRTUAL KNEE REPLACEMENT COMPARATIVE ANALYSIS USING DATA FROM THE OAI
PRECEDING STATUS e
F. Eckstein y, z, M.J. Hannon x, T. Fujii k, R.M. Boudreau k, W. Wirth y, z, S. Maschek y, z, A. Guermazi ¶, #, F.W. Roemer yy, #, M. Nevitt zz, C. Ladel xx, L. Sharma kk, D.J. Hunter ¶¶, C.K. Kwoh ##. y Paracelsus Med. Univ., Salzburg, Austria; z Chondrometrics Gmbh, Ainring, Germany; x Univ. of Pittsburgh Sch. of Med., Pittsburgh, PA, USA; k Univ. of Pittsburgh Graduate Sch. of Publ. Hlth., Pittsburgh, PA, USA; ¶ Boston Univ. Sch. of Med., Boston, MA, USA; # Boston Imaging Core Lab, Boston, MA, USA; yy Univ. of Erlangen, Erlangen, Germany; zz Univ. of California, San xx Merck KGaA, Darmstadt, Germany; Francisco, CA, USA; kk Northwestern Univ., Chicago, IL, USA; ¶¶ Univ. of Sydney, Sydney, ## Univ. of Arizona Coll. of Med., Tuscon, AZ, USA Australia; Purpose: Quantitative cartilage loss was found to be greater in knees prospectively undergoing surgical (sKRþ), or reaching virtual knee replacement status as defined by symptoms only (vKRþ), than in matched controls (sKR-/vKR-). These findings suggest that cartilage loss is related to clinical outcomes and is a useful (and validated) imaging biomarker for disease modifying OA drugs. However, magnitudes of cartilage loss in sKRþ and vKRþ cases, relative to controls and to radiographic change, have not been studied in parallel. The objective of this study hence was to examine the relationship between cartilage loss and surgical/virtual KR case/control status; 2) to compare discrimination of combined surgical/virtual KR vs. control
Baseline values and one-year change in laminar cartilage T2 times in knees with/without osteophytes
Osteophytes Mean Baseline cartilage T2 times (ms): ecMF Superficial layer 48.4 Deep layer 41.2 ecLF Superficial layer 47.3 Deep layer 43.0 One-year change in cartilage T2 times (ms): ecMF Superficial layer 0.5 Deep layer 0.4 ecLF Superficial layer 0.6 Deep layer 0.2
No Osteophytes
SD
95% CI
6.9 5.5 4.7 3.6
45.9 39.2 45.7 41.6
4.1 2.9 2.1 2.1
2.2 1.6 0.3 1.1
Difference
Mean
SD
95% CI
50.9 43.2 49.0 44.3
46.2 39.9 47.2 43.1
5.2 3.6 4.5 3.0
44.1 38.5 45.5 41.9
1.2 0.8 1.5 0.6
0.8 1.3 1.1 0.2
3.9 3.2 2.1 2.3
0.8 0.0 1.9 1.1
Mean
SD
95% CI
p-value
48.2 41.3 49.0 44.3
2.2 1.3 0.1 0.1
1.6 1.2 1.2 0.9
1.0 1.1 2.3 1.9
5.4 3.8 2.5 1.6
0.18 0.28 0.94 0.88
2.3 2.6 0.2 0.7
1.3 1.7 1.7 0.0
1.1 0.9 0.6 0.6
3.5 3.4 0.4 1.3
1.0 0.0 2.9 1.2
0.27 0.06 0.01 0.95
Abstracts / Osteoarthritis and Cartilage 25 (2017) S76eS444
Results: The presence of ACL injury was significantly (p¼0.05) related to lateral tibial plateau cartilage volume decrease over 24 months; b¼56.7 (95% confidence interval¼112.62, 0.72). Alignment (p¼0.02) and presence of ACL injury (p¼0.01) were significantly related to increased BML volume at the medial tibial plateau at 72 months; varus alignment b¼2.9 (95% confidence interval¼0.55, 5.29), ACL injury b¼2.9 (95% confidence interval¼0.66, 5.15). Presence of ACL injury, alignment, or interaction between these factors did not impact cartilage or BML changes for the remaining regions over both 24 and 72 months including at the lateral femoral condyles. The small sample size likely accounted for some of the nonsignificant findings. Conclusions: Considering the interactions between ACL injury and alignment were not significant for predicting cartilage or BML volume changes, alignment had a similar impact on OA progression in both participants with and without evidence of ACL injury. However, ACL injury and alignment did impact structural progression in distinct locations. Following ACL injury, previous studies have demonstrated more frequent damage to the lateral compartment including cartilage matrix degradation. These changes likely contribute to OA initiation, and the current findings indicate these changes continue to impact OA progression, specifically at the lateral tibial plateau. In regards to the BML changes, varus alignment increases the load distribution on the medial compartment. This led to further structural damage as indicated by the increase in medial tibial plateau BML. ACL injury also resulted in increased BML over time at this location. Changes in joint kinematics after ACL injury could lead to a modified loading environment accounting for this structural progression. 388 BASELINE VALUES AND CHANGE IN SUPERFICIAL AND DEEP LAYER CARTILAGE T2 TIMES IN EXTERNAL FEMORAL SUBREGIONS DO NOT DIFFER BETWEEN KNEES WITH AND WITHOUT OSTEOPHYTES e DATA FROM THE OSTEOARTHRITIS INITIATIVE W. Wirth y, z, S. Maschek y, z, F. Roemer x, k, F. Eckstein y, z. y Paracelsus Med. Univ. Salzburg & Nuremberg, Salzburg, Austria; z Chondrometrics GmbH, Ainring, Germany; x Boston Imaging Core Lab, Boston, MA, USA; k Univ. of Erlangen, Erlangen, Germany Purpose: We previously reported significantly greater cartilage thickness in external femoral subregions of knees with osteophytes (OPs) but without joint space narrowing (JSN), compared to contralateral knees without any signs of radiographic knee osteoarthritis (neither OP nor JSN). The results of this between-knee, within-person comparison were hypothesized to reflect cartilage swelling or hypertrophy. Cartilage transverse relaxation time (T2) mapping has been shown to be sensitive to cartilage hydration, collagen content and collagen orientation, and to also reflect mechanical cartilage properties. The objective of the current study was therefore to explore whether compositional cartilage changes can be observed in external femoral regions of these knees using laminar (deep/superficial layer) cartilage T2 times. Methods: From 4796 Osteoarthritis Initiative (OAI) participants, 84 had OPs but no JSN in one of their knees and no signs of radiographic OA (OPs or JSN) in the contralateral knee. Sagittal 3T multi-echo spin echo MRIs were only acquired in one of both knees (resolution: 0.31x0.31x3mm, repetition time: 2700ms, echo time: 10, 20, 30, 40, 50, 60, 70ms, 1st echo excluded from analysis) , whereas sagittal DESS MRIs for cartilage morphometry were available for both knees, Baseline MESE
MRIs were available in 32 knees with OPs (age: 60.2 ± 10.0 years, BMI: 27.6 ± 4.6, 56% female) and in 28 knees without OPs (age: 61.1 ± 9.4 years, BMI: 28.0 ± 5.0, 50% female) of the above cohort. One-year follow-up MESE MRIs were available in 24 knees with, and in 26 knees without OPs. Deep and superficial cartilage layer T2 times (each 50% of the cartilage thickness) were computed using a non-linear curve-fitting in external medial and lateral femoral subregions (ecMF/ecLF), in which greater cartilage thickness was previously reported in OP vs. non-OP knees based on the sagittal DESS MRIs. Baseline values and change in cartilage T2 times in the ecMF and ecLF were compared using t-tests. Results: The T2 times in the ecMF were slightly longer in the superficial and deep cartilage layer in knees with than in knees without OPs (Table), but the differences were not statistically significant (p0.18). Further, no significant differences (p0.88) were observed in the superficial or deep ecLF layer (Table). The one-year longitudinal change in superficial T2 in the ecLF differed significantly (p¼0.01) between knees with and without osteophytes; yet, this difference was primarily driven by a T2 decrease in knees without OPs (Table). The longitudinal T2 change in the ecMF tended to differ between knees with OPs (decrease) vs. those without OPs (increase), but again the difference failed to reach the significance level (p0.06, Table). Conclusions: T2 times in ecMF and the ecLF cartilage did not differ significantly between knees with early signs of radiographic OA (OPs, but no JSN) and those without signs of radiographic OA (no OPs and no JSN). Although the study had a limited sample size, the current results do not support the hypothesis that thicker cartilage in external (medial and lateral) femoral subregions of knees with early radiographic OA is associated with compositional cartilage alterations that can be detected using T2 relaxation time analyses. 389 QUANTITATIVE CARTILAGE THICKNESS CHANGE SURGICAL AND VIRTUAL KNEE REPLACEMENT COMPARATIVE ANALYSIS USING DATA FROM THE OAI
PRECEDING STATUS e
F. Eckstein y, z, M.J. Hannon x, T. Fujii k, R.M. Boudreau k, W. Wirth y, z, S. Maschek y, z, A. Guermazi ¶, #, F.W. Roemer yy, #, M. Nevitt zz, C. Ladel xx, L. Sharma kk, D.J. Hunter ¶¶, C.K. Kwoh ##. y Paracelsus Med. Univ., Salzburg, Austria; z Chondrometrics Gmbh, Ainring, Germany; x Univ. of Pittsburgh Sch. of Med., Pittsburgh, PA, USA; k Univ. of Pittsburgh Graduate Sch. of Publ. Hlth., Pittsburgh, PA, USA; ¶ Boston Univ. Sch. of Med., Boston, MA, USA; # Boston Imaging Core Lab, Boston, MA, USA; yy Univ. of Erlangen, Erlangen, Germany; zz Univ. of California, San xx Merck KGaA, Darmstadt, Germany; Francisco, CA, USA; kk Northwestern Univ., Chicago, IL, USA; ¶¶ Univ. of Sydney, Sydney, ## Univ. of Arizona Coll. of Med., Tuscon, AZ, USA Australia; Purpose: Quantitative cartilage loss was found to be greater in knees prospectively undergoing surgical (sKRþ), or reaching virtual knee replacement status as defined by symptoms only (vKRþ), than in matched controls (sKR-/vKR-). These findings suggest that cartilage loss is related to clinical outcomes and is a useful (and validated) imaging biomarker for disease modifying OA drugs. However, magnitudes of cartilage loss in sKRþ and vKRþ cases, relative to controls and to radiographic change, have not been studied in parallel. The objective of this study hence was to examine the relationship between cartilage loss and surgical/virtual KR case/control status; 2) to compare discrimination of combined surgical/virtual KR vs. control
Baseline values and one-year change in laminar cartilage T2 times in knees with/without osteophytes
Osteophytes Mean Baseline cartilage T2 times (ms): ecMF Superficial layer 48.4 Deep layer 41.2 ecLF Superficial layer 47.3 Deep layer 43.0 One-year change in cartilage T2 times (ms): ecMF Superficial layer 0.5 Deep layer 0.4 ecLF Superficial layer 0.6 Deep layer 0.2
No Osteophytes
SD
95% CI
6.9 5.5 4.7 3.6
45.9 39.2 45.7 41.6
4.1 2.9 2.1 2.1
2.2 1.6 0.3 1.1
Difference
Mean
SD
95% CI
50.9 43.2 49.0 44.3
46.2 39.9 47.2 43.1
5.2 3.6 4.5 3.0
44.1 38.5 45.5 41.9
1.2 0.8 1.5 0.6
0.8 1.3 1.1 0.2
3.9 3.2 2.1 2.3
0.8 0.0 1.9 1.1
Mean
SD
95% CI
p-value
48.2 41.3 49.0 44.3
2.2 1.3 0.1 0.1
1.6 1.2 1.2 0.9
1.0 1.1 2.3 1.9
5.4 3.8 2.5 1.6
0.18 0.28 0.94 0.88
2.3 2.6 0.2 0.7
1.3 1.7 1.7 0.0
1.1 0.9 0.6 0.6
3.5 3.4 0.4 1.3
1.0 0.0 2.9 1.2
0.27 0.06 0.01 0.95