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Change in MRI-Detected subchondral bone marrow lesions is associated with cartilage loss – the MOST study A longitudinal multicenter study of knee osteoarthritis
  1. Frank W Roemer (f.w.roemer{at}gmx.de)
  1. Boston University Medical Center, United States
    1. Ali Guermazi (ali.guermazi{at}bmc.org)
    1. Boston University Medical Center, United States
      1. M Kassim Javaid (mkj{at}mrc.soton.ac.uk)
      1. Botnar Research Centre, University of Oxford, United Kingdom
        1. John A Lynch (jlynch{at}psg.ucsf.edu)
        1. University of California San Francisco, United States
          1. Jingbo Niu (niujp{at}bu.edu)
          1. Boston University School of Medicine, United States
            1. Yuqing Zhang (yuqing{at}bu.edu)
            1. Boston University School of Medicine, United States
              1. David T Felson (dfelson{at}bu.edu)
              1. Boston University School of Medicine, United States
                1. Cora E Lewis (clewis{at}dopm.uab.edu)
                1. University of Alabama, Birmingham, United States
                  1. James Torner (james-torner{at}uiowa.edu)
                  1. University of Iowa, United States
                    1. Michael C Nevitt (mnevitt{at}psg.ucsf.edu)
                    1. University of California San Francisco, United States

                      Abstract

                      Objective: (1) To describe the natural history of subchondral bone marrow lesions (BMLs) in a sample of subjects with knee osteoarthritis (OA) or at risk of developing it. (2) To examine the association of change in BMLs from baseline (BL) to 30-month follow-up (FU) with the risk of cartilage loss in the same subregion at FU.

                      Methods: 1.0T MRI was performed using proton density-weighted fat-suppressed sequences. BML size and cartilage status were scored in the same subregions according to the WORMS system. Subregions were categorized based on comparison of BL and FU BML status. A logistic regression model was used to assess the association of change in BML status with cartilage loss over 30 months using stable BMLs as the reference group.

                      Results: 395 knees were included. 66% of prevalent BMLs changed in size; 50% showed either regression or resolution at FU. The adjusted odds ratios [95% confidence intervals] of cartilage loss in the same subregion at FU for the different groups were 1.2 [0.5,1.6] for regressing BMLs, 0.9 [0.5,1.6] for resolving BMLs, 2.8 [1.5,5.2] for progressing BMLs, 0.2 [0.1,0.3] for subregions with no BMLs at BL and FU, and 3.5 [2.1,5.9] for newly developing BMLs. BML size at baseline was associated with risk of subsequent cartilage loss.

                      Conclusions: The majority of pre-existing BMLs decreased in size at FU. Absence of BMLs was associated with a decreased risk of cartilage loss while progressing and new BMLs showed a high risk of cartilage loss in the same subregion.

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