Magnetic resonance imaging (MRI)-defined cartilage degeneration and joint pain are associated with poor physical function in knee osteoarthritis - the Oulu Knee Osteoarthritis study

P Kaukinen; J Podlipská; A Guermazi; J Niinimäki; P Lehenkari; F W Roemer; M T Nieminen; J M Koski; S Saarakkala; J P A Arokoski

doi:10.1016/j.joca.2017.07.002

Magnetic resonance imaging (MRI)-defined cartilage degeneration and joint pain are associated with poor physical function in knee osteoarthritis - the Oulu Knee Osteoarthritis study

Osteoarthritis Cartilage. 2017 Nov;25(11):1829-1840. doi: 10.1016/j.joca.2017.07.002. Epub 2017 Jul 8.

Authors

P Kaukinen¹, J Podlipská², A Guermazi³, J Niinimäki⁴, P Lehenkari⁵, F W Roemer⁶, M T Nieminen⁷, J M Koski⁸, S Saarakkala⁹, J P A Arokoski¹⁰

Affiliations

¹ Institute of Clinical Medicine, University of Eastern Finland, Kuopio, Finland; Department of Physical and Rehabilitation Medicine, Kuopio University Hospital, Kuopio, Finland. Electronic address: paivi.kaukinen@kuh.fi.
² Research Unit of Medical Imaging, Physics and Technology, University of Oulu, Oulu, Finland. Electronic address: Jana.Podlipska@oulu.fi.
³ Quantitative Imaging Center, Department of Radiology, Boston University School of Medicine, Boston, MA, USA. Electronic address: Ali.Guermazi@bmc.org.
⁴ Research Unit of Medical Imaging, Physics and Technology, University of Oulu, Oulu, Finland; Department of Diagnostic Radiology, Oulu University Hospital and University of Oulu, Oulu, Finland. Electronic address: jaakko.niinimaki@oulu.fi.
⁵ Department of Anatomy, University of Oulu, Oulu, Finland; Department of Surgery, Medical Research Center, Oulu University Hospital, Oulu, Finland. Electronic address: petri.lehenkari@oulu.fi.
⁶ Quantitative Imaging Center, Department of Radiology, Boston University School of Medicine, Boston, MA, USA; Department of Radiology, University of Erlangen-Nuremberg, Erlangen, Germany. Electronic address: frank.roemer@uk-erlangen.de.
⁷ Research Unit of Medical Imaging, Physics and Technology, University of Oulu, Oulu, Finland; Medical Research Center, University of Oulu and Oulu University Hospital, Finland. Electronic address: miika.nieminen@oulu.fi.
⁸ Department of Internal Medicine, Mikkeli Central Hospital, Mikkeli, Finland. Electronic address: f.koski@fimnet.fi.
⁹ Research Unit of Medical Imaging, Physics and Technology, University of Oulu, Oulu, Finland; Department of Diagnostic Radiology, Oulu University Hospital and University of Oulu, Oulu, Finland; Medical Research Center, University of Oulu and Oulu University Hospital, Finland. Electronic address: Simo.Saarakkala@oulu.fi.
¹⁰ Department of Physical and Rehabilitation Medicine, Helsinki University Hospital, Helsinki, Finland; University of Helsinki, Helsinki, Finland. Electronic address: jari.arokoski@hus.fi.

PMID: 28698105
DOI: 10.1016/j.joca.2017.07.002

Abstract

Objective: The main aim was to investigate the associations between Magnetic Resonance Imaging (MRI)-defined structural pathologies of the knee and physical function.

Design: A cohort study with frequency matching on age and sex with eighty symptomatic subjects with knee pain and suspicion or diagnosis of knee osteoarthritis (OA) and 57 asymptomatic subjects was conducted. The subjects underwent knee MRI, and the severity of structural changes was graded by MRI Osteoarthritis Knee Score (MOAKS) in separate knee locations. WOMAC function subscores were recorded and physical function tests (20-m and 5-min walk, stair ascending and descending, timed up & go and repeated sit-to-stand tests) performed. The association between MRI-defined structural pathologies and physical function tests and WOMAC function subscores were evaluated by linear regression analysis with adjustment for demographic factors, other MRI-features and pain with using effect size (ES) as a measure of the magnitude of an association.

Results: Cartilage degeneration showed significant association with poor physical performance in TUG-, stair ascending and descending-, 20-m- and 5-min walk-tests (ESs in the subjects with cartilage degeneration anywhere between 0.134 [95%CI 0.037-0.238] and 0.224 [0.013-0.335]) and with increased WOMAC function subscore (ES in the subjects with cartilage degeneration anywhere 0.088 [0.012-0.103]). Also, lateral meniscus maceration and extrusion were associated with poor performance in stair ascending test (ESs 0.067 [0.008-0.163] and 0.077 [0.012-0.177]).

Conclusions: After adjustments cartilage degeneration was associated with both decreased self-reported physical function and poor performance in the physical function tests. Furthermore, subjects with lateral meniscus maceration and extrusions showed significantly worse performance in stair ascending tests.

Keywords: Disability; Magnetic resonance imaging; Osteoarthritis; Pain.

MeSH terms

Aged
Arthralgia / physiopathology
Cartilage, Articular / diagnostic imaging*
Cohort Studies
Female
Humans
Knee Joint / diagnostic imaging*
Magnetic Resonance Imaging
Male
Menisci, Tibial / diagnostic imaging
Middle Aged
Osteoarthritis, Knee / diagnostic imaging*
Osteoarthritis, Knee / physiopathology
Severity of Illness Index
Walk Test