A Pilot, Two-year Longitudinal Study of the Interrelationship Between Trabecular Bone and Articular Cartilage in the Osteoarthritic Knee

Objective: To examine the relationship between structural changes of trabecular bone and cartilage, in patients with varying degrees of osteoarthritis (OA) over 2 years, using magnetic resonance imaging.

Methods: High-resolution, axial images were acquired for assessing trabecular bone structure, using a 3-D fast gradient-echo sequence. High-resolution, fat-suppressed, sagittal images were acquired for assessing cartilage structure, using a 3-D spoiled gradient-echo sequence. In a subset of the patients, sagittal images were acquired for measuring T(2) relaxation time, using a 2-D dual-echo spin echo sequence.

Results: A large variation in bone and cartilage parameters is evident among individual subjects in each group, however, group-specific means demonstrate decreasing trends (in bone and cartilage parameters) in osteoarthritic subjects (especially in mild OA subjects). The mean T(2) increased significantly (P<0.05) between the baseline and follow-up exams for all cartilage compartments except the lateral tibia. A positive relationship was established between cartilage changes and localized bone changes closest to the joint line, while a negative relationship was established between cartilage changes and global bone changes farthest from the joint line.

Conclusion: This study quantifies the changes in bone and cartilage structural parameters over time, and demonstrates a longitudinal relationship between the morphological changes in bone and cartilage structure in patients with varying degrees of OA. Although a large variation of bone and cartilage changes is apparent among subjects, significant trends are evident in a relatively small sample size, with a short follow-up duration.