RESEARCH - Bone marrow lesions predict increase in knee cartilage defects and loss of cartilage volume in middle-aged women without knee pain over 2 years

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Ann Rheum Dis. Published Online First: 14 July 2008. doi:10.1136/ard.2008.092221

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Extended Report

Bone Marrow Lesions predict increase in knee cartilage defects and

loss of cartilage volume in middle-aged women without knee pain over 2

years

Anita E Wluka 1*, Fahad S Hanna 1, Miranda Davies-Tuck 2, Yuanyuan

Wang 2, Robin J Bell 2, R. 2, 2 and Flavia M.

Cicuttini 2

1 Monash University Medical School and Baker Heart Research Institute, Australia

2 Monash University Medical School, Australia

Abstract

Objective: Bone Marrow Lesions (BMLs) are important in established

knee osteoarthritis (OA), predicting pain and progression of disease.

Whether BMLs are also associated with longitudinal changes in knee

structure in an asymptomatic population is unknown.

Methods: 148 healthy pain free women in middle age with no history of

knee injury or clinical knee OA who had an MRI performed on their

dominant knee at baseline, had another MRI 2 years later to assess

whether having a BML present at baseline affected change in

tibiofemoral cartilage defects and tibial cartilage volume.

Results: BMLs were present in 14.9% of women at baseline. The risk of

progression of total tibiofemoral cartilage defects was significantly

higher where a very large BML was present (OR 5.55, 95% CI 1.04, 29.6)

compared to where no BML was present, after adjusting for potential

confounders. In the lateral compartment, the rate of cartilage volume

loss was significantly greater where a BML was present after adjusting

for confounders (Regression coefficient 39.2 mm3 95% CI 11.1, 67.2, p

= 0.007).

Conclusions: In healthy women without pain at baseline, large BMLs

were associated with both progression of cartilage defects in the

whole tibiofemoral joint and more rapid lateral tibial cartilage loss.

These data suggest that the relationship between BMLs and knee

cartilage in healthy women is similar to that described in established

OA. It is possible that BMLs may predict increased risk of knee OA,

and facilitate the identification of novel interventions to prevent

disease.

http://ard.bmj.com/cgi/content/abstract/ard.2008.092221v1?papetoc

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