Navigation Links
Meniscal damage and joint malalignment predictors of cartilage loss
Date:6/2/2008

Marked by cartilage and bone degradation, progressive knee osteoarthritis (OA) is believed to result in part from a combination of several local mechanical factors. Lack of joint stability, poor joint alignment and injuries to the disks of meniscal tissue that cushion the knee all affect load distribution and the toll to the vulnerable OA knee. However, in studies of knee OA progression, either meniscal damage or malalignment has been considered, but not both together, and no studies have included joint laxity.

Unlike radiographs, magnetic resonance imaging (MRI) can distinguish articular cartilage from meniscal tissue and detect the impact of specific factors on OA progression. Almost all studies of knee OA progression with MRI outcomes define cartilage loss with qualitative cartilage assessments. For a clearer picture of the role of various mechanical factors in knee OA, researchers at Northwestern University and Salzburg Univeristy applied quantitative measures of cartilage lossdecreases in cartilage volume and thickness and an increase in bare bone areaas well as cartilage integrity score. Their results, presented in the June 2008 issue of Arthritis & Rheumatism (www.interscience.wiley.com/journal/arthritis), indicate three factors that independently predict cartilage loss with a direct impact on knee OA: medial meniscal damage, lateral meniscal damage, and varus, or bow-legged, malalignment of the knee joint. Notably, quantitative cartilage loss outcome measures were more sensitive in revealing these relationships than previously applied qualitative approaches.

The study's participants, 153 women and men with radiographic evidence of knee OA, were recruited from local senior citizens groups and the registry of the Beuhler Center on Aging at Northwestern University. The mean age was 66 years and the mean BMI was 30. None of the subjects had a history of rheumatoid arthritis, gout, joint infection, or meniscectomy. A total of 251 osteoarthritic knees were thoroughly scanned with MRI and rigorously studied. Meniscal damage and meniscal extrusion were graded using the Whole-Organ MRI Score (WORMS). Varus-valgus alignment and medial-lateral laxity were also measured. Focusing separately on medial and lateral segments of tibial and weightbearing femur cartilage of the knee joint, cartilage volume, percentage of subchondral bone covered with cartilage, exposed subchondral bone area, and the average thickness of cartilage were measured using specialized software. Cartilage integrity was also scored. Two years later, the entire process was repeated. Odds ratios were determined for each of the four mechanical factors using logistic regression analysis, adjusting for age, sex, BMI, and the other factors.

Medial meniscal damage significantly increased the likelihood of cartilage volume loss, cartilage thickness decrease, and denuded bone increase in both the medial tibial and the medial weightbearing femoral segments. Similarly, lateral meniscal damage predicted quantitative cartilage loss in both the lateral tibial and the lateral weightbearing femoral segments. Varus malalignment was strongly associated with cartilage loss from each medial surface; valgus (knock-knee) malalignment was not associated with lateral surface loss. Meniscal extrusion and joint laxity had inconsistent effects. Using the qualitative cartilage assessment, however, no significant relationship with outcome was detected for either meniscal damage or malalignment.

Dr. Leena Sharma, the study's leading author and spokesperson, commented "It is important to note that local factors, such as those examined in this study, may participate in vicious circles with the worsening of knee OA. Whenever along the OA disease timeline a local impairment develops, it may contribute to subsequent OA progression and cartilage loss, especially given the vulnerable milieu of the already damaged OA knee. Ultimately, strategies that interrupt these vicious circles may be especially powerful."


'/>"/>

Contact: Sean Wagner
swagner@wiley.com
781-388-8550
Wiley-Blackwell
Source:Eurekalert

Related medicine news :

1. Meniscal damage and the development of persistent knee pain
2. New stem cell therapy may aid the repair of damaged brains
3. Miracle leaves that may help protect against liver damage
4. Acne Drug Prevents Tissue Damage From Emphysema
5. Muscle-derived stem cells prove effective in reparing sphincter damage to restore continence
6. Drug therapy for PKU reverses heart damage
7. Chemotherapy causes delayed severe neural damage
8. SEIU Seeks Damages for CNAs Effort to Silence Workers, Suppress Criticism of Anti-Union Tactics
9. Protecting Patient Images From Damage and Disaster
10. Mouth may tell the tale of lung damage caused by smoking
11. New Drug Protects Against Radiation Damage
Post Your Comments:
*Name:
*Comment:
*Email:
(Date:5/26/2017)... , ... May 26, 2017 , ... Yisrayl Hawkins, Pastor ... publication this week that is focusing on the Peace Agreements being discussed by President ... East sprint in a race to try to speed up peace talks in the ...
(Date:5/26/2017)... ... ... Lowe acts as host and helps educate and inform the public using the “Informed” ... reconnect with America as it explores some of the best places to hike and ... inventive new place for a family vacation, and have discovered hiking. Many will agree ...
(Date:5/26/2017)... ... May 26, 2017 , ... “When the Stars Lead Home”: ... the creation of published author Laura Weigel Douglas, an avid reader who lives in ... house that sometimes feels like Green Hills Adventure Camp. She couldn’t be more grateful. ...
(Date:5/26/2017)... ... May 26, 2017 , ... ... recipient of proceeds from its 14th Annual Clays for Kids fundraiser, to be ... 30, Bennett, Colorado. , As part of BluSky’s partnership with The Adoption ...
(Date:5/26/2017)... ... ... “Cactus Jack: Against All Odds”: the story of Coach Cactus Jack and the impact ... the creation of published author, Walter Hubbard, a retired wildlife and fisheries biologist and ... Walter. Walter and Jane have three adult children and a granddaughter. Walter ...
Breaking Medicine News(10 mins):
(Date:5/23/2017)... May 23, 2017  Leaf Healthcare, recognized for ... devices for pressure ulcer prevention, will unveil its ... of Critical Care Nurses, National Teaching Institute and ... The Leaf Patient Monitoring System is the ... hospital environment.  The system seamlessly tracks patient movement ...
(Date:5/22/2017)... , May 22, 2017  As the specialty ... whole continue to make the revolutionary shift from ... important for ensuring positive patient outcomes and shaping ... are shifting focus away from clinical trials and ... of long-term specialty drug therapy utilization in precise ...
(Date:5/18/2017)... , May 17, 2017  Bayer announced today that ... will be presented at the 53 rd Annual ... taking place June 2-6 in Chicago ... ASCO span prostate, colorectal, liver and thyroid cancers, as ... the Phase II CHRONOS-1 trial of copanlisib in patients ...
Breaking Medicine Technology: