Unicompartmental versus bicompartmental joint space width measures: Which reflect whole joint structural damage better? Data from IMI-APPROACH
Osteoarthritis and Cartilage, vol. 34, pp. 297–303
Abstract
OBJECTIVE: To investigate the associations between whole joint cartilage and meniscal morphology on MRI and radiographic joint space width (JSW) measures and in knee osteoarthritis (KOA), to determine whether bicompartmental measures demonstrate stronger associations than unicompartmental ones, and to evaluate their correlations with Kellgren and Lawrence grading. DESIGN: A cross-sectional analysis of baseline radiographs and MRIs from 262 KOA participants in the prospective, multicenter IMI-APPROACH cohort was conducted. Radiographic measures included minimum joint space width (mJSW), fixed location JSW (JSW(x)), mean JSW, and joint line convergence angle (JLCA), assessed using fully automated software. JSW was evaluated both unicompartmentally and bicompartmentally. Cartilage morphology, full-thickness cartilage loss, meniscal extrusion, tears, and maceration were assessed using the semi-quantitative MRI Osteoarthritis Knee Score to summarize whole-joint cartilage and meniscal morphology. Associations of radiographic measures with MRI outcomes were assessed using multivariable linear regression; Spearman correlations with Kellgren and Lawrence (KL) were also evaluated. RESULTS: MRI-defined meniscal maceration was associated with unicompartmental and bicompartmental JSW measures. Full-thickness cartilage loss was associated with unicompartmental (95% CI [-0.16;-0.02]) and bicompartmental mJSW (95% CI [-0.14;-0.02]), and JLCA (95% CI [0.04;0.22]). Models explained 32-39% of variance for unicompartmental and 23-45% for bicompartmental measures (R²). Bicompartmental measures showed stronger correlations with KL grading than unicompartmental measures (95% CI: -0.31 to -0.02). CONCLUSIONS: Associations between whole-joint cartilage and meniscal degeneration are similar for uni- and bicompartmental JSW, with bicompartmental JSW showing stronger correlations with KL grades. These findings support including both compartments in radiographic assessment to improve structural evaluation in KOA.
Authors 13
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Eva Bax corresponding
University Medical Center Utrecht
Affiliation as printed
Department of Orthopaedic surgery, University Medical Center Utrecht, the Netherlands. Electronic address: e.a.bax-2@umcutrecht.nl
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Roel J.H. Custers corresponding
University Medical Center Utrecht
Affiliation as printed
Department of Orthopaedic surgery, University Medical Center Utrecht, the Netherlands. Electronic address: r.j.h.custers@umcutrecht.nl
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Nienke van Egmond corresponding
University Medical Center Utrecht
Affiliation as printed
Department of Orthopaedic surgery, University Medical Center Utrecht, the Netherlands. Electronic address: n.vanegmond@umcutrecht.nl
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Moyo C. Kruyt corresponding
University Medical Center Utrecht
Affiliation as printed
Department of Orthopaedic surgery, University Medical Center Utrecht, the Netherlands. Electronic address: m.c.kruyt@umcutrecht.nl
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Hassan Rayegan corresponding
Bozorgmehr University of Qaenat
Affiliation as printed
Department of Mechanical Engineering, Bozorgmehr University of Qaenat, Iran. Electronic address: HassanRayegan@buqaen.ac.ir
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Leiden University Medical Center
Affiliation as printed
Departments of Rheumatology, Clinical Epidemiology, Leiden University Medical Center, the Netherlands. Electronic address: g.kloppenburg@lumc.nl
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Francisco Javier Blanco corresponding
Universidade da Coruña · Instituto de Investigación Biomédica de A Coruña
Affiliation as printed
Grupo de Investigación de Reumatologia (GIR), INIBIC-Complejo Hospitalario Universitario de A Coruña, Centro Interdisciplinar de Quimica y Biologia, CICA-UDC, Universidad de A Coruña, Spain. Electronic address: fblagar@sergas.es
Grupo de Investigación de Reumatologia (GIR), INIBIC-Complejo Hospitalario Universitario de A Coruña, Centro Interdisciplinar de Quimica y Biologia, CICA-UDC. Universidad de A Coruña, Spain. Electronic address: fblagar@sergas.es
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Ida Kristin Haugen corresponding
Affiliation as printed
Center for Treatment of Rheumatic and Musculoskeletal Diseases (REMEDY), Diakonhjemmet Hospital, Norway. Electronic address: ida.haugen@diakonsyk.no
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Françis Berenbaum corresponding
Inserm · Sorbonne Université · Assistance Publique – Hôpitaux de Paris · Hôpital Saint-Antoine
Affiliation as printed
Department of Rheumatology, Sorbonne University, INSERM CRSA, AP-HP Saint-Antoine Hospital, France. Electronic address: francis.berenbaum@aphp.fr
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Frank W. Roemer corresponding
Boston University · Friedrich-Alexander-Universität Erlangen-Nürnberg · Universitätsklinikum Erlangen
Affiliation as printed
Department of Radiology, Universitätsklinikum Erlangen & Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), Germany; Department of Radiology, Boston University Chobanian & Avedisian School of Medicine, MA, USA. Electronic address: frank.roemer@uk-erlangen.de
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Harrie Weinans corresponding
University Medical Center Utrecht · Delft University of Technology
Affiliation as printed
Department of Orthopaedic surgery, University Medical Center Utrecht, the Netherlands; Department of Biomechanical Engineering, Faculty 3mE, TU Delft, the Netherlands. Electronic address: h.h.weinans@umcutrecht.nl
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S.C. Mastbergen corresponding
University Medical Center Utrecht
Affiliation as printed
Department of Rheumatology & Clinical Immunology, University Medical Center Utrecht, the Netherlands. Electronic address: s.mastbergen@umcutrecht.nl
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Mylène P. Jansen corresponding
University Medical Center Utrecht
Affiliation as printed
Department of Rheumatology & Clinical Immunology, University Medical Center Utrecht, the Netherlands. Electronic address: m.p.jansen-36@umcutrecht.nl
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