The progressive course of osteoarthritis is usually slow, noted Dr. Frank Roemer at Boston University Medical Center and the MOST study team note in the journal Radiology, scheduled for print publication in the September issue.
However, "it would be useful to identify a subgroup of patients with no or early disease who are at high risk for fast cartilage loss," the authors write. "Such patients would be ideal for testing new treatments and should have the greatest need for preventive maneuvers or treatments."
The goal of the MOST study was to identify predictors of fast tibiofemoral joint cartilage loss over 30 months in subjects with little or no structural osteoarthritis at baseline. Included were 347 knees in 336 subjects (mean age, 61 years; mean BMI, 29.5 kg/m2).
MRI of the knees showed that 74.1% had no cartilage loss, 20.2% exhibited slow cartilage loss, and 5.7% had rapid cartilage loss, the report indicates.
For each unit increase in BMI, Roemer's group found that the odds of fast cartilage loss increased by 11% (p = 0.04). Age, gender, and ethnicity did not affect the risk of fast cartilage loss.
Other strong indicators of fast cartilage loss were meniscal tears (adjusted OR, 3.19; p = 0.03) or extrusion (adjusted OR, 3.62; p = 0.01), synovitis or effusion (adjusted OR, 3.36; p = 0.07), and any high-grade MR-depicted feature (adjusted OR, 8.99; p < 0.001).
"Patients with these risk factors may be ideal subjects for preventative or treatment trials," Roemer and associates advise.
Last Updated: 2009-07-23 12:41:25 -0400 (Reuters Health)
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