2025 ISAKOS Biennial Congress ePoster
Relationship Between Patient-Reported Outcome Measures (Proms) And Mri Abnormalities In Early Knee Osteoarthritis
Kentaro Fujita, MD JAPAN
Yasushi Takata, MD, PhD, Kanazawa, Ishikawa JAPAN
Tomoyuki Kanayama, MD, Kanazawa, Ishikawa JAPAN
Yoshihiro Ishida, MD, Kahoku-Gun, Ishikawa JAPAN
Naoki Takemoto, MD, Kanazawa, Ishikawa JAPAN
Manase Nishimura, MD, Kanazawa, Ishikawa JAPAN
Takuya Sengoku, PT, PhD, Kanazawa JAPAN
Yushin Mizuno, MSc, PT, Kanazawa, Ishikawa JAPAN
Junsuke Nakase, MD, PhD, Kanazawa, Ishikawa JAPAN
Department of Orthopaedic Surgery, Kanazawa University Hospital,, Kanazawa, Ishikawa, JAPAN
FDA Status Not Applicable
Summary
Medial meniscus tears, synovitis/effusion, and bone marrow lesions detected by MRI are significantly associated with Knee Injury and Osteoarthritis Outcome Score (KOOS) in patients with early knee osteoarthritis (KOA). Early treatment targeting these MRI lesions might be important to prevent KOA progression.
ePosters will be available shortly before Congress
Abstract
Introduction
Early knee osteoarthritis (KOA) is characterized by the presence of knee symptoms without definitive radiographic abnormalities, typically classified as Kellgren-Lawrence (KL) grade < 2. Recent studies have reported the importance of using MRI to understand the pathology of early KOA, aiming to improve early diagnosis and treatment of KOA. However, the relationship between MRI abnormalities and clinical knee symptoms in early KOA remains unclear. This study aimed to assess the association between MRI abnormalities and the Knee Injury and Osteoarthritis Outcome Score (KOOS) in patients with early KOA classified as KL grade 0 or 1.
Methods
This nonrandomized, prospective, multicenter clinical trial included 157 patients with medial knee pain who were diagnosed with KL grade 0 or 1 based on plain radiographs and underwent MRI between 2018 and 2023. The MRI abnormalities included cartilage abnormalities, bone marrow lesions (BMLs), subchondral bone cysts (BMC), subchondral bone attrition (SBA), osteophytes, synovitis/effusion, medial meniscus tears, medial meniscus extrusion (MME), and medial collateral ligament (MCL) bursitis. The Mann-Whitney U test was used to compare the mean values of each of the five KOOS subscales between two groups, categorized by the presence or absence of each MRI lesion. Furthermore, we performed a multiple regression analysis using each of the five KOOS subscales as an outcome variable, with age, body mass index, and MRI lesions, which were significantly different in the Mann-Whitney U test, as explanatory variables. Statistical significance was set at p <0.05.
Results
There were 63 male and 94 female patients, with a mean age of 59.1 ± 11.7 years. The prevalence of cartilage abnormalities was observed in 148 cases (94.2%), BMLs in 67 cases (42.7%), BMC in 29 cases (18.5%), SBA in 93 cases (59.2%), osteophytes in 118 cases (75.2%), medial meniscus tears in 131 cases (83.4%), synovitis/effusion in 122 cases (77.7%), MME in 108 cases (68.8%), and MCL bursitis in 115 cases (73.3%). The Mann-Whitney U test showed that patients with BMLs had significantly lower scores on the KOOS Pain (p=0.004) and KOOS ADL (p=0.027). Patients with medial meniscus tears had significantly lower scores on the KOOS Symptom (p=0.007) KOOS Pain (p=0.0001), KOOS ADL (p=0.003), KOOS Sports(p=0.043), KOOS QOL(p=0.004). Patients with synovitis/effusion had significantly lower scores on the KOOS Symptom (p=0.017), KOOS ADL(p=0.032). Patients with MME had significantly lower scores on the KOOS Symptom (p=0.022), KOOS Pain(p=0.048). Multiple regression analysis showed that age (p=0.015) and synovitis/effusion (p=0.039) were significant factors related to KOOS Symptoms. Medial meniscus tears (p=0.001) and BML (p=0.009) were significantly associated with KOOS Pain. Medial meniscus tears was significantly related to KOOS ADL (p=0.04) and KOOS Sports (p=0.024). Medial meniscus tears (p=0.003) and age (p=0.047) were associated with KOOS QOL.
Conclusion
Medial meniscus tears, synovitis/effusion, and BML were associated with KOOS. Early treatment targeting these lesions might be key in preventing the progression of KOA.