Does spontaneous cartilage thickening occur in osteoarthritic knees? Data from IMI-APPROACH and the OAI
Year: 2025
Type: article
Abstract: OBJECTIVE: Determine whether spontaneous cartilage thickening (i.e. without specific intervention) occurs in patients with or at high risk of knee osteoarthritis (OA) and compare characteristics with knees exhibiting cartilage thinning. DESIGN: 1447 knees from IMI-APPROACH and OAI with radiographic and MRI data at baseline, one year, and two years were included. Cartilage thickening was defined as an increase in both radiographic average whole-joint minimum joint space width (mJSW) and MRI mean cartilage thickness over the total femorotibial subchondral bone area (ThCtAB) according to per-patient fitted linear regression lines over the two-year period. Knees with decreases in both were categorized as thinning. Characteristics in structural and clinical parameters between both groups were compared. RESULTS: Cartilage thickening was observed in 203 knees (14%). Patients with thickening were younger (median 59 vs 64 years, p<0.001), more often female (69% vs 59%, p=0.011), and had lower KL grades (32% KL grade 0 or 1 vs 21%, p<0.001). Over two years, thickening knees showed an increase in mJSW (+0.11mm/year) and ThCtAB (+0.03mm/year) while thinning knees showed a decrease (-0.15mm/year and -0.05 mm/year, respectively). No significant differences were found in BMI or weight change. Fewer hyaluronic acid injections were observed during follow-up in the thickening group (p=0.045). Sensitivity analyses, using alternative definitions of thickening based on JSW and MRI thresholds, confirmed these findings. CONCLUSIONS: Spontaneous cartilage thickening occurs in a relevant proportion of knees with or at risk of knee OA. This intrinsic thickening warrants further investigation into the mechanisms and clinical relevance.
Source: Osteoarthritis and Cartilage
Institutions: Paracelsus Medical University, Utrecht University, University Medical Center Utrecht, Leiden University Medical Center, Universidade da Coruña, Servicio Gallego de Salud, Instituto de Investigación Biomédica de A Coruña, Diakonhjemmet Hospital, Inserm, Sorbonne Université, Assistance Publique – Hôpitaux de Paris, Hôpital Saint-Antoine
Language: English
Subfield: Rheumatology
Field: Medicine
Domain: Health Sciences
Open Access status: hybrid
Estimated APC paid: $3,700
Funders: U.S. Department of Health and Human Services, Amgen, Bristol-Myers Squibb, Eli Lilly and Company, Pfizer, AstraZeneca, GlaxoSmithKline, Sanofi, Celgene, Novartis Pharmaceuticals Corporation, CSL Behring, Merck KGaA, Zoetis, European Federation of Pharmaceutical Industries and Associations, Boehringer Ingelheim España, Innovative Health Initiative, European Commission, ZonMw, Nederlandse Organisatie voor Wetenschappelijk Onderzoek, Gedeon Richter, Servier, Novartis Farmacéutica, Sun Pharma, Nordic Pharma Group, National Institutes of Health, UCB US, Cilag
Awards: G1048107671, G1073258374, G1143620864, G1256772101, G1725953725, Clinical Centers for the Osteoarthritis Initiative, G2794021759, G2806376747, G2861369480, G2973790809, G3049869442, G3207356259, G3429939743, G3838259607, G390694876, G393177772, G3971452047, G409491633, Data Coordinating Center for the Osteoarthritis Initiative, Clinical Centers for the Osteoarthritis Initiative, G5646291224, G5654539734, G5702163051, G5716223526, G581468509, G604760239, G6470355408, Applied Public-Private Research enabling OsteoArthritis Clinical Headway, G659721583, G6954856633, G7825834944, Clinical Centers for the Osteoarthritis Initiative^Rhode Island, G7876590852, G8234285353, G8602293357, Clinical Centers for the Osteoarthritis Initiative, G8855321598, G897039181
OpenAlex ID: W4417072335