Longitudinal study of changes in tibial and femoral cartilage in knee osteoarthritis

Objective. Despite the increasing interest in knee cartilage volume as an outcome measure in studies of osteoarthritis (OA), it is unclear what components of knee cartilage will be most useful as markers of structural change in the tibiofemoral joint. This study was undertaken to longitudinally compare changes in femoral and tibial cartilage volume in patients with OA. Methods. One hundred seventeen patients with knee OA (58.1% women; mean +/- SD age 63.7 +/- 10.2 years) were examined. Femoral and tibial cartilage volumes (medial and lateral tibiofemoral joints) were determined from T1-weighted fat-saturated magnetic resonance images of the knee from coronal views. Results. The study population was followed up for a mean +/- SD of 1.9 +/- 0.2 years. In the medial tibiofemoral joint, the mean +/- SD loss of cartilage was 0.15 +/- 0.30 ml/year for femoral cartilage and 0.10 +/- 0.25 ml/year for tibial cartilage. In the lateral tibiofemoral joint, the average loss was 0.15 +/- 0.22 and 0.12 +/- 0.16 ml/year for femoral and tibial cartilage, respectively. There was a significant correlation between the degree of loss of tibial cartilage and the degree of loss of femoral cartilage, in both tibiofemoral joints (r = 0.81, P < 0.001 at the medial tibiofemoral joint; r = 0.71, P < 0.001 at the lateral tibiofemoral joint). Conclusion. Longitudinal changes in tibial cartilage and those in femoral cartilage are strongly related to one another. This suggests that in tibiofemoral disease, measuring tibial cartilage alone may be adequate, given the facts that measurements of the total femoral cartilage are less reproducible and there are difficulties inherent in identifying the most appropriate component of femoral cartilage to measure.