Regional dGEMRIC analysis in patients at risk of osteoarthritis provides additional information about activity related changes in cartilage structure

Abstract

Background

Previously, a positive effect of exercise on cartilage structure was indicated with delayed gadolinium-enhanced magnetic resonance imaging (MRI) of cartilage (dGEMRIC). However, in that study only one full-thickness region of interest (ROI) in the medial femoral condyle was analyzed.

Purpose

To improve the knowledge about exercise effects on cartilage structure by re-analyzing previous images with regional dGEMRIC analysis.

Material and Methods

Thirty patients (age range, 38–50 years) with a previous medial meniscus resection were divided into three groups according to self-reported change in physical activity (PA) level in a 4-month exercise intervention study: Group I (n = 11), increased PA level; Group II (n = 13), no change in PA level; and Group III (n = 6), reduced PA level. dGEMRIC index was analyzed at inclusion and after 4 months. Anterior (less load) and posterior (more load) ROIs of medial and lateral femoral condyles were analyzed, as well as superficial and deep cartilage regions.

Results

Group I increased the dGEMRIC index in the posterior cartilage (P = 0.004). The increase was larger in the lateral (P = 0.005) than the medial compartment in both superficial and deep cartilage regions. The dGEMRIC index did not change in Group II. In Group III, the dGEMRIC index decreased in the medial posterior cartilage (P = 0.03).

Conclusion

In patients with a previous medial meniscectomy, the beneficial effect of exercise varies between different locations within the joint, the largest improvement being observed in lateral posterior cartilage, i.e. the load-bearing cartilage in the compartment without a meniscus lesion. The effects of exercise do not seem to vary with cartilage depth.

Keywords

Cartilate osteoarthritis functional magnetic resonance imaging (fMRI)magnetic resonance diffusion/perfusion knee contrast agent intravenous

Get full access to this article

View all access options for this article.

References

Bashir

Gray

Hartke

. Nondestructive imaging of human cartilage glycosaminoglycan concentration by MRI. Magn Reson Med 1999; 41: 857–865.

Tiderius

Olsson

Leander

. Delayed gadolinium-enhanced MRI of cartilage (dGEMRIC) in early knee osteoarthritis. Magn Reson Med 2003; 49: 488–492.

Tiderius

Olsson

Nyquist

. Cartilage glycosaminoglycan loss in the acute phase after an anterior cruciate ligament injury: delayed gadolinium-enhanced magnetic resonance imaging of cartilage and synovial fluid analysis. Arthritis Rheum 2005; 52: 120–127.

Tiderius

Svensson

Leander

. dGEMRIC (delayed gadolinium-enhanced MRI of cartilage) indicates adaptive capacity of human knee cartilage. Magn Reson Med 2004; 51: 286–290.

Heinegard

Johnell

Lidgren

. The Bone and Joint Decade 2000–2010. Acta Orthop Scand 1998; 69: 219–220.

Maroudas

Venn

. Chemical composition and swelling of normal and osteoarthrotic femoral head cartilage. II. Swelling. Ann Rheum Dis 1977; 36: 399–406.

Maroudas

Bayliss

Venn

. Further studies on the composition of human femoral head cartilage. Ann Rheum Dis 1980; 39: 514–523.

Allen

Denham

Swan

. Late degenerative changes after meniscectomy. Factors affecting the knee after operation. J Bone Joint Surg Br 1984; 66: 666–671.

Roos

Lauren

Adalberth

. Knee osteoarthritis after meniscectomy: prevalence of radiographic changes after twenty-one years, compared with matched controls. Arthritis Rheum 1998; 41: 687–693.

10.

Tapper

Hoover

. Late results after meniscectomy. J Bone Joint Surg Am 1969; 51: 517–526.

11.

Neuman

Tjornstrand

Svensson

. Longitudinal assessment of femoral knee cartilage quality using contrast enhanced MRI (dGEMRIC) in patients with anterior cruciate ligament injury–comparison with asymptomatic volunteers. Osteoarthritis Cartilage 2011; 19: 977–983.

12.

Lohmander

Englund

Dahl

. The long-term consequence of anterior cruciate ligament and meniscus injuries: osteoarthritis. Am J Sports Med 2007; 35: 1756–1769.

13.

Owman

Tiderius

Neuman

. Association between findings on delayed gadolinium-enhanced magnetic resonance imaging of cartilage and future knee osteoarthritis. Arthritis Rheum 2008; 58: 1727–1730.

14.

Roos

Dahlberg

. Positive effects of moderate exercise on glycosaminoglycan content in knee cartilage: a four-month, randomized, controlled trial in patients at risk of osteoarthritis. Arthritis Rheum 2005; 52: 3507–3514.

15.

Burstein

Velyvis

Scott

. Protocol issues for delayed Gd(DTPA)(2-)-enhanced MRI (dGEMRIC) for clinical evaluation of articular cartilage. Magn Reson Med 2001; 45: 36–41.

16.

Hawezi

Lammentausta

Svensson

. In vivo transport of Gd-DTPA(2-) in human knee cartilage assessed by depth-wise dGEMRIC analysis. J Magn Reson Imaging 2011; 34: 1352–1358.

17.

Prasad

. Would sub-regional analysis improve sensitivity in knee dGEMRIC? J Mol Imag Dynamic 2012; 2: 105–105.

18.

Gandy

Dieppe

Keen

. No loss of cartilage volume over three years in patients with knee osteoarthritis as assessed by magnetic resonance imaging. Osteoarthritis Cartilage 2002; 10: 929–937.

19.

Tiderius

Hori

Williams

. dGEMRIC as a function of BMI. Osteoarthritis Cartilage 2006; 14: 1091–1097.

20.

Abramoff

Magalhães

Ram

. Image processing with ImageJ. Biophotonics International 2004; 11: 36–42.

21.

Van Ginckel

Baelde

Almqvist

. Functional adaptation of knee cartilage in asymptomatic female novice runners compared to sedentary controls. A longitudinal analysis using delayed Gadolinium Enhanced Magnetic Resonance Imaging of Cartilage (dGEMRIC). Osteoarthritis Cartilage 2010; 18: 1564–1569.

22.

Kiviranta

Tammi

Jurvelin

. Moderate running exercise augments glycosaminoglycans and thickness of articular cartilage in the knee joint of young beagle dogs. J Orthop Res 1988; 6: 188–195.

23.

Haapala

Arokoski

Hyttinen

. Remobilization does not fully restore immobilization induced articular cartilage atrophy. Clin Orthop Relat Res 1999; 362: 218–229.

24.

Dumond

Presle

Pottie

. Site specific changes in gene expression and cartilage metabolism during early experimental osteoarthritis. Osteoarthritis Cartilage 2004; 12: 284–295.

25.

Fernandes

Martel-Pelletier

Lascau-Coman

. Collagenase-1 and collagenase-3 synthesis in normal and early experimental osteoarthritic canine cartilage: an immunohistochemical study. J Rheumatol 1998; 25: 1585–1594.

26.

Pfander

Swoboda

Kirsch

. Expression of early and late differentiation markers (proliferating cell nuclear antigen, syndecan-3, annexin VI, and alkaline phosphatase) by human osteoarthritic chondrocytes. Am J Pathol 2001; 159: 1777–1783.

27.

Siversson

Tiderius

Neuman

. Repeatability of T1-quantification in dGEMRIC for three different acquisition techniques: two-dimensional inversion recovery, three-dimensional look locker, and three-dimensional variable flip angle. J Magn Reson Imaging 2010; 31: 1203–1209.