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Weak associations between structural changes on MRI and symptoms, function and muscle strength in relation to knee osteoarthritis

  • Knee
  • Published:
Knee Surgery, Sports Traumatology, Arthroscopy Aims and scope

Abstract

Purpose

To explore associations between MRI-defined structural abnormalities and clinical features related to knee osteoarthritis (OA).

Methods

Structural and clinical knee OA features were assessed in 87 women (45 with knee OA symptoms). Structural features were quantified by the Kellgren and Lawrence grade on radiography and by the Boston-Leeds Osteoarthritis Knee Score on MRI. Clinical features were assessed using the Knee Injury and Osteoarthritis Outcome Score, functional tests and muscle strength measurements. Associations were examined using regression analyses.

Results

Limited significant associations between structural and clinical features were found. An increased meniscal signal was associated with more pain/symptoms (P < 0.027). An anterior cruciate ligament tear was associated with poorer stair climbing test performance (P = 0.045). In a stepwise linear regression model, patellofemoral cartilage integrity and pain explained 28 % of the isometric quadriceps strength variability. The amount of cartilage lesions, loose bodies and pain explained 38 % of the isokinetic quadriceps strength variability. Synovitis/effusion and patellofemoral cartilage integrity combined with pain explained 34 % of the isometric hamstring strength variability.

Conclusion

Although MRI-detected cartilage lesions, synovitis/effusion and loose bodies did explain part of the muscle strength variability, results suggest that MRI does not improve the link between joint degeneration and the clinical expression of knee OA. MRI contributes less than expected to the understanding of pain and function in knee OA and possibly offers little opportunity to develop structure-modifying treatments in knee OA that could influence the patient’s pain and function.

Level of evidence

Case series with no comparison groups, Level IV.

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Acknowledgments

We would like to thank S. Verweijen for her assistance in performing the clinical measurements, W. Vanhoef for the radiographic assessment and S. Ghysels for performing the MRI scans. We would also like to thank the ‘Leuven Biostatistics and Statistical Bioinformatics Centre’ for their statistical advice. This study was financially supported by the Fund for Scientific Research Flanders (FWO)—KN1.5.017.08.

Conflict of interest

The authors declare that they have no conflict of interest.

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Authors and Affiliations

  1. Department of Rehabilitation Sciences, Faculty of Kinesiology and Rehabilitation Sciences, KU Leuven, Tervuursevest 101, 3001, Heverlee, Belgium

    Isabel A. C. Baert, Filip Staes, Armaghan Mahmoudian & Sabine M. P. Verschueren

  2. Department of Health Care, Artesis University College of Antwerp, Antwerp, Belgium

    Isabel A. C. Baert & Steven Truijen

  3. Department of Rehabilitation Sciences and Physiotherapy, Faculty of Medicine and Health Sciences, University of Antwerp, Antwerp, Belgium

    Steven Truijen

  4. Division of Radiology, Faculty of Medicine, UZ Leuven, Leuven, Belgium

    Nathalie Noppe & Geert Vanderschueren

  5. Division of Rheumatology, UZ-KU Leuven, Leuven, Belgium

    Frank P. Luyten

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  1. Isabel A. C. Baert
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  2. Filip Staes
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  3. Steven Truijen
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  4. Armaghan Mahmoudian
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  5. Nathalie Noppe
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  6. Geert Vanderschueren
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  7. Frank P. Luyten
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  8. Sabine M. P. Verschueren
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Corresponding author

Correspondence to Sabine M. P. Verschueren.

Additional information

Frank P. Luyten and Sabine M. P. Verschueren share senior authorship.

Appendix

Appendix

See Table 6.

Table 6 Presence of structural abnormalities on MRI (BLOKS) in the study population
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Baert, I.A.C., Staes, F., Truijen, S. et al. Weak associations between structural changes on MRI and symptoms, function and muscle strength in relation to knee osteoarthritis. Knee Surg Sports Traumatol Arthrosc 22, 2013–2025 (2014). https://doi.org/10.1007/s00167-013-2434-y

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  • DOI: https://doi.org/10.1007/s00167-013-2434-y

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