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<p>Knee flexion contracture (FC), or loss of passive knee extension (KE), is common in knee osteoarthritis (OA) and linked to worse pain, function, and earlier joint replacement. Its relationship with structural progression over time on magnetic resonance imaging (MRI) remains unclear. This study evaluated whether baseline loss of knee extension was associated with longitudinal structural changes on MRI. A retrospective cohort analysis was conducted using data from 1018 participants (1131 knees) from an Osteoarthritis Initiative (OAI) sub-cohort. Baseline KE was measured using a goniometer. Structural changes were assessed annually over four years using the MRI Osteoarthritis Knee Score (MOAKS). Associations between baseline KE loss and longitudinal MOAKS outcomes were evaluated using ANCOVA, adjusting for demographic, radiographic and clinical covariates. Baseline KE loss correlated with subsequent worsening of MOAKS-evaluated pathologies in central structures, including meniscal hypertrophy (Year 1 [<i>p</i> = 0.001]; Year 4 [<i>p</i> = 0.042]), medial meniscal extrusion (Year 3 [<i>p</i> = 0.02]; Year 4 [<i>p</i> = 0.03]), lateral meniscal extrusion (Year 4 [<i>p</i> = 0.04]), and larger tibial bone marrow lesion (BML) size (Year 3 [<i>p</i> = 0.01]). Baseline KE loss also correlated with improved MOAKS scores in anterior and central structures, with reduced lateral meniscal extrusion (Year 3 [<i>p</i> = 0.004]; Year 4 [<i>p</i> = 0.046]), tibial BML size (Year 1 [<i>p</i> = 0.03]; Year 2 [<i>p</i> = 0.02]; Year 4 [<i>p</i> = 0.015]), tibial BML number (Year 2 [<i>p</i> = 0.006]; Year 4 [<i>p</i> = 0.01]), and tibial cystic BML percentage (Year 1 [<i>p</i> = 0.04]; Year 2 [<i>p</i> = 0.01]; Year 4 [<i>p</i> = 0.01]) and femur (Year 2 [<i>p</i> = 0.01]). Baseline KE was associated with structural changes in knee OA over four years including worse central meniscal scoring, but better BML scores and meniscal extrusion in the anterior compartments. Lost KE in those with OA may predict longitudinal patterns of regional structural progression.</p>

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Baseline loss of knee extension is associated with regional MRI progression in knee osteoarthritis: a retrospective longitudinal cohort study—data from the osteoarthritis initiative

  • 期刊论文

  • 发表日期：

    2025年10月23日

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  • Daniel Chan Chun Kong,
  • Philip G. Conaghan,
  • T. Mark Campbell

摘要

Knee flexion contracture (FC), or loss of passive knee extension (KE), is common in knee osteoarthritis (OA) and linked to worse pain, function, and earlier joint replacement. Its relationship with structural progression over time on magnetic resonance imaging (MRI) remains unclear. This study evaluated whether baseline loss of knee extension was associated with longitudinal structural changes on MRI. A retrospective cohort analysis was conducted using data from 1018 participants (1131 knees) from an Osteoarthritis Initiative (OAI) sub-cohort. Baseline KE was measured using a goniometer. Structural changes were assessed annually over four years using the MRI Osteoarthritis Knee Score (MOAKS). Associations between baseline KE loss and longitudinal MOAKS outcomes were evaluated using ANCOVA, adjusting for demographic, radiographic and clinical covariates. Baseline KE loss correlated with subsequent worsening of MOAKS-evaluated pathologies in central structures, including meniscal hypertrophy (Year 1 [p = 0.001]; Year 4 [p = 0.042]), medial meniscal extrusion (Year 3 [p = 0.02]; Year 4 [p = 0.03]), lateral meniscal extrusion (Year 4 [p = 0.04]), and larger tibial bone marrow lesion (BML) size (Year 3 [p = 0.01]). Baseline KE loss also correlated with improved MOAKS scores in anterior and central structures, with reduced lateral meniscal extrusion (Year 3 [p = 0.004]; Year 4 [p = 0.046]), tibial BML size (Year 1 [p = 0.03]; Year 2 [p = 0.02]; Year 4 [p = 0.015]), tibial BML number (Year 2 [p = 0.006]; Year 4 [p = 0.01]), and tibial cystic BML percentage (Year 1 [p = 0.04]; Year 2 [p = 0.01]; Year 4 [p = 0.01]) and femur (Year 2 [p = 0.01]). Baseline KE was associated with structural changes in knee OA over four years including worse central meniscal scoring, but better BML scores and meniscal extrusion in the anterior compartments. Lost KE in those with OA may predict longitudinal patterns of regional structural progression.