Author | Feature (method) | Structural progression outcome | Adjustment for confounders | Association (magnitude) crude | Association (magnitude) adjusted | Association | Quality (score %) |
---|---|---|---|---|---|---|---|
MRI bone marrow lesion - cohorts | Â | ||||||
Felson 2003 [70] | Baseline presence of BML in medial or lateral TFJ (C) | OARSI JSN grade progression of TFJ (L) | Age, sex, and BMI | NR | OR 6.5, | + | High (83) |
95 % CI 3.0 to 14.0 | |||||||
Dore 2010 [124] | Baseline semi-quantitative MRI BML size (C) TFJ | Incident TKR over 5 years (L) | Age, sex, BMI, knee baseline pain, leg strength, cartilage defects, tibial bone area, ROA | OR (95 % CI) | OR (95 % CI) | + | High (64) |
2.04 (1.55 to 2.69) | 2.10 (1.13 to 3.90) | ||||||
p <0.01 | p = 0.019 | ||||||
Driban 2013 [72] | Knee baseline BML volume (C) | 48-month change in OARSI JSN grade (L) | Age, sex, BMI | NR | Baseline BML volume | + | High (61) |
OR 1.27, 95 % CI 1.11 to 1.46 | |||||||
BML volume 48 month change (L) (TFJ) | (TFJ) | BML volume regression | |||||
OR 3.36, 95 % CI 1.55 to 7.28 | |||||||
Davies-Tuck 2010 [67] | Incident BML (new BML after 2 years with no BMLs at baseline) MRI TFJ (L) | Progression in semi-quantitative MRI cartilage defects score after 2 years. TFJ (L) | Age, gender, BMI, baseline cartilage volume | OR (95 % CI) | OR (95 % CI) | + | High (61) |
Medial TFJ | Medial TFJ | Association in the lateral TFJ and a trend in the medial TFJ | |||||
1.86 (0.70 to 4.93) p = 0.21 | 2.63 (0.93 to 7.44) p = 0.07 | ||||||
Lateral TFJ | Lateral TFJ | ||||||
3.0 (1.01 to 8.93) p = 0.05 | 3.13 (1.01 to 9.68) p = 0.05 | ||||||
Hochberg 2014 [44] | Semi-quantitative MRI baseline femoral condyle BML size (C) | Incident TKR over 6 years (L) | Age, gender, BMI, race, marital status, depressive symptoms, quality of life, mechanical pain, KL grade, clinical effusion. | Medial TFJ | Medial TFJ | + | High (61) |
p <0.0001 | p = 0.02 | ||||||
Raynauld 2011 [75] | Baseline semi-quantitative BML score (C) TFJ | Incidence of TKR over 3 years (L) | Age, sex, BMI, JSW, WOMAC, | NR | OR (95% CI) | + | High (61) |
BML medial plateau | |||||||
1.81 (1.08 to 2.03) | |||||||
p = 0.025 | |||||||
Raynauld 2013 [74] | Baseline semi-quantitative BML WORMS score (C) medial TFJ | Incident TKR (L) 4 year follow up | Age, BMI, gender WOMAC, CRP | NR | TKR incidence | + | High (61) |
OR (95 % CI) 2.107 (1.26 to 3.54) p = 0.005 time to TKR incidence hazard ratio (95% CI) 2.13 (1.38 to 3.30) p = 0.001 | |||||||
Time to TKR (L) | |||||||
Crema 2014 [71] | MRI BML (semi-quantitative) | Cartilage loss (semi-quantitative) | Age, gender, BMI | NR | β = 0.37 to 0.64 p <0.001 | + | High (56) |
(C) all regions | (L) (all regions) | ||||||
Guermazi 2014 Abstract [73] | Baseline semi-quantitative BML score WORMS (C) | Cartilage thickness loss over 30 months (L) | Age, sex, body mass index, and anatomical alignment axis (degrees) | NR | Combined BML score in the medial and lateral TFJ compartment | + | High (56) |
OR 1.9, 95 % CI 1.1 to 3.3 | |||||||
Scher 2008 [87] | Presence of any baseline semi-quantitative MRI BMLs (C) | Incident TKR (L) over 3 years | Age | NR | OR (95 % CI) | + | High (56) |
8.95 (1.49 to 53.68) | |||||||
p = 0.02 | |||||||
Sowers 2011 [28] | Semi-quantitative MRI BML, size in TFJ (C) | Progression in KL grade | Nil | R (95 % CI) medial tibia ~ 0.46 (0.35 to 0.55) | NR | + | Low (53) |
(11-year follow up) (L) | Lateral tibia ~0.23 (0.13 to 0.33) | ||||||
Kothari 2010 [82] | Semi-quantitative baseline MRI BML, (WORMS) (C) TFJ | Semi-quantitative cartilage defect score change over 2 years (WORMS) (L) TFJ. | Age, sex, BMI, other bone lesions | OR 4.04, | OR 3.75, | + | Low (50) |
95 % CI 2.25 to 7.26 | 95 % CI 1.59 to 8.82 | ||||||
Raynauld 2008 [85] | Change in BML size (mm) at 24 months in medial TFJ (L) | Medial cartilage volume (L) at 24 months in medial TFJ | Age, gender, BMI, meniscal extrusion and tear, pain and bone lesions at baseline | NR | Change in BML size with femoral cartilage volume loss | - | Low (50) |
Larger medial BML size means more cartilage loss in medial compartment | |||||||
β = −0.31 | |||||||
standard error (0.08) | |||||||
p = 0.0004 | |||||||
Roemer 2009 [90] | Change in MRI semi-quantitative BML size (WORMS) (L) TFJ and PFJ | Progression in semi-quantitative cartilage defects in (WORMS) over 30 months (L) TFJ and PFJ | Age, sex, BMI, baseline KL grade | NR | OR (95 % CI) | + | Low (50) |
Incident BML OR 3.5 (2.1 to 5.9) | |||||||
Progression of BML 2.8 (1.5 to 3.2) | |||||||
Resolution of BML OR 0.9 (0.5 to 1.6) | |||||||
Stable BML OR 1.0 (reference) | |||||||
Dore 2010 [76] | Baseline semi-quantitative BML severity (C) (medial and lateral TFJ) | Ipsi-compartmental annual Cartilage volume loss (L) | Age, sex, BMI, meniscal damage | NR | Baseline | - | Low (50) |
BML severity | Bigger BML means bigger volume loss | ||||||
β = −22.1 to −42.0, for all regions | |||||||
(p <0.05) | |||||||
Parsons 2014 Abstract [83] | Baseline semi-quantitative BML score (C) | Annual TFJ JSN (L) | Age, sex, baseline KL grade | NR | β = −0.10, 95 % CI | + | Low (50) |
−0.18 to | |||||||
−0.02 | |||||||
Wildi 2010 [95] | 24-month regional change in TFJ BML score WORMS (L) | 24-month regional change in cartilage volume (L) | nil | R correlation coefficients all <0.07 | NR | NC | Low (50) |
p >0.367 for all three compartments at 24 months | |||||||
Pelletier 2007 [84] | Regional Semi-quantitative baseline BML score (medial or lateral TFJ) (C) | Regional cartilage volume over 24 months (medial or lateral TFJ) (L) | NR | Lateral compartment BML score | NR | Â | Low (50) |
β = −0.31, p = 0.001 | |||||||
Driban 2011 [79] | Baseline BML volume (C) and 24 month change in BML volume (L) in TFJ compartments | 24-month change in full thickness cartilage lesion area (L) | Age, sex, body mass index | NR | Baseline BML volume r = 0.48, 95 % CI 0.20 to 0.69 | + | Low (50) |
Baseline femur BML volume with loss in ipsicompartmental full thickness cartilage lesion area. | |||||||
p <0.002 | |||||||
Tanamas 2010 [89] | Baseline semi-quantitative MRI BML size (C) TFJ | Cartilage volume change over 2 years (L) TFJ Incident TKR over 4 years | Age, sex, BMI, baseline tibial cartilage volume and bone area | R (95 % CI) | R (95 % CI) | + | Low (50) |
Total cartilage loss | Total cartilage loss | ||||||
0.61 (−0.11 to 1.33) | 1.09 (0.24, 1.93) | ||||||
OR (95 % CI) | OR (95 % CI) | ||||||
Incident TKR | Incident TKR | ||||||
1.55 (1.04 to 2.29) | 1.57 (1.04 to 2.35) | ||||||
 |  |  |  | p = 0.03 | p = 0.03 |  |  |
Madan-Sharma 2008 [93] | Baseline MRI semi-quantitative BML (C) TFJ | OARSI medial TFJ JSN grade progression over 2 years (L) TFJ | Age, sex, BMI, family effect | NR | 0.9 RR, | NA | Low (47) |
95 % CI 0.18 to 3.0 | |||||||
Tanamas 2010 [88] | Semi-quantitative change in MRI BML severity (C) | Incident TKR over 4 years (L) | Age, gender, KL grade | OR (95 % CI) | OR (95 % CI) | + | Low (47) |
Medial TFJ | Medial TFJ | Association in the medial TFJ but not in the lateral TFJ | |||||
1.72 | 1.99 | ||||||
(0.93 to 3.18) | (1.01 to 3.90) | ||||||
p = 0.08 | p = 0.05 | ||||||
Lateral TFJ | Lateral TFJ | ||||||
0.95 (0.48 to 1.88) | 0.96 (0.48 to 1.94) | ||||||
p = 0.89 | p = 0.91 | ||||||
Roemer 2012 [86] | Semi-quantitative BML (WORMS) TFJ and PFJ (C) | Semi-quantitative cartilage score 6-month progression TFJ and PFJ (L) | Age, sex, treatment, and BMI. | NR | BML TFJ OR 4.74, 95 % CI 1.14 to 19.5 | + | Low (44) |
p = 0.032 | BMLs and cartilage score correlate | ||||||
BML PFJ OR, 1.63 (0.67 to 3.92) | |||||||
Crema 2013 [78] | MRI incident BML (WORMS) | Progressive (30 month) semi-quantitative cartilage defect (WORMS) TFJ (L) | Age, sex, BMI, malalignment, meniscal disease | NR | OR (95 % CI) | + | Low (44) |
TFJ | Medial TFJ 7.6 | ||||||
(L) | (5.1 to 11.3) | ||||||
Lateral TFJ | |||||||
11.9 (6.2 to 23.0) | |||||||
Hernandez-Molina 2008 [81] | Crude presence of central BMLs on MRI (C) TFJ | Semi-quantitative cartilage defect (WORMS) (L) TFJ | Alignment, BMI, KL grade, sex, and age. | NR | Medial TFJ cartilage loss | + | Low (44) |
OR 6.1, | |||||||
95 % CI 1.0, 35.2 | |||||||
Koster 2011 [25] | Baseline BML presence (C) TFJ | Any progression in KL grade over 1 year (L) TFJ | Age, BMI | OR (95 % CI) | OR (95 % CI) | + | Low (44) |
6.01 (1.92 to 18.8) | 5.29 (1.64 to 17.1) | ||||||
p = 0.002 | p = 0.005 | ||||||
Hunter 2006 [91] | Change in MRI semi-quantitative BML score (L) TFJ | Change in semi-quantitative cartilage defect score (WORMS) (L) medial or lateral TFJ | Limb alignment | Ipsilateral cartilage loss | Ipsilateral cartilage loss | NA after adjustment | Low (44) |
β = 0.65 | β = 0.26 | ||||||
p = 0.003 | p = 0.16 | ||||||
Contralateral cartilage loss | Contralateral cartilage loss | ||||||
β = −0.27 | β = −0.16 | ||||||
p = 0.22 | p = 0.52 | ||||||
Roemer 2009 [94] | Baseline MRI BML crude presence or absence (WORMS) (L) TFJ | Semi-quantitative cartilage defect progression over 30 months (WORMS) (L) TFJ | Age, sex, race, BMI, alignment | OR (95 % CI) | OR (95 % CI) | NA | Low (44) |
Slow cartilage loss OR 1.74 (0.85 to 3.55) | Slow cartilage loss OR 1.79 (0.83 to 3.87) | ||||||
Fast cartilage loss OR 1.32 (0.37 to 4.78) | Fast cartilage loss OR 1.0 (0.24 to 4.10) | ||||||
Kubota 2010 [92] | MRI BML semi-quantitative volume score change over 6 months (L) TFJ | KL grade progression over 6 months (L) TFJ | Nil | BML score higher in KL progression group | NR | NC | Low (39) |
p = 0.044 | |||||||
Driban 2012 abstract [80] | MRI BML volume change (L) TFJ over 24 months | Change in cartilage thickness and denuded area of bone (L) TFJ over 24 months | Nil | Cartilage thickness | NR | + | Low (28) |
r = −0.34, p = 0.04 | |||||||
denuded bone | |||||||
r = 0.42, p = 0.01 | |||||||
Femoral cartilage indices p >0.05 | |||||||
Carrino 2006 [77] | Crude presence of MRI BML, TFJ (C) and (L) | Any grade of cartilage defect TFJ (C) and (L) | Nil | NR | NR | + | Low (22) |
MRI bone marrow lesion - cross-sectional studies | Â | ||||||
Baranyay 2007 [63] | MRI BML defined as large or not large/absent in the medial and lateral compartments of TFJ (C) | MRI semi-quantitative cartilage defects of medial and lateral compartments of TFJ (C) | Age, gender, BMI, cartilage volume or bone area | OR (95 % CI) | OR (95 % CI) | + | High (71 %) |
Quantitative cartilage volume medial and lateral TFJ (C) | Cartilage defect Medial TFJ | Cartilage defect Medial TFJ | Cartilage defects | ||||
1.81 (1.26 to 2.59) p = 0.005 | 1.80 (1.21 to 2.69) p = 0.004 | NA | |||||
Lateral TFJ | Lateral TFJ | Cartilage volume | |||||
1.52 (1.14 to 2.04) | 1.45 (1.02 to 2.07) | ||||||
p = 0.005 | p = 0.04 | ||||||
No association with ipsicompartmental cartilage volume | No association with ipsicompartmental cartilage volume | ||||||
Guymer 2007 [35] | Presence or absence of MRI BMLs | Presence or absence of semi-quantitative cartilage defects | Age, height, weight, and tibial cartilage volume | OR (95 % CI) | OR (95 % CI) | + | High (71) |
(C) TFJ | (C) TFJ | Medial TFJ | Medial TFJ | A positive association is observed in the medial but not the lateral TFJ | |||
6.46 (1.04 to 38.39) | 3.51 (1.08 to 11.42) | ||||||
p = 0.04 | p = 0.04 | ||||||
Lateral TFJ | Lateral TFJ | ||||||
1.17 (0.22 to 6.26) | 1.02 (0.17 to 6.12) | ||||||
p = 0.85 | p = 0.98 | ||||||
Stehling 2010 [65] | Presence of any MRI semi-quantitative BMLs (C) | Presence of any WORMS MRI cartilage defects (C) | Age, gender and BMI, KL score, knee injury or knee surgery, family history of TKR and Heberden's nodes | NR | p <0.0001 | + | High (71) |
Torres 2006 [103] | MRI BML (WORMS) (C) TFJ and PFJ | Semi-quantitative cartilage (WORMS) (C) | Nil | R = 0.56 | NR | + | High (68) |
Ip 2011 [99] | Semi-quantitative MRI BML (C) | KL grade (C) | Age, sex, BMI, OA stage, joint effusion, and meniscal damage | NR | Highest BML score p <0.001 | + | High (68) |
Hayes 2005 [22] | Semi-quantitative MRI BML (C) | KL grade (C) | Nil | p = 0.005 | NR | + | High (61) |
Kornaat 2005 [100] | Semi-quantitative MRI BML (KOSS) | Semi-quantitative cartilage defects (KOSS) TFJ and PFJ (C) | Nil | OR (95 % CI) | NR | + | Low (57) |
PFJ | |||||||
TFJ and PFJ (C) | 17 (3.8 to 72) | ||||||
TFJ | |||||||
120 (6.5 to 2,221) | |||||||
Gudbergsen 2013 [98] | Semi-quantitative MRI BML (BLOKS) (C) | KL grade (C) | Nil | KL grade | NR | + | Low (57) |
p = 0.046 lateral | |||||||
p <0.001 medial | |||||||
Link 2003 [101] | Semi-quantitative MRI BML, (C) | KL grade (C) | Nil | p <0.05 | NR | + | Low (54) |
Sowers 2003 [29] | Semi-quantitative MRI BML (C) | Semi-quantitative cartilage defect (C) | Nil | p for trend | NR | + | Low (54) |
p <0.0001 | |||||||
Felson 2001 [96] | Semi-quantitative MRI BMLs (C) | KL grade (C) | Nil | NR | NR | + | Low (54) |
Lo 2005 [102] | Semi-quantitative MRI BML (WORMS ≥ 1) (C) | KL grade ≥ 2 (C) | Nil | NR | NR | + | Low (50) |
Meredith 2009 [64] | Sum of semi-quantitative MRI | Sum of semi-quantitative MRI | Nil | p <0.0003 | NR | + | Low (50) |
BML scores in the TFJ and PFJ (C) | Cartilage defect scores in the TFJ and PFJ (C) | ||||||
Fernandez-Madrid 1994 [97] | Crude presence of MRI BMLs (C) | KL grade (C) | Nil | p <0.001 | NR | + | Low (46) |
Scher 2008 [87] | Semi-quantitative MRI BML (C) | Semi-quantitative cartilage defect (modified Noyes) (C) | Nil | p = 0.012 | NR | + | Low (43) |
MRI bone marrow lesion - case control studies | Â | ||||||
Ratzlaff 2014 [104] | Total tibial BML volume 12 and 24 months before TKR and interval change between 12 and 24 (C) and (L) TFJ | Incident TKR (L) | NB matched cases and controls | OR (95 % CI) | NR | + | High (65) |
12 months (C) | True of TFJ but not PFJ | ||||||
1.68 (1.33 to 2.13) | |||||||
24 months (C) | |||||||
1.35 (1.02 to 1.78) | |||||||
12 to 24 months change (L) | |||||||
1.23 (1.03 to 1.46) | |||||||
Zhao 2010 [105] | Baseline crude presence of MRI BMLs at (C) TFJ | Overlying cartilage defect progression after 1 year (WORMS) (L) TFJ | Nil | Change in cartilage defect scores for areas with and without underlying BMLs | NR | + | Low (56) |
p = 0.00003 | |||||||
Aitken 2013 Abstract [17] | Semi-quantitative BMLs tibia, femur and patella | Cartilage volume and defect score tibia and femur | Age, sex, BMI | NR | Tibial cartilage volume | - | Low (47) |
β = −433 mm3 per unit increase in BML | |||||||
p <0.01 | |||||||
Stahl 2011 [41] | Semi-quantitative MRI BML size (WORMS) (L) TFJ | Semi-quantitative cartilage defect size (L) TFJ | Nil | NR | p <0.165 | NA | Low (47) |
MRI osteophyte - cohort studies | Â | ||||||
De-Lange 2014 abstract [106] | Semi-quantitative osteophyte (KOSS) (C) | Radiographic progression of JSN of TFJ (L) | Age, gender, BMI and baseline JSN | NR | OR (95 % CI) | + | High (61) |
1.8 (1.1 to 3.1) | Higher OST score, the higher the JSN | ||||||
Liu 2014 Abstract [45] | Baseline semi-quantitative osteophyte score (WORMS) (C) TFJ | Incident TKR at 6-months follow up (L) | Activity of daily living disability score | NR | RR (95 % CI) 3.01 (1.39 to 6.52) | + | Low (50) |
Sowers 2011 [28] | Semi-quantitative MRI osteophyte size in TFJ (C) | Progression in KL grade (11-year follow up) (L) | Nil | R (95 % CI) medial tibia ~ 0.65 (0.59 to 0.71) | NR | + | Low (53) |
Lateral tibia ~0.57 (0.49 to 0.63) | |||||||
MRI osteophyte - cross-sectional studies | Â | ||||||
Stehling 2010 [65] | Presence of any MRI semi-quantitative osteophytes (C) | Presence of any WORMS MRI cartilage defects (C) | Age, gender and BMI, KL score, knee injury or knee surgery, family history of TKR and Heberden’s nodes | NR | p = 0.0037 | + | High (71) |
Torres 2006 [103] | MRI osteophyte, (WORMS) TFJ and PFJ (C) | Semi-quantitative cartilage (WORMS) TFJ and PFJ (C) | Nil | R = 0.73 | NR | + | High (68) |
Hayes 2005 [22] | Semi-quantitative MRI osteophyte (C) | KL grade (C) | Nil | p <0.001 | NR | + | High (61) |
Meredith 2009 [64] | Sum of semi-quantitative MRI | Sum of semi-quantitative MRI | Nil | p <0.0001 | NR | + | Low (50) |
Osteophyte scores in the TFJ and PFJ (C) | cartilage defect scores in the TFJ and PFJ (C) | ||||||
McCauley 2001 [26] | MRI central osteophyte presence (C) TFJ | MRI cartilage lesion presence (C) TFJ | Nil | Crude association of 32 of 35 central osteophytes having adjacent cartilage lesions | NR | + | Low (29) |
Crude, unadjusted | |||||||
Roemer 2012 [108] | MRI osteophyte | Cartilage defect (WORMS) (C) | Age, sex, BMI, race, TFJ radiographic OA | OR 2378.1, | OR 108.8, | + | Low (57) |
95 % CI 249.8 to 22643.4 | 95 % CI 14.2 to 834.9 | ||||||
(WORMS) (C) | |||||||
p for trend <0.0001 | |||||||
Link 2003 [101] | Semi-quantitative MRI osteophytes (C) | KL grade (C) | Nil | p <0.01 | NR | + | Low (54) |
Fernandez-Madrid 1994 [97] | Crude presence of MRI osteophytes (C) | KL grade (C) | Nil | p <0.001 | NR | + | Low (46) |
MRI bone attrition - cohort studies | Â | ||||||
Kothari 2010 [82] | Semi-quantitative baseline MRI attrition | Semi-quantitative cartilage defect score change over 2 years (WORMS) (L) TFJ. | Age, sex BMI, other bone lesions | OR 3.17, | OR 1.85, | NA | Low (50) |
95 % CI 1.64 to 6.16 | 95 % CI 0.71 to 4.82 | ||||||
(WORMS) (C) TFJ | |||||||
MRI bone attrition - cross-sectional studies | Â | ||||||
Torres 2006 [103] | MRI attrition (WORMS) TFJ and PFJ (C) | Semi-quantitative cartilage (WORMS) TFJ and PFJ (C) | Nil | R = 0.75 | NR | + | High (68) |
Reichenbach 2008 [110] | Semi-quantitative MRI bone attrition (WORMS) (C) | KL grade and semi-quantitative cartilage defects (WORMS) (C) | Nil | NR | NR | + | Low (43) |
Crude correlation | |||||||
MRI bone attrition - case control studies | Â | ||||||
Neogi 2009 [109] | Baseline semi-quantitative MRI bone attrition size (WORMS) (C) TFJ | Cartilage defects progression (WORMS) after 30 months TFJ | Age, sex, BMI | OR 5.5, | OR 3.0, | + | Low (59) |
95 % CI 3.0 to 10.0 | 95 % CI 2.2 to 4.2 | ||||||
MRI bone Shape/dimension – cohort studies |  | ||||||
Cicuttini 2004 [111] | Baseline quantitative MRI tibial bone area (C) | TKR incidence (L) over 4 years | Age, sex, height, weight, BMI, WOMAC, ROA severity | NR | OR (95 % CI) | + | High (78) |
1.2 (1.0 to 1.4) | |||||||
p = 0.02 | |||||||
Ding 2008 [20] | Baseline MRI tibial bone area (C) TFJ | Progressive cartilage volume loss (L) TFJ | Age, sex, BMI, OA family history, muscle strength and ROA. | β (95 % CI) | β (95 % CI) | - | High (72) |
Medial femoral cartilage | Medial femoral cartilage | ||||||
β = 0.17 (0.04 to 0.29) | β = 0.35 (0.14 to 0.56) | ||||||
Total femoral cartilage | Total femoral cartilage | ||||||
β = 0.07 | β = 0.13 | ||||||
(0.003 to 0.14) | (0.02 to 0.25) | ||||||
Ding 2006 [18] | Baseline MRI tibial bone area (C) TFJ | Change in semi-quantitative MRI cartilage defect scores over 2.3 years (L) TFJ | Age, sex, BMI, radiographic OA \features | NA | OR (95%CI) | - | High (61) |
Medial TFJ | |||||||
1.24 (1.01 to 1.51) | |||||||
p = 0.04 | |||||||
Lateral TFJ | |||||||
2.07 (1.52 to 2.82) | |||||||
p <0.001 | |||||||
Everhart 2014 [114] | Baseline TFJ subchondral surface ratio of medial and lateral TFJ compartments (C) | Radiographic progression of lateral or medial TFJ knee OA at 48 months (L) | Sex, race, age, BMI, tobacco use, activity level, knee coronal alignment, baseline symptoms, injury history, surgery history, KL grade, and JSW | Unadjusted medial SSR vs progression of medial JSN | Neither medial nor lateral SSR was associated lateral or medial ROA progression in adjusted analysis p <0.05. | NA | High (61) |
OR 1.43, 95 % CI 1.15 to 1.77 | |||||||
p = 0.0015 | |||||||
Medial SSR vs progression of lateral JSN | |||||||
OR 1.87, 95 % CI 1.44 to 2.42 | |||||||
p <0.001 | |||||||
Davies-Tuck 2008 [112] | Baseline MRI tibial bone plateau area (C) TFJ | Progressive semi-quantitative cartilage defect score (L) medial and lateral TFJ | Age, sex, BMI, baseline cartilage defect score, baseline cartilage volume and baseline tibial plateau area | Lateral TFJ | OR (95 % CI) | + | High (56) |
OR (95 % CI) −0.01 (−0.06 to 0.03) p = 0.59 | Lateral TFJ 0.06 (0.004 to 0.11) p = 0.03 Medial TFJ 0.07 (0.03 to 0.12) p = 0.002 | ||||||
Carnes 2012 [113] | MRI tibial bone area (C) | Semi-quantitative cartilage defect progression TFJ (L) | Age, sex, BMI, cartilage defects, BML | Lateral tibial bone area OR 1.11, 95 % CI 1.0 to 1.23 | OR (95 % CI) bone area medial 1.12 (1.01 to 1.26) and lateral tibial (1.35 (1.12 to 1.63) | + | Low (50) |
Dore 2010 [68] | Baseline tibial bone area MRI (C) | Increase or no increase in semi-quantitative MRI tibial cartilage defects over 2.7 years (L) | Age, sex, body mass index, baseline cartilage defects, and subchondral bone mineral density | NR | OR (95 % CI) medial tibia 1.6 (1.0 to 2.6) p = 0.04 lateral tibia 2.4 (1.4 to 4.0) p <0.01 | + Bone area size is associated with increasing cartilage defect scores | Low (50) |
Hudelmaier 2013 [180] Abstract | Annual change in segmented MRI knee bone area (L) | Baseline KL grade (C) | Nil | Medial tibia p <0.05 | NR | + The higher the KL grade the larger the increase in bone area | Low (50) |
MRI bone shape/dimension - cross-sectional studies | Â | ||||||
Ding 2005 [19] | MRI quantitative tibial bone area (C) | Semi-quantitative MRI knee cartilage defect severity scores (C) TFJ | Age, sex, BMI, family history, cartilage volume | β (95 % CI) medial TFJ 0.06 (0.03 to 0.09) lateral TFJ 0.09 (0.05 to 0.13) | β (95 % CI) medial TFJ 0.11 (0.07 to 0.15) lateral TFJ 0.17 (0.11 to 0.22) | + Association maintained for the whole TFJ and by compartment | High (64) |
Kalichman 2007 [165] | MRI patellar length ratio, trochlea sulcus angle (C) | JSN grade (C) | Age, sex, BMI | NR | Trochlea sulcus angle p for trend, medial JSN p = 0.0162, lateral JSN p = 0.1206 | NC | High (64) |
Kalichman 2007 [115] | MRI patellar length ratio, trochlea sulcus angle (C) | Cartilage defect (WORMS) (C) | Age, sex, BMI | NR | Trochlea sulcus angle p for trend, medial cartilage loss p = 0.0016, lateral cartilage loss p = 0.0009 | + | Low (57) |
Stefanik 2012 [116] | MRI lateral trochlear inclination and trochlear angle (C) | Semi-quantitative cartilage defect (WORMS) (C) | Age, sex, BMI | NR | Lateral trochlear inclination OR 2, 95 % CI 1.9 to 3.7, p <0.0001, trochlear angle OR 2.0, 95 % CI 1.2 to 3.5, p <0.0001 | + | Low (57) |
Frobell 2010 [107] | MRI bone area - manual segmentation (C) | KL grade, OARSI JSN grade (C) | Age and BMI | Medial tibia JSN and KL p <0.0125 | Medial tibia JSN and KL p <0.0125 | + | Low (57) |
Wang 2005 [66] | Annual % change in tibial bone area (L) 2 years follow up | Baseline JSN (C) | Age, sex, BMI, WOMAC score, SF-36 score, physical activity, radiographic OA features, baseline tibial plateau bone area. | β (95 % CI) medial tibia β = 0.35 (−1.10 to 1.80) p = 0.63, lateral tibia −0.87 (−2.35 to 0.61) p = 0.25 | β (95 % CI) medial tibia 1.88 (0.43 to 3.33) p = 0.01 lateral tibia −0.42 (−2.31 to 1.48) p = 0.66 | + Association with medial tibia but not in the lateral tibia | Low (57) |
Jones 2004 [23] | Tibial bone area (MRI) (C) | Radiographic JSN (C) | Age, sex, height, weight | β (95 % CI) medial tibia β = −0.03 (−0.11 to 0.06), lateral tibia −0.00 (−0.07 to 0.06) | β (95 % CI) medial tibia β = −0.00 (−0.04 to 0.06), lateral tibia +0.00 (−0.04 to 0.05) | NA | Low (50) |
Eckstein 2010 [117] | MRI tibial bone area (segmented) (C) | OARSI JSN grade (C) | Nil | p <0.01 | NR | + | Low (43) |
MRI bone shape/dimension - case–control studies |  | ||||||
Bowes 2013 [118] | Change in segmented MRI 3D bone area over 4 years (L) | KL grade defined ROA knee (C) and (L) | Nil | NR bone area increased significantly faster in ROA vs non-ROA p <0.0001 | NR | + Higher KL grades had greater increase in bone area, | High (71) |
Neogi 2013 [120] | MRI 3D bone shape (tibia, femur and patella) (C) | Incident TFJ ROA KL grade ≥2 (L) | Age, sex, BMI | NR | OR 3, 95 % CI 1.8 to 5.0 | + Developing 3D OA knee shape is associated with increasing ROA knee | High (65) |
Hunter 2013 abstract [119] | Change in MRI knee bone area over 24 months (L) | Incident TFJ ROA (KL grade ≥2) (L) | NR | NR | Hazard ratio (95 % CI) range from 1.17 (1.08 to 1.27) to 3.97 (2.38 to 6.63), all highly statistically significant | + for all bone regions Enlarging bone area associated with increasing ROA knee | Low (59) |
Wluka 2005 [121] | Change in MRI tibial bone area (L) | Baseline radiographic JSN (C) | Age, BMI, pain, physical activity | Medial tibial bone area R = 160, 95 % CI 120 to 201, p <0.001 | Medial tibial bone area R = 145, 95 % CI 103 to 186, p <0.001 | + | Low (47) |
MRI bone cyst - cohort studies | Â | ||||||
Kotharii 2010 [82] | Semi-quantitative baseline MRI bone cyst (WORMS) (C) TFJ | Semi-quantitative cartilage defect score change over 2 years (WORMS) (L) TFJ. | Age, sex BMI, other bone lesions | OR 1.66, 95 % CI 0.55 to 4.99 | OR 0.47, 95 % CI 0.11 to 2.03 | NA | Low (50) |
Tanamas 2010 [88] | Semi-quantitative change in MRI bone cyst size (L) | Knee Cartilage volume loss over 2 years (L) TFJ | Nil | β (95 % CI) lateral tibial cartilage loss in cyst regression relative to stable and progressive cysts | NR | + | Low (47) |
β = −11.81 (−16.64 to −6.98) | |||||||
Madan-Sharma 2008 [93] | Baseline MRI semi-quantitative bone cyst (C) TFJ | OARSI medial TFJ JSN grade progression over 2 years (L) TFJ | Age, sex, BMI and family effect | NR | RR 1.6, 95 % CI 0.5 to 4.0 | NA | Low (47) |
Carrino 2006 [77] | Crude presence of MRI bone cyst TFJ (C) and (L) | Any grade of cartilage defect TFJ (C) and (L) | Nil | NR | NR | + | Low (22) |
MRI bone cyst -– cross-sectional studies |  | ||||||
Stehling 2010 [65] | Presence of any MRI semi-quantitative cyst (C) | Presence of any WORMS MRI cartilage defects (C) | Age, gender and BMI, KL score, knee injury or knee surgery, family history of TKR and Heberden’s nodes | NR | p = 0.0131 | + | High (71) |
Torres 2006 [103] | MRI bone cyst (WORMS) TFJ and PFJ (C) | Semi-quantitative cartilage (WORMS) TFJ and PFJ (C) | Nil | R = 0.75 | Â | NC | High (68) |
Hayes 2005 [22] | Semi-quantitative MRI bone cyst (C) | KL grade (C) | Nil | p = 0.02 | NR | + | High (61) |
Link 2003 [101] | Crude presence of MRI bone cyst (C) | KL grade (C) | Nil | p <0.01 | NR | + | Low (54) |
Crema 2010 [122] | MRI Bone cysts (WORMS) (C) | Cartilage defect (WORMS) (C) | Nil | NR | NR | + | Low (50) |
CT bone cyst – cross-sectional studies |  | ||||||
Okazaki 2014 [40] | Number of CT bone cysts (medial femur and tibia) (C) | Knee KL grade (C) | Nil | p <0.05 | Nil | +with KL grade in medial TFJ | Low (50) |
MRI subchondral bone morphometry - cohort studies | Â | ||||||
Lo 2012 Abstract [53] | MRI BVF, trabecular number, thickness and spacing (C) | OARSI medial TFJ JSN progression between 24 and 48 months (L) | Nil | OR 2.4, 95 % CI 1.1 to 5.0, p = 0.02 | NR | BVF, trabecular number and thickness are positively associated with JSN progression but negatively associated with trabecular spacing. | Low (50) |
MRI subchondral bone morphometry - cross-sectional studies | Â | ||||||
Driban 2011 [50] Abstract | MRI bone volume fraction, trabecular number, spacing & thickness of medial tibia (C) | The presence of any grade of radiographic medial & lateral JSN (C) | Nil | R = 0.09 to 1.77 | NR | + Medial JSN associated with higher BVF, trabecular number and thickness but lower spacing | High (71) |
Driban 2011 [49] | MRI bone volume fraction (C) | Radiographic JSN (C) | Nil | NR | NR | + Higher JSN score, lower JSW) were associated with higher BVF | High (64) |
Lindsey 2004 [123] | MRI bone volume fraction trabecular and trabecular number (TFJ) (C) | Cartilage volume of tibia or femur in contralateral TFJ compartment (C) | Nil | Medial TFJ cartilage with lateral TFJ BVF and trabecular number. β = 0.29 to 0.36, p = 0.0020 to 0.02 | NR | + With contralateral BVF and trabecular number, but – with trabecular spacing | High (64) |
Lo 2012 [54] | MRI bone volume fraction, trabecular thickness, number, spacing and DXA BMD of (proximal medial tibia) (C) | Radiographic medial JSN grade (C) | Nil | All p <0.0001 | Nil | + (BV/TV, thickness, number, BMD) (spacing) | High (64) |
Chiba 2012 [34] | MRI bone volume fraction and trabecular thickness of the medial & lateral femur & tibia. (C) | Metric JSW (radiographic) of the medial and lateral TFJ (C) | Nil | Bone volume fraction −0.48 (p <0.001) trabecular thickness −0.51 (p <0.001) | NR | - | Low (57) |
DXA BMD - cohort studies | Â | ||||||
Dore 2010 [68] | Baseline proximal tibial BMD, DXA (C) | Increase or no increase in semi-quantitative MRI tibial cartilage defects over 2.7 years (L) | Age, sex, BMI, baseline cartilage defects and subchondral tibial bone area | NR | OR (95 % CI) medial tibia 1.6 (1.2 to 2.1) p <0.01 lateral tibia 1.2 (0.9, 1.6) p = 0.19 | + Association only observed in medial tibia | Low (50) |
Lo 2012 Abstract [53] | DXA-measured medial:lateral periarticular BMD (paBMD) (C) | OARSI medial TFJ JSN progression (L) | Nil | OR 8.4, 95 % CI 2.8 to 25.0, p <0.0001 | nil | + JSN association with baseline M:L paBMD | Low (50) |
Bruyere 2003 [42] | Subchondral tibial bone BMD (DXA) (C) | Minimum medial JSW TFJ after one year (L) | Age, sex, BMI, minimum JSW | NR | R = −0.43, p = 0.02 | Negative correlation i.e., lower BMD gives bigger JSW or less JSN | Low (44) |
DXA BMD - cross-sectional studies | Â | ||||||
Dore 2009 [52] | DXA tibial subchondral BMD (C) | Radiograph JSN grade and MRI cartilage defect and volume (C) | Age, sex BMI | NR | Medial tibial BMD vs JSN R = 0.11, p <0.01, defect R = 0.16, p <0.01, cartilage volume R = 0.12, p = 0.01 | + Higher the BMD the greater the JSN and cartilage defects, | High (71) |
Lo 2006 [55] | DXA medial:lateral BMD ratio at the tibial plateau (C) | Radiographic JSN grade (medial and lateral TFJ) (C) | Age, sex, BMI | p <0.0001 | NR | + With medial JSN, − with lateral JSN | High (71) |
Lo 2012 [54] | DXA BMD (proximal medial tibia) (C) | Radiographic medial JSN grade (C) | Nil | p <0.0001 | NR | + | High (64) |
Akamatsu 2014 [31] Abstract | BMD (DXA) (C) (medial tibia and femoral condyle) | Medial TFJ JSN (radiographic) (C) | Nil | Tibia R = 0.571, p <0.001 femur R = 0.550, p < 0.001 | NR | + Medial femoral and tibial condyle BMD correlated with medial JSN | Low (57) |
Volumetric CT BMD - case control studies | Â | ||||||
Bennell 2008 [56] | Volumetric BMD in tibial subchondral trabecular bone (C) | KL grade (C) | Age, sex, BMI | NR | p <0.05 | NC BMD falls in posterior tibial plateau as KL increases but anteriorly increase in BMD noted | Low (59) |
Knee scintigraphic subchondral bone cohort studies | Â | ||||||
Mazzuca 2004 [37] | Baseline late-phase subchondral bone scintigraphy (adjusted for healthy diaphysis uptake) of the medial tibia and whole knee (C) | Progression of minimum JSN of the medial TFJ from baseline to 30 months (L) | Age, BMI, KL grade (NB all women) | r = 0.22 to 0.30 (p <0.05) | r = 0 to 0.08 (p <0.05) | NA after adjustment for covariates | High (56) |
Mazzuca 2005 [38] | Baseline late-phase subchondral bone scintigraphy (adjusted for healthy diaphysis uptake) of the medial tibia and whole knee (C) | Progression of minimum JSN of the medial TFJ from baseline to 30 months (L) | Baseline JSW, treatment group | NR | Coefficient 0.221, 95 % CI 0.003 to 0.439, p = 0.049 | + The greater the scintigraphic bone signal the greater the JSN | High (56) |
Dieppe 1993 [58] | Baseline late and or early-phase subchondral bone scintigraphy signal (C) | Progression of JSN by ≥2 mm or knee operation incidence after 5 years (L) | Nil | p <0.005 | NR | + | Low (50) |
Knee scintigraphic subchondral bone cross-sectional studies | Â | ||||||
Kraus 2009 [59] | Ipsilateral late-phase bone scintigraphy, semi-quantitative retention scoring of TFJ (C) | Ipsilateral OARSI scale of JSN (C) | Age, gender, BMI, osteophyte OARSI score, knee alignment knee symptoms | Coefficient 0.47 to 0.48 (p <0.0001) | Coefficient 0.26 to 0.29 (p = 0.0005 to 0.001) | + | High (71) |
McCrae 1992 [62] | Late-phase ‘extended bone uptake’ pattern bone scintigraphy, presence around the TFJ (C) | Radiographic JSN presence (C) | Nil | OR 47.3, 95% CI 6.4 to 352, p <0.01 | NR | + | Low (50) |
2D knee bone shape – cross-sectional studies |  | ||||||
Haverkamp 2011 [36] | 2D bone shape knee. 1. Femur and tibial width 2. Elevation of lateral tibial plateau (C) | 1. Presence of diffuse cartilage defects semi-quantitative scoring (MRI). 2. Presence of ROA knee (KL ≥2) (C) | NB (this is a population of women only) ROA models adjusted for age, BMI; cartilage defect models adjusted for KL only | OR (95 % CI) bone width vs knee ROA 2.03 (1.55 to 2.66) p <0.001 bone width Presence of diffuse cartilage defects p <0.001 | OR (95 % CI) knee ROA 1.94 (1.44 to 2.62) p <0.001 | + Wider bones and elevated tibial plateau were associated with the presence of ROA knee. Cartilage defects were only associated with bone width | Low (46) |