Prognostic factors for cartilage degeneration in the knee after meniscectomy and cruciate ligament injuries. A prospective observational MRI cohort study

Osteoarthritis (OA) is a serious medical condition with considerable
socio-economic impact. In the Netherlands more than ¤320 million are spent on
treatment of such conditions per annum. The knee is affected in 350.000
(general practice, RIVM) to 1.400.000 (self reported in 25+ population, Picavet
et al). Moreover, knee complaints are the third largest cause for work related
problems of the locomotor system. Large prospective studies have confirmed knee
trauma to be a significant risk factor for knee OA (Wilder 2002).
If sufficient data on patients would be available on occurrence and of
progression of OA (e.g. ligament injury, obese, family, occupation etc),
certain high-risk groups of patients could be distinguished. Not only could
these patients benefit most from preventive measurements (i.e. exercise,
chondroprotective agents, cartilage transplantation etc), but this would be
cost-effective for society as well.

Method
The proposed study is based on a 1997 collected dataset of 859 patients. The
latter study focused on the validity of MRI of the knee as a cost-effective
tool to select patients who will benefit from arthroscopic treatment. These
patients had knee complaints more than four weeks. The knee complaints were
clinically and radiologically evaluated. The average age was 31 years. Based on
standard clinical assessment, patients were divided in two groups: Patients
with high suspicion of intra-articular pathology requiring arthroscopic
treatment and patients with low or absent suspicion of intra-articular
pathology therefore not needing arthroscopic. MRI was performed by all
patients.

Main Objectives

1.To identify high risk patient groups for development of knee osteoarthritis
(OA) in a cohort 9-10 years after meniscus, cruciate ligament and cartilage
lesions.

2.To determine the use of 3T MRI state of the art imaging in detecting early OA
in the knee.

3.To determine if functionality of the knee is affected by arthroscopic
intervention.

4.To determine if genetic predisposition (hand OA, family history) is
associated with occurrence and development of OA of the knee.

The proposed study is based on a 1997 collected dataset of 859 patients.The
original data from history taking, physical examination, plain films, MRI and
arthroscopy will be made available from the original database and incorporated
in a new database.
All 859 patients are considered eligible for this study and will be recalled
for follow-up. Patients are seen at the outpatient clinic of the department of
Orthopaedic Surgery of the LUMC. Physical examination, plain films and MRI will
be performed. Mouthswabs, blood and urine will be taken. The patients are asked
to fill in three questionnaires.
In a second and last vist to the LUMC, MRI of the knee will be performed.

Two one hour visits to the LUMC.
Maximum time to complete the questionnaires at home: one hour.
Minimal X-ray exposure.
One venapunction