A degenerative medial meniscus retains some protective effect against osteoarthritis-induced subchondral bone changes

Abstract

ObjectivesThe objective was to estimate the impact of the meniscus on cartilage and subchondral bone in knee osteoarthritis (OA). MethodsIn a sample of 46 knee specimens (26 females), 13 (7 females) were classified as OA according to the Kellgren-Lawrence classification. Outerbridge and meniscal grading were performed. Using micro-computed tomography images, we analyzed the cartilage thickness, subchondral plate thickness and micro-architecture of trabecular subchondral bone at different depths and in two different locations of the medial tibial plateau: one peripheral (PER) covered by the meniscus and one central (CENT) uncovered by the meniscus. ResultsUncoverage by the meniscus was associated with bone sclerosis, defined as higher bone volume to total volume (BV/TV), higher trabecular number, thicker trabeculae with lower spacing, and anisotropy and a more plate-like architecture. The protective effect of meniscal coverage was observed in the uppermost 5 to 6 mm of the subchondral bone. As compared with normal knees, knees with OA showed significantly higher bone sclerosis (P <0.05–0.001) at the PER location, but only BV/TV (P=0.03) and trabecular number (P=0.02) differed between OA and non-OA knees at the CENT location uncovered by meniscus. ConclusionsOA results showed a partial dedifferentiation of the subchondral bone micro-architecture between PER and CENT locations probably due to menisci that still retain some of their protective effects on the subchondral bone.