Abstract
ObjectiveTo explore whether and which quantitative 3D measures of medial and/or lateral meniscus position and size are associated with subsequent medial femorotibial structural progression of knee osteoarthritis and to determine the correlation between central slice and total meniscus measures.Materials and MethodsKnees with radiographic osteoarthritis from Osteoarthritis Initiative participants with longitudinal medial MRI-based cartilage thickness and radiographic joint space width (JSW) loss over 12 months were selected. These 37 structural progressor knees (64.7 ± 8.0y, 30.2 ± 4.6 kg/m2, 35% men) were matched 1:1 to 37 non-progressor knees (64.6 ± 9.8y, 30.2 ± 4.4 kg/m2, 35% men) without cartilage thickness or JSW loss. Quantitative measures of meniscus position and size were computed from manual segmentations of coronal baseline MRIs. Cohen’s D was used as measure of effect size.ResultsMaximum extrusion distance of the total medial meniscus and mean extrusion in the central 5 and in the central slice were greater for progressor than non-progressor knees (Cohen’s D 0.58–0.66). No significant differences were observed for medial tibial coverage or mean extrusion (entire meniscus). Among medial meniscus morphology measures, only mean height differed between progressor vs non-progressor knees (Cohen’s D 0.40). Among lateral meniscus measures, height and volume were greater in progressor vs. non-progressor knees (Cohen’s D 0.46–0.83). Mean extrusion measures were highly correlated between the entire meniscus and the central (r = 0.88) or the central 5 (r = 0.93) slices.Conclusions3D maximum and central medial meniscus extrusion may serve as predictors for subsequent structural progression. Central meniscus extrusion measures could substitute 3D extrusion measurement across the entire meniscus.
Highlights
Menisci distribute the load in the femorotibial joint [1], have a lubricative function, and are effective in reducing the stress on the articular cartilage during joint mobility [2]
The primary purpose of the current study was to explore whether quantitative measures of medial and/or lateral meniscus position and morphology differ between knees with and without subsequent medial femorotibial progression, and which of the medial or lateral meniscus 3D measures are most strongly associated with structural progression
We investigated whether quantitative measures of medial and lateral meniscus position and morphology differ between knees with and without subsequent medial femorotibial structural progression using a matched study design and explored whether quantitative measures obtained from the center of the meniscus can serve as surrogate for quantitative measures obtained from the entire meniscus
Summary
Menisci distribute the load in the femorotibial joint [1], have a lubricative function, and are effective in reducing the stress on the articular cartilage during joint mobility [2]. Meniscal damage and extrusion are common in older individuals, even in those without knee symptoms or radiographic OA [3]. The cause for the extrusion has been attributed to the disruption of circumferential collagen bundle fibers in the meniscus [4] and to a posterior root tear [5]. The menisci are considered of central importance for knee joint health [6]. Meniscal damage has been suggested to be a local risk factor for structural progression [7,8,9,10] and to be associated with subsequent knee replacement [11]. Surgical removal of the meniscus after injury was reported to be a significant risk factor for developing radiographic OA [12]. Quantitative (3D) measurement technology of meniscus position and size from MRI [13] has been shown to be
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