Abstract
BackgroundMeniscus extrusion or hypertrophy may occur in knee osteoarthritis (OA). However, currently no data are available on the position and size of the meniscus in asymptomatic men and women with normal meniscus integrity.MethodsThree-dimensional coronal DESSwe MRIs were used to segment and quantitatively measure the size and position of the medial and lateral menisci, and their correlation with sex, height, weight, and tibial plateau area. 102 knees (40 male and 62 female) were drawn from the Osteoarthritis Initiative "non-exposed" reference cohort, including subjects without symptoms, radiographic signs, or risk factors for knee OA. Knees with MRI signs of meniscus lesions were excluded.ResultsThe tibial plateau area was significantly larger (p < 0.001) in male knees than in female ones (+23% medially; +28% laterally), as was total meniscus surface area (p < 0.001, +20% medially; +26% laterally). Ipsi-compartimental tibial plateau area was more strongly correlated with total meniscus surface area in men (r = .72 medially; r = .62 laterally) and women (r = .67; r = .75) than contra-compartimental or total tibial plateau area, body height or weight. The ratio of meniscus versus tibial plateau area was similar between men and women (p = 0.22 medially; p = 0.72 laterally). Tibial coverage by the meniscus was similar between men and women (50% medially; 58% laterally), but "physiological" medial meniscal extrusion was greater in women (1.83 ± 1.06mm) than in men (1.24mm ± 1.18mm; p = 0.011).ConclusionsThese data suggest that meniscus surface area strongly scales with (ipsilateral) tibial plateau area across both sexes, and that tibial coverage by the meniscus is similar between men and women.
Highlights
Meniscus extrusion or hypertrophy may occur in knee osteoarthritis (OA)
Given the higher prevalence of knee OA in women and the important role of the meniscus in knee joint biomechanics and OA development, we explored whether meniscus size, shape or position differ between asymptomatic men and women who do not have clinical knee OA
We explored the correlation of meniscus morphology with body height, weight, and tibial plateau area, to propose a “relative measure” of meniscus size that can be directly compared between men and women, and that can be potentially used to efficiently explore whether the meniscus is hypertrophied or has lost substance in knee OA [17,19] in mixed cohorts of men and women
Summary
Currently no data are available on the position and size of the meniscus in asymptomatic men and women with normal meniscus integrity. The reason why women develop knee OA more frequently than men is currently not understood. Since the meniscus is known to undergo morphological changes in OA [14,17], this hypothesis needs to be tested under physiological conditions, prior to the onset of disease. For this reason, the morphology of the meniscus was studied in asymptomatic and radiographically normal men and women without MRI signs of meniscus lesions
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