Predictors of degenerative medial meniscus extrusion: radial component and knee osteoarthritis

Abstract

meniscal extrusion was greater and more severe in knees with a radial tear component than in knees without a radial component. The incidence and degree of major extrusion was similar in knees with root tears and non-root tears. A radial component and knee osteoarthritis severity were similarly predictive of absolute and relative extrusion. Meniscal extrusion in osteoarthritic knees was associated not only with degenerative meniscal tear but also with osteoarthritis severity. Therefore, arthroscopic meniscal procedures, especially meniscal repair, should be cautiously considered in patients with meniscal extrusion.

Factors Associated with Meniscal Extrusion in Knees with or at Risk for Osteoarthritis: The Multicenter Osteoarthritis Study

“…We demonstrated that meniscal tears are not the only factors associated with meniscal extrusion; other factors, such as tibiofemoral cartilage damage and knee malalignment, are independently associated with meniscal extrusion. The relationship between meniscal tears and meniscal extrusion has been explored previously (22)(23)(24)(25)(26)30). The intricately woven pattern of collagen fibrils is responsible for the strength of the meniscus, which maintains its shape and structure when axially loaded (43).…”

“…Lee et al (24) assessed the association of arthroscopy-depicted chondral lesions and preoperative radiographic KellgrenLawrence grade with meniscal extrusion and found that only the Kellgren-Lawrence grade was significantly related to extrusion. However, a cross-sectional MR imaging study conducted by Lerer et al (25) showed a significant association between moderate to severe MR imaging-depicted medial compartment articular cartilage damage and medial meniscal extrusion.…”

“…Subjects were participants in the Multicenter Osteoarthritis (MOST) study, a prospective epidemiologic study of 3026 people aged 50-79 years (overall mean age, 62.5 years) with a goal of identifying risk factors for incident and progressive knee OA in a population either with or at high risk of developing considered by many authors as the most relevant factor associated with extrusion of the meniscus (25,(27)(28)(29), it has been demonstrated that several types of meniscal tears, including nonroot tears, are also related to meniscal extrusion (23,24,30). Magnetic resonance (MR) imaging has become established as the most important imaging modality in the assessment of knee pathologic findings, exhibiting excellent diagnostic performance in the detection of meniscal pathologic abnormalities (31,32).…”

“…Tearing of the meniscus is a known factor related to meniscal extrusion (22)(23)(24)(25)(26). Although root tears are Implication for Patient Care n Several factors are associated with meniscal extrusion; targeting such factors during management might help prevent meniscal extrusion and further deterioration of the tibiofemoral joint in subjects who have or are at risk for knee osteoarthritis (OA); further exploration of the longitudinal effect of management of these factors on meniscal extrusion and on progression of knee OA is needed.…”

Arthroscopic Centralization of an Extruded Lateral Meniscus

“…4 It has also been reported that extrusion of the meniscus is associated with development of osteoarthritis (OA) 5,6 and knee pain 7 in patients with OA. The posterior root tear or radial tear could be surgically repaired to the normal shape; however, meniscal transplantation has been the only surgical intervention for the extrusion of the lateral meniscus after meniscectomy or in patients with OA.…”