Quantitative measures of meniscus extrusion predict incident radiographic knee osteoarthritis – data from the Osteoarthritis Initiative

Abstract

SUMMARY Objective To test the hypothesis that quantitative measures of meniscus extrusion predict incident radiographic knee osteoarthritis (KOA), prior to the advent of radiographic disease. Methods 206 knees with incident radiographic KOA (Kellgren Lawrence Grade (KLG) 0 or 1 at baseline, developing KLG 2 or greater with a definite osteophyte and joint space narrowing (JSN) grade ≥1 by year 4) were matched to 232 control knees not developing incident KOA. Manual segmentation of the central five slices of the medial and lateral meniscus was performed on coronal 3T DESS MRI and quantitative meniscus position was determined. Cases and controls were compared using conditional logistic regression adjusting for age, sex, BMI, race and clinical site. Sensitivity analyses of early (year [Y] 1/2) and late (Y3/4) incidence was performed. Results Mean medial extrusion distance was significantly greater for incident compared to non-incident knees (1.56 mean ± 1.12 mm SD vs 1.29 ± 0.99 mm; +21%, P < 0.01), so was the percent extrusion area of the medial meniscus (25.8 ± 15.8% vs 22.0 ± 13.5%; +17%, P < 0.05). This finding was consistent for knees restricted to medial incidence. No significant differences were observed for the lateral meniscus in incident medial KOA, or for the tibial plateau coverage between incident and non-incident knees. Restricting the analysis to medial incident KOA at Y1/2 differences were attenuated, but reached significance for extrusion distance, whereas no significant differences were observed at incident KOA in Y3/4. Conclusion Greater medial meniscus extrusion predicts incident radiographic KOA. Early onset KOA showed greater differences for meniscus position between incident and non-incident knees than late onset KOA.

Baseline meniscal extrusion associated with incident knee osteoarthritis after 30 months in overweight and obese women

“…Several recent studies described a new approach for quantitative MRI analysis of meniscal extrusion using 3D imaging techniques 9,10 , which might be a more reliable way to assess volumetric morphometry and extrusion of the meniscus and a more truthful representation of the in vivo situation.…”

“…The generally accepted idea is that a displaced meniscus affects the weight-bearing and load distribution capacities within the knee joint, which leads to loss of cartilage and increase in bone marrow lesions, ultimately resulting in knee OA [6][7][8] . Multiple studies affirm this relationship between meniscal extrusion and the development of knee OA or features thereof [6][7][8][9][10] . However, most of these studies were carried out in cohorts of subjects with established OA.…”

Five‐minute knee MRI for simultaneous morphometry and T2 relaxometry of cartilage and meniscus and for semiquantitative radiological assessment using double‐echo in steady‐state at 3T

“…Cartilage thickness and meniscal volume and locations are morphological parameters sensitive to changes in early-OA and, consequently, were analyzed in this study. 6,27 Average cartilage thickness over the total area of subchondral bone on the tibial plateau in the medial femorotibial compartment was measured using a manual, quality-controlled segmentation using custom software (Chondrometrics, Ainring, Germany). Meniscus volume measurements in the posterior horn of the medial meniscus were performed manually using Amira FEI (Hillsboro, OR).…”

Baseline Cartilage Thickness and Meniscus Extrusion Predict Longitudinal Cartilage Loss by Quantitative Magnetic Resonance Imaging

“…Most recently, Driban et al examined a cohort from the OAI database and note accelerated knee OA in patients with MRI findings of medial meniscus pathology with extrusion and others with subchondral damage at baseline [25]. Similarly, OAI data showed that medial meniscus extrusion predicts a higher rate of incident radiographic knee OA, and that extrusion was more pronounced in those with earlier incident OA [26]. …”