Relationship Between Medial Meniscal Extrusion and Cartilage Loss in Specific Femorotibial Subregions: Data From the Osteoarthritis Initiative

Abstract

Objective Medial meniscal extrusion is known to be related to structural progression of knee OA. However, it is unclear whether medial meniscal extrusion is more strongly associated with cartilage loss in certain medial femorotibial subregions than to others. Methods Segmentation of the medial tibial and femoral cartilage (baseline; 1-year follow-up) and the medial meniscus (baseline) was performed in 60 participants with frequent knee pain (age 61.3±9.2y, BMI 31.3±3.9 kg/m2) and with unilateral medial radiographic joint space narrowing (JSN) grade 1–3, using double echo steady state MR-images. Medial meniscal extrusion distance and extrusion area (%) between the external meniscal and tibial margin at baseline, and longitudinal medial cartilage loss in eight anatomical subregions were determined. Results A significant association (Pearson correlation coefficient) was seen between medial meniscus extrusion area in JSN knees and cartilage loss over one year throughout the entire medial femorotibial compartment. The strongest correlation was with cartilage loss in the external medial tibia (r=−0.34 [p<0.01] in JSN, and r=−0.30 [p=0.02] in noJSN knees). Conclusion Medial meniscus extrusion was associated with subsequent medial cartilage loss. The external medial tibial cartilage may be particularly vulnerable to thinning once the meniscus extrudes and its surface is “exposed” to direct, non-physiological, cartilage-cartilage contact.

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

“…The coronal MPR DESS sequence was preferred over the IW TSE because of the lower slice thickness (1.5 mm vs 3 mm). The coronal MPR DESS was reconstructed from the near-isotropic sagittal DESS gradient echo datasets, but it has been previously shown to provide a comparable sensitivity to change as the sagittal DESS or coronal FLASH sequence for cartilage analyses 18 and has also been previously used for 3D meniscus analyses 11,19,32 . The use of non-isotropic reconstructed gradient echo datasets is another potential limitation of this manuscript.…”

Osteoarthritis year in review 2016: imaging

“…In terms of other prognostic factors in the knee, medial meniscal damage and extrusion on MRI were associated with cartilage loss over a period of 12e30 months 68,69 , whereas BMLs and synovitis rather surprisingly were not. In women with KOA, the infrapatellar fat pad (IPFP) maximal area appeared to have a negative association with knee symptoms and development of cartilage damage 70 and larger IPFP volumes seem positively associated with knee cartilage volume and concomitant reduction in structural abnormalities on CR and MRI 71 (Fig.…”

Advances in combining gene therapy with cell and tissue engineering-based approaches to enhance healing of the meniscus

“…As meniscal root tears disrupt the circumferential fibers that provide hoop strength, meniscal extrusion with altered biomechanical properties of the meniscus is a critical clinical consequence 17–19 . Importantly, recent studies have shown that meniscal extrusion may be closely associated with progressive cartilage loss and accelerated OA 20 . Furthermore, meniscal cysts may occur in both the lateral and medial sides.…”