Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress
Clinical Collections
Advances in Alzheimer’s

Keynote webinar | Spotlight on medication adherence

LIVE: Thursday 27th June 2024, 18:00-19:30 (CEST)
Join our expert panel to discover why you need to understand the drivers of non-adherence in your patients, and how you can optimize medication adherence in your clinics to drastically improve patient outcomes.
ADVANCED SEARCH
Log in
Top
European Radiology
Published in: European Radiology 7/2020

01-07-2020 | Knee Osteoarthritis | Ultrasound

US detection of medial meniscus extrusion can predict the risk of developing radiographic knee osteoarthritis: a 5-year cohort study

Authors: Daisuke Chiba, Eiji Sasaki, Seiya Ota, Shugo Maeda, Daisuke Sugiyama, Shigeyuki Nakaji, Yasuyuki Ishibashi

Published in: European Radiology | Issue 7/2020

Login to get access

Abstract

Objectives

To clarify the relationship between the baseline value of medial meniscus extrusion (MME) and the radiographic change of knee osteoarthritis (KOA) through a 5-year follow-up.

Methods

Overall, 472 participants and 944 knees were eligible. MME (mm) was measured at the baseline, and KOA was radiographically evaluated at both baseline and 5-year follow-up by Kellgren-Lawrence grade (KLG). Radiographic KOA (ROA) was defined as the knee showing KLG ≥ 2. Incident ROA (iROA) was defined if the baseline KLG of 0–1 increased to KLG ≥ 2 in 5 years. Progressive ROA (pROA) was defined if the baseline KLG of 2–3 worsened to a higher grade in 5 years. Receiver operating characteristic (ROC) curve and generalized estimating equations were used for analysis.

Results

Of 574 non-ROA knees at the baseline, 43 knees (7.5%) developed iROA; of 370 ROA knees, 47 knees (12.7%) developed pROA. Based on the ROC curves, 4 mm was the optimal cutoff to detect the risk of iROA (area under curve [AUC] 0.639 [right knee]; AUC 0.641 [left knee]) and that of pROA (AUC 0.750 [right knee]; AUC 0.863 [left knee]). Multiple regression analysis showed that the 4-mm cutoff of MME was significantly associated with both the prevalence of iROA (regression coefficient [B] 1.909; p ≤ 0.001; adjusted odds ratio [aOR] 6.746) and that of pROA (B 1.791; p ≤ 0.001; aOR 5.993).

Conclusions

On ultrasonography, the participants with more extruded medial meniscus showed a higher prevalence of both iROA and pROA. Ultrasonography could identify patients who had a risk of developing KOA.

Key Points

• Through a 5-year follow-up, the current cohort study was conducted to clarify the relationship between the baseline value of medial meniscus extrusion (MME) and the radiographic change of knee osteoarthritis (KOA).
• More extruded medial meniscus evaluated by ultrasonography was associated with the development of radiographic KOA.
• Ultrasonography could identify the patients who had a risk of developing KOA, and the 4-mm cutoff of MME was optimal to detect this risk.
Literature
1.
Felson DT, Lawrence RC, Dieppe PA et al (2000) Osteoarthritis: new insights. Part 1: the disease and its risk factors. Ann Intern Med 133:635–646PubMed
2.
Dieppe PA, Lohmander LS (2005) Pathogenesis and management of pain in osteoarthritis. Lancet 365:965–973PubMed
3.
Hunter DJ, Bierma-Zeinstra S (2019) Osteoarthritis. Lancet 393:1745–1759PubMed
4.
Zhang Y, Xu L, Nevitt MC et al (2001) Comparison of the prevalence of knee osteoarthritis between the elderly Chinese population in Beijing and whites in the United States: the Beijing osteoarthritis study. Arthritis Rheum 44:2065–2071PubMed
5.
Yoshimura N, Muraki S, Oka H et al (2009) Prevalence of knee osteoarthritis, lumbar spondylosis, and osteoporosis in Japanese men and women: the research on osteoarthritis/osteoporosis against disability study. J Bone Miner Metab 9:620–628
6.
Losina E, Weinstein AM, Reichmann WM et al (2013) Lifetime risk and age at diagnosis of symptomatic knee osteoarthritis in the US. Arthritis Care Res (Hoboken) 65:703–711
7.
Cross M, Smith E, Hoy D et al (2014) The global burden of hip and knee osteoarthritis: estimates from the global burden of disease 2010 study. Ann Rheum Dis 73:1323–1330PubMed
8.
Ackerman IN, Zomer E, Gilmartin-Thomas JF, Liew D (2018) Forecasting the future burden of opioids for osteoarthritis. Osteoarthritis Cartilage 26:350–355PubMed
9.
Ackerman IN, Pratt C, Gorelik A, Liew D (2018) Projected burden of osteoarthritis and rheumatoid arthritis in Australia: a population-level analysis. Arthritis Care Res (Hoboken) 70:877–883
10.
Liu Q, Wang S, Lin J, Zhang Y (2018) The burden for knee osteoarthritis among Chinese elderly: estimates from a nationally representative study. Osteoarthritis Cartilage 26:1636–1642PubMed
11.
Turkiewicz A, Kiadaliri AA, Englund M (2019) Cause-specific mortality in osteoarthritis of peripheral joints. Osteoarthritis Cartilage 27:848–854PubMed
12.
Kon E, Filardo G, Drobnic M et al (2012) Non-surgical management of early knee osteoarthritis. Knee Surg Sports Traumatol Arthrosc 20:436–449PubMed
13.
Fransen M, McConnell S, Harmer AR, van der Esch M, Simic M, Bennell KL (2015) Exercise for osteoarthritis of the knee. Cochrane Database Syst Rev 1:CD004376PubMed
14.
Maheu E, Rannou F, Reginster JY (2016) Efficacy and safety of hyaluronic acid in the management of osteoarthritis: evidence from real-life setting trials and surveys. Semin Arthritis Rheum 45:S28–S33PubMed
15.
Piscitelli P, Iolascon G, Di Tanna G et al (2012) Socioeconomic burden of total joint arthroplasty for symptomatic hip and knee osteoarthritis in the Italian population: a 5-year analysis based on hospitalization records. Arthritis Care Res (Hoboken) 64:1320–1327
16.
Nielen JTH, Boonen A, Dagnelie PC et al (2018) Disease burden of knee osteoarthritis patients with a joint replacement compared to matched controls: a population-based analysis of a Dutch medical claims database. Osteoarthritis Cartilage 26:202–210PubMed
17.
Loza E, Lopez-Gomez JM, Abasolo L et al (2009) Economic burden of knee and hip osteoarthritis in Spain. Arthritis Rheum 61:158–165PubMed
18.
Sharif B, Garner R, Hennessy D, Sanmartin C, Flanagan WM, Marshall DA (2017) Productivity costs of work loss associated with osteoarthritis in Canada from 2010 to 2031. Osteoarthritis Cartilage 25:249–258PubMed
19.
Berthiaume MJ, Raynauld JP, Martel-Pelletier J et al (2005) Meniscal tear and extrusion are strongly associated with progression of symptomatic knee osteoarthritis as assessed by quantitative magnetic resonance imaging. Ann Rheum Dis 64:556–563PubMed
20.
Raynauld JP, Martel-Pelletier J, Berthiaume MJ et al (2006) Long term evaluation of disease progression through the quantitative magnetic resonance imaging of symptomatic knee osteoarthritis patients: correlation with clinical symptoms and radiographic changes. Arthritis Res Ther 8:R21PubMed
21.
Ding C, Martel-Pelletier J, Pelletier JP et al (2007) Knee meniscal extrusion in a largely non-osteoarthritic cohort: association with greater loss of cartilage volume. Arthritis Res Ther 9:R21PubMedPubMedCentral
22.
Pelletier JP, Raynauld JP, Berthiaume MJ et al (2007) Risk factors associated with the loss of cartilage volume on weight-bearing areas in knee osteoarthritis patients assessed by quantitative magnetic resonance imaging: a longitudinal study. Arthritis Res Ther 9:R74PubMedPubMedCentral
23.
Wang Y, Wluka AE, Pelletier JP et al (2010) Meniscal extrusion predicts increases in subchondral bone marrow lesions and bone cysts and expansion of subchondral bone in osteoarthritic knees. Rheumatology (Oxford) 49:997–1004
24.
Crema MD, Nevitt MC, Guermazi A et al (2014) Progression of cartilage damage and meniscal pathology over 30 months is associated with an increase in radiographic tibiofemoral joint space narrowing in persons with knee OA--the MOST study. Osteoarthritis Cartilage 22:1743–1747PubMedPubMedCentral
25.
Bloecker K, Wirth W, Guermazi A et al (2015) Relationship between medial meniscal extrusion and cartilage loss in specific femorotibial subregions: data from the osteoarthritis initiative. Arthritis Care Res (Hoboken) 67:1545–1552PubMedCentral
26.
Guermazi A, Eckstein F, Hayashi D et al (2015) Baseline radiographic osteoarthritis and semi-quantitatively assessed meniscal damage and extrusion and cartilage damage on MRI is related to quantitatively defined cartilage thickness loss in knee osteoarthritis: the multicenter osteoarthritis study. Osteoarthritis Cartilage 23:2191–2198PubMedPubMedCentral
27.
Emmanuel K, Quinn E, Niu J et al (2016) Quantitative measures of meniscus extrusion predict incident radiographic knee osteoarthritis--data from the osteoarthritis initiative. Osteoarthritis Cartilage 24:262–269PubMed
28.
Felson DT, Niu J, Neogi T et al (2016) Synovitis and the risk of knee osteoarthritis: the MOST study. Osteoarthritis Cartilage 24:458–464PubMed
29.
Sharma L, Nevitt M, Hochberg M et al (2016) Clinical significance of worsening versus stable preradiographic MRI lesions in a cohort study of persons at higher risk for knee osteoarthritis. Ann Rheum Dis 75:1630–1636PubMed
30.
Teichtahl AJ, Cicuttini FM, Abram F et al (2017) Meniscal extrusion and bone marrow lesions are associated with incident and progressive knee osteoarthritis. Osteoarthritis Cartilage 25:1076–1083PubMed
31.
van der Voet JA, Runhaar J, van der Plas P, Vroegindeweij D, Oei EH, Bierma-Zeinstra SMA (2017) Baseline meniscal extrusion associated with incident knee osteoarthritis after 30 months in overweight and obese women. Osteoarthritis Cartilage 25:1299–1303PubMed
32.
Hein CN, Deperio JG, Ehrensberger MT, Marzo JM (2011) Effects of medial meniscal posterior horn avulsion and repair on meniscal displacement. Knee 18:189–192PubMed
33.
Bao HR, Zhu D, Gong H, Gu GS (2013) The effect of complete radial lateral meniscus posterior root tear on the knee contact mechanics: a finite element analysis. J Orthop Sci 18:256–263PubMed
34.
Guess TM, Razu S, Jahandar H, Stylianou A (2015) Predicted loading on the menisci during gait: the effect of horn laxity. J Biomech 48:1490–1498PubMedPubMedCentral
35.
Gokkus K, Atmaca H, Uğur L, Özkan A, Aydin AT (2016) The relationship between medial meniscal subluxation and stress distribution pattern of the knee joint: finite element analysis. J Orthop Sci 21:32–37PubMed
36.
Rowland G, Mar D, McIff T, Nelson J (2016) Evaluation of meniscal extrusion with posterior root disruption and repair using ultrasound. Knee 23:627–630PubMed
37.
Friedman L, Finlay K, Jurriaans E (2001) Ultrasound of the knee. Skeletal Radiol 30:361–377PubMed
38.
39.
Chiba D, Maeda S, Sasaki E et al (2017) Meniscal extrusion seen on ultrasonography affects the development of radiographic knee osteoarthritis: a 3-year prospective cohort study. Clin Rheumatol 36:2557–2564PubMed
40.
Bevers K, Vriezekolk JE, Bijlsma JW, van den Ende CH, den Broeder AA (2015) Ultrasonographic predictors for clinical and radiological progression in knee osteoarthritis after 2 years of follow-up. Rheumatology (Oxford) 54:2000–2003
41.
42.
Roos EM, Roos HP, Lohmander LS, Ekdahl C, Beynnon BD (1998) Knee injury and osteoarthritis outcome score (KOOS)--development of a self-administered outcome measure. J Orthop Sports Phys Ther 28:88–96PubMed
43.
Nakamura N, Takeuchi R, Sawaguchi T, Ishikawa H, Saito T, Goldhahn S (2011) Cross-cultural adaptation and validation of the Japanese Knee Injury and Osteoarthritis Outcome Score (KOOS). J Orthop Sci 16:516–523PubMed
44.
Kawaguchi K, Enokida M, Otsuki R, Teshima R (2012) Ultrasonographic evaluation of medial radial displacement of the medial meniscus in knee osteoarthritis. Arthritis Rheum 64:173–180PubMed
45.
Sharma L, Eckstein F, Song J et al (2008) Relationship of meniscal damage, meniscal extrusion, malalignment, and joint laxity to subsequent cartilage loss in osteoarthritic knees. Arthritis Rheum 58:1716–1726PubMed
46.
Sharma L, Chmiel JS, Almagor O et al (2014) Significance of preradiographic magnetic resonance imaging lesions in persons at increased risk of knee osteoarthritis. Arthritis Rheumatol 66:1811–1819PubMedPubMedCentral
47.
Gale DR, Chaisson CE, Totterman SM, Schwartz RK, Gale ME, Felson DT (1999) Meniscal subluxation: association with osteoarthritis and joint space narrowing. Osteoarthritis Cartilage 7:526–532PubMed
48.
Roemer FW, Kwoh CK, Hannon MJ et al (2015) What comes first? Multi-tissue involvement leading to radiographic osteoarthritis: magnetic resonance imaging-based trajectory analysis over four years in the osteoarthritis initiative. Arthritis Rheumatol 67:2085–2096PubMedPubMedCentral
49.
Svensson F, Felson DT, Turkiewicz A et al (2019) Scrutinizing the cut-off for “pathological” meniscal body extrusion on knee MRI. Eur Radiol 29:2616–2623PubMedPubMedCentral
50.
Chhabra A, Ashikyan O, Hlis R et al (2019) The International Society of Arthroscopy, Knee Surgery and Orthopaedic Sports Medicine classification of knee meniscus tears: three-dimensional MRI and arthroscopy correlation. Eur Radiol 29:6372–6384PubMed
51.
Eijgenraam SM, Bovendeert FAT, Verschueren J et al (2019) T2 mapping of the meniscus is a biomarker for early osteoarthritis. Eur Radiol 29:5664–5672PubMedPubMedCentral
Metadata
Title
US detection of medial meniscus extrusion can predict the risk of developing radiographic knee osteoarthritis: a 5-year cohort study
Authors
Daisuke Chiba
Eiji Sasaki
Seiya Ota
Shugo Maeda
Daisuke Sugiyama
Shigeyuki Nakaji
Yasuyuki Ishibashi
Publication date
01-07-2020
Publisher
Springer Berlin Heidelberg
Published in
European Radiology / Issue 7/2020
Print ISSN: 0938-7994
Electronic ISSN: 1432-1084
DOI
https://doi.org/10.1007/s00330-020-06749-1

Other articles of this Issue 7/2020

European Radiology 7/2020 Go to the issue

Hepatobiliary-Pancreas

Extracellular contrast-enhanced MRI with diffusion-weighted imaging for HCC diagnosis: prospective comparison with gadoxetic acid using LI-RADS

Chest

Radiomics for lung adenocarcinoma manifesting as pure ground-glass nodules: invasive prediction

Correction

Correction to: A quantitative model based on clinically relevant MRI features differentiates lower grade gliomas and glioblastoma

Neuro

Degree of microstructural changes within T1-SE versus T1-GE hypointense lesions in multiple sclerosis: relevance for the definition of “black holes”

Musculoskeletal

Bone marrow edema around the hip in non-traumatic pain: dual-energy CT vs MRI

Hepatobiliary-Pancreas

Risk stratification in primary sclerosing cholangitis: comparison of biliary stricture severity on MRCP versus liver stiffness by MR elastography and vibration-controlled transient elastography