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Published in: Knee Surgery, Sports Traumatology, Arthroscopy 2/2011

01-02-2011 | Knee

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

Authors: Dae-Hee Lee, Bum-Sik Lee, Jong-Min Kim, Kyung-Sook Yang, Eun-Jong Cha, Ji-Hun Park, Seong-Il Bin

Published in: Knee Surgery, Sports Traumatology, Arthroscopy | Issue 2/2011

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Abstract

Purpose

The purpose of this study was to determine the effect of a radial tear on degenerative medial meniscus posterior horn tear extrusion and to identify predictors of medial meniscus extrusion.

Methods

We reviewed the records of 102 knees with medial meniscus posterior horn tears and degeneration that underwent a partial meniscectomy. Tears were classified as root (n = 17) and non-root (n = 85) tears, or as radial (n = 46) and non-radial (n = 56) tears. Groups were compared in terms of absolute and relative meniscal extrusion, and the proportion of knees with major (>3 mm) extrusion. Multiple regression analysis was used to identify predictors of extrusion.

Results

The radial group had greater mean absolute (4 ± 1 vs. 3 ± 1 mm, P = 0.001) and relative (31 ± 11 vs. 23 ± 12%, P = 0.031) extrusion than the non-radial group. The radial group also had a greater proportion of major extrusions than the non-radial group (74% vs. 26%; P = 0.016). In contrast, the root tear and non-root tear groups were similar in terms of mean absolute (3 ± 1 vs. 3 ± 1 mm, P = n.s.) and relative (30 ± 7 vs. 26 ± 13%; P = n.s.) extrusion and in terms of proportion with major extrusions (59 vs. 55%; P = n.s.). Extrusion was found to be associated with a similar strength with both the presence of a radial component and the preoperative Kellgren-Lawrence grade.

Conclusion

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.
Literature
1.
go back to reference Adams JG, McAlindon T, Dimasi M, Carey J, Eustace S (1999) Contribution of meniscal extrusion and cartilage loss to joint space narrowing in osteoarthritis. Clin Radiol 54:502–506CrossRefPubMed Adams JG, McAlindon T, Dimasi M, Carey J, Eustace S (1999) Contribution of meniscal extrusion and cartilage loss to joint space narrowing in osteoarthritis. Clin Radiol 54:502–506CrossRefPubMed
2.
go back to reference Allaire R, Muriuki M, Gilbertson L, Harner C (2008) Biomechanical consequences of a tear of the posterior root of the medial meniscus. Similar to total meniscectomy. J Bone Joint Surg Am 90:1922–1931CrossRefPubMed Allaire R, Muriuki M, Gilbertson L, Harner C (2008) Biomechanical consequences of a tear of the posterior root of the medial meniscus. Similar to total meniscectomy. J Bone Joint Surg Am 90:1922–1931CrossRefPubMed
3.
go back to reference Bin SI, Kim JC, Kim JM, Park SS, Han YK (2002) Correlation between type of discoid lateral menisci and tear pattern. Knee Surg Sports Traumatol Arthrosc 10:218–222CrossRefPubMed Bin SI, Kim JC, Kim JM, Park SS, Han YK (2002) Correlation between type of discoid lateral menisci and tear pattern. Knee Surg Sports Traumatol Arthrosc 10:218–222CrossRefPubMed
4.
go back to reference Bin SI, Kim JM, Shin SJ (2004) Radial tears of the posterior horn of the medial meniscus. Arthroscopy 20:373–378CrossRefPubMed Bin SI, Kim JM, Shin SJ (2004) Radial tears of the posterior horn of the medial meniscus. Arthroscopy 20:373–378CrossRefPubMed
5.
go back to reference Chan W, Huang GS, Hsu SM, Chang YC, Ho WP (2008) Radiographic joint space narrowing in osteoarthritis of the knee: relationship to meniscal tears and duration of pain. Skeletal Radiol 37:917–922CrossRefPubMed Chan W, Huang GS, Hsu SM, Chang YC, Ho WP (2008) Radiographic joint space narrowing in osteoarthritis of the knee: relationship to meniscal tears and duration of pain. Skeletal Radiol 37:917–922CrossRefPubMed
6.
go back to reference Choi NH, Son KM, Victoroff B (2008) Arthroscopic all-inside repair for a tear of posterior root of the medial meniscus: a technical note. Knee Surg Sports Traumatol Arthrosc 16:891–893CrossRefPubMed Choi NH, Son KM, Victoroff B (2008) Arthroscopic all-inside repair for a tear of posterior root of the medial meniscus: a technical note. Knee Surg Sports Traumatol Arthrosc 16:891–893CrossRefPubMed
7.
go back to reference Costa CR, Morrison WB, Carrino JA (2004) Medial meniscus extrusion on knee MRI: is extent associated with severity of degeneration or type of tear? AJR Am J Roentgenol 183:17–23PubMed Costa CR, Morrison WB, Carrino JA (2004) Medial meniscus extrusion on knee MRI: is extent associated with severity of degeneration or type of tear? AJR Am J Roentgenol 183:17–23PubMed
8.
go back to reference Gale DR, Chaisson CE, Totterman SM, Schwartz RK, Gale ME, Felson D (1999) Meniscal subluxation: association with osteoarthritis and joint space narrowing. Osteoar Cartil 7:526–532CrossRef Gale DR, Chaisson CE, Totterman SM, Schwartz RK, Gale ME, Felson D (1999) Meniscal subluxation: association with osteoarthritis and joint space narrowing. Osteoar Cartil 7:526–532CrossRef
9.
go back to reference Habata T, Uematsu K, Kasanami R, Hattori K, Takakura Y, Tohma Y, Fujisawa Y (2006) Long-term clinical and radiographic follow-up of total resection for discoid lateral meniscus. Arthroscopy 22:1339–1343CrossRefPubMed Habata T, Uematsu K, Kasanami R, Hattori K, Takakura Y, Tohma Y, Fujisawa Y (2006) Long-term clinical and radiographic follow-up of total resection for discoid lateral meniscus. Arthroscopy 22:1339–1343CrossRefPubMed
10.
go back to reference Hunter DJ, Zhang YQ, Tu X, Lavalley M, Niu JB, Amin S, Guermazi A, Genant H, Gale D, Felson DT (2006) Change in joint space width: hyaline articular cartilage loss or alteration in meniscus? Arthritis Rheum 54:2488–2495CrossRefPubMed Hunter DJ, Zhang YQ, Tu X, Lavalley M, Niu JB, Amin S, Guermazi A, Genant H, Gale D, Felson DT (2006) Change in joint space width: hyaline articular cartilage loss or alteration in meniscus? Arthritis Rheum 54:2488–2495CrossRefPubMed
12.
go back to reference Koenig J, Ranawat A, Umans H, Difelice G (2009) Meniscal root tears: diagnosis and treatment. Arthroscopy 25:1025–1032CrossRefPubMed Koenig J, Ranawat A, Umans H, Difelice G (2009) Meniscal root tears: diagnosis and treatment. Arthroscopy 25:1025–1032CrossRefPubMed
13.
go back to reference Lee DH, Kim TH, Kim JM, Bin SI (2009) Results of subtotal/total or partial meniscectomy for discoid lateral meniscus in children. Arthroscopy 25:496–503CrossRefPubMed Lee DH, Kim TH, Kim JM, Bin SI (2009) Results of subtotal/total or partial meniscectomy for discoid lateral meniscus in children. Arthroscopy 25:496–503CrossRefPubMed
14.
go back to reference Lee JH, Lim YJ, Kim KB, Kim KH, Song JH (2009) Arthroscopic pullout suture repair of posterior root tear of the medial meniscus: radiographic and clinical results with a 2-year follow-up. Arthroscopy 25:951–958CrossRefPubMed Lee JH, Lim YJ, Kim KB, Kim KH, Song JH (2009) Arthroscopic pullout suture repair of posterior root tear of the medial meniscus: radiographic and clinical results with a 2-year follow-up. Arthroscopy 25:951–958CrossRefPubMed
15.
go back to reference Lee S, Jee WH, Kim JM (2008) Radial tear of the medial meniscal root: reliability and accuracy of MRI for diagnosis. Am J Roentgenol 191:81–85CrossRef Lee S, Jee WH, Kim JM (2008) Radial tear of the medial meniscal root: reliability and accuracy of MRI for diagnosis. Am J Roentgenol 191:81–85CrossRef
16.
go back to reference Lerer DB, Umans HR, Hu MX, Jones MH (2004) The role of meniscal root pathology and radial meniscal tear in medial meniscal extrusion. Skeletal Radiol 33:569–574CrossRefPubMed Lerer DB, Umans HR, Hu MX, Jones MH (2004) The role of meniscal root pathology and radial meniscal tear in medial meniscal extrusion. Skeletal Radiol 33:569–574CrossRefPubMed
17.
go back to reference Lim HC, Bae JH, Wang JH, Seok CW, Kim MK (2010) Non-operative treatment of degenerative posterior root tear of the medial meniscus. Knee Surg Sports Traumatol Arthrosc 18:535–539CrossRefPubMed Lim HC, Bae JH, Wang JH, Seok CW, Kim MK (2010) Non-operative treatment of degenerative posterior root tear of the medial meniscus. Knee Surg Sports Traumatol Arthrosc 18:535–539CrossRefPubMed
18.
go back to reference Magee T (2008) MR findings of meniscal extrusion correlated with arthroscopy. J Magn Reson Imaging 28:466–470CrossRefPubMed Magee T (2008) MR findings of meniscal extrusion correlated with arthroscopy. J Magn Reson Imaging 28:466–470CrossRefPubMed
20.
go back to reference Mikulicz J (1878) Ueber individuelle Formdifferenzen am Femur und an der Tibia des Menschen. Mit Berücksichtigung der Statik des Kniegelenks. Arch Anat Entwick:351-404 Mikulicz J (1878) Ueber individuelle Formdifferenzen am Femur und an der Tibia des Menschen. Mit Berücksichtigung der Statik des Kniegelenks. Arch Anat Entwick:351-404
21.
go back to reference Nicholas S, Golant A, Schachter A, Lee S (2009) A new surgical technique for arthroscopic repair of the meniscus root tear. Knee Surg Sports Traumatol Arthrosc 17:1433–1436CrossRefPubMed Nicholas S, Golant A, Schachter A, Lee S (2009) A new surgical technique for arthroscopic repair of the meniscus root tear. Knee Surg Sports Traumatol Arthrosc 17:1433–1436CrossRefPubMed
22.
go back to reference Puig L, Monllau JC, Corrales M, Pelfort X, Melendo E, Caceres E (2006) Factors affecting meniscal extrusion: correlation with MRI, clinical, and arthroscopic findings. Knee Surg Sports Traumatol Arthrosc 14:394–398CrossRefPubMed Puig L, Monllau JC, Corrales M, Pelfort X, Melendo E, Caceres E (2006) Factors affecting meniscal extrusion: correlation with MRI, clinical, and arthroscopic findings. Knee Surg Sports Traumatol Arthrosc 14:394–398CrossRefPubMed
23.
go back to reference Raynauld JP, Martel-Pelletier J, Berthiaume MJ, Beaudoin G, Choquette D, Haraoui B, Tannenbaum H, Meyer J, Beary J, Cline G, Pelletier JP (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:R21–R33CrossRefPubMed Raynauld JP, Martel-Pelletier J, Berthiaume MJ, Beaudoin G, Choquette D, Haraoui B, Tannenbaum H, Meyer J, Beary J, Cline G, Pelletier JP (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:R21–R33CrossRefPubMed
24.
go back to reference Rennie WJ, Finlay DB (2006) Meniscal extrusion in young athletes: associated knee joint abnormalities. AJR Am J Roentgenol 186:791–794CrossRefPubMed Rennie WJ, Finlay DB (2006) Meniscal extrusion in young athletes: associated knee joint abnormalities. AJR Am J Roentgenol 186:791–794CrossRefPubMed
25.
go back to reference Seo JH, Li G, Shetty GM, Kim JH, Bae JH, Jo ML, Kim JS, Lee SJ, Nha KW (2009) Effect of repair of radial tears at the root of the posterior horn of the medial meniscus with the pullout suture technique: a biomechanical study using porcine knees. Arthroscopy 25:1281–1287CrossRefPubMed Seo JH, Li G, Shetty GM, Kim JH, Bae JH, Jo ML, Kim JS, Lee SJ, Nha KW (2009) Effect of repair of radial tears at the root of the posterior horn of the medial meniscus with the pullout suture technique: a biomechanical study using porcine knees. Arthroscopy 25:1281–1287CrossRefPubMed
26.
go back to reference Sharma L, Eckstein F, Song J, Guermazi A, Prasad P, Kapoor D, Cahue S, Marshall M, Hudelmaier M, Dunlop D (2008) Relationship of meniscal damage, meniscal extrusion, malalignment, and joint laxity to subsequent cartilage loss in osteoarthritic knees. Arthritis Rheum 58:1716–1726CrossRefPubMed Sharma L, Eckstein F, Song J, Guermazi A, Prasad P, Kapoor D, Cahue S, Marshall M, Hudelmaier M, Dunlop D (2008) Relationship of meniscal damage, meniscal extrusion, malalignment, and joint laxity to subsequent cartilage loss in osteoarthritic knees. Arthritis Rheum 58:1716–1726CrossRefPubMed
27.
go back to reference Sugita T, Kawamata T, Ohnuma M, Yoshizumi Y, Sato K (2001) Radial displacement of the medial meniscus in varus osteoarthritis of the knee. Clin Orthop Relat Res 387:171–177CrossRefPubMed Sugita T, Kawamata T, Ohnuma M, Yoshizumi Y, Sato K (2001) Radial displacement of the medial meniscus in varus osteoarthritis of the knee. Clin Orthop Relat Res 387:171–177CrossRefPubMed
28.
go back to reference Vedi V, Williams A, Tennant SJ, Spouse E, Hunt DM, Gedroyc WM (1999) Meniscal movement. An in vivo study using dynamic MRI. J Bone Joint Surg Br 81:37–41CrossRefPubMed Vedi V, Williams A, Tennant SJ, Spouse E, Hunt DM, Gedroyc WM (1999) Meniscal movement. An in vivo study using dynamic MRI. J Bone Joint Surg Br 81:37–41CrossRefPubMed
Metadata
Title
Predictors of degenerative medial meniscus extrusion: radial component and knee osteoarthritis
Authors
Dae-Hee Lee
Bum-Sik Lee
Jong-Min Kim
Kyung-Sook Yang
Eun-Jong Cha
Ji-Hun Park
Seong-Il Bin
Publication date
01-02-2011
Publisher
Springer-Verlag
Published in
Knee Surgery, Sports Traumatology, Arthroscopy / Issue 2/2011
Print ISSN: 0942-2056
Electronic ISSN: 1433-7347
DOI
https://doi.org/10.1007/s00167-010-1274-2

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