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Open Access 01-04-2019 | Musculoskeletal

Meniscal body extrusion and cartilage coverage in middle-aged and elderly without radiographic knee osteoarthritis

Authors: Fredrik Svensson, David T Felson, Fan Zhang, Ali Guermazi, Frank W Roemer, Jingbo Niu, Piran Aliabadi, Tuhina Neogi, Martin Englund

Published in: European Radiology | Issue 4/2019

Abstract

Objectives

To determine meniscal extrusion and cartilage coverage on magnetic resonance (MR) images and factors associated with these parameters in knees of middle-aged and elderly persons free from radiographic tibiofemoral osteoarthritis (OA).

Methods

Seven hundred eighteen persons, free of radiographic tibiofemoral OA, aged 50–90 years from Framingham, MA, USA, were included. We measured meniscal extrusion on 1.5 T MRI of both knees to evaluate both medial and lateral meniscal body extrusion and cartilage coverage. We also determined meniscal morphology and structural integrity. The multivariable association with age, body mass index (BMI), and ipsilateral meniscal damage was also evaluated.

Results

The mean meniscal body extrusion medially was 2.7 mm and laterally 1.8 mm. The tibial cartilage coverage was about 30% of ipsilateral cartilage surface (both compartments). The presence of ipsilateral meniscal damage was associated with more extrusion in only the medial compartment, 1.0 mm in men and 0.6 mm in women, and less cartilage coverage proportion, -5.5% in men and -4.6% in women.

Conclusions

Mean medial meniscal body extrusion in middle-aged or older persons without radiographic tibiofemoral OA approximates the commonly used cutoff (3 mm) to denote pathological extrusion. Medial meniscal damage is a factor associated with medial meniscal body extrusion and less cartilage coverage.

Key Points

• Medial meniscal extrusion in middle-aged/older persons without OA is around 3 mm.

• Lateral meniscal extrusion in middle-aged/older persons without OA is around 2 mm.

• Meniscal damage is associated with medial meniscal extrusion and less cartilage coverage.

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Kurosawa H, Fukubayashi T, Nakajima H (1980) Load-bearing mode of the knee joint: physical behavior of the knee joint with or without menisci. Clin Orthop Relat Res:283–290

Walker PS, Erkman MJ (1975) The role of the menisci in force transmission across the knee. Clin Orthop Relat Res:184–192

Krause WR, Pope MH, Johnson RJ, Wilder DG (1976) Mechanical changes in the knee after meniscectomy. J Bone Joint Surg Am 58:599–604CrossRefPubMed

Kenny C (1997) Radial displacement of the medial meniscus and Fairbank’s signs. Clin Orthop Relat Res (339):163–173

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

Gale DR, Chaisson CE, Totterman SM, Schwartz RK, Gale ME, Felson D (1999) Meniscal subluxation: association with osteoarthritis and joint space narrowing. Osteoarthritis Cartilage 7:526–532CrossRefPubMed

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):171–177

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 183:17–23CrossRefPubMed

Englund M, Roos EM, Lohmander LS (2003) Impact of type of meniscal tear on radiographic and symptomatic knee osteoarthritis: a sixteen-year followup of meniscectomy with matched controls. Arthritis Rheum 48:2178–2187CrossRefPubMed

10.

Englund M, Lohmander LS (2004) Risk factors for symptomatic knee osteoarthritis fifteen to twenty-two years after meniscectomy. Arthritis Rheum 50:2811–2819CrossRefPubMed

11.

Hunter DJ, Zhang YQ, Tu X et al (2006) Change in joint space width: hyaline articular cartilage loss or alteration in meniscus? Arthritis Rheum 54:2488–2495CrossRefPubMed

12.

Hunter DJ, Zhang YQ, Niu JB et al (2006) The association of meniscal pathologic changes with cartilage loss in symptomatic knee osteoarthritis. Arthritis Rheum 54:795–801CrossRefPubMed

13.

Englund M, Niu J, Guermazi A et al (2007) Effect of meniscal damage on the development of frequent knee pain, aching, or stiffness. Arthritis Rheum 56:4048–4054CrossRefPubMed

14.

Englund M, Guermazi A, Gale D et al (2008) Incidental meniscal findings on knee MRI in middle-aged and elderly persons. N Engl J Med 359:1108–1115CrossRefPubMedPubMedCentral

15.

Allen DM, Li L, Crema MD et al (2010) The relationship between meniscal tears and meniscal position. Ther Adv Musculoskelet Dis 2:315–323

16.

Englund M, Felson DT, Guermazi A et al (2011) Risk factors for medial meniscal pathology on knee MRI in older US adults: a multicentre prospective cohort study. Ann Rheum Dis 70:1733–1739CrossRefPubMed

17.

Choi CJ, Choi YJ, Lee JJ, Choi CH (2010) Magnetic resonance imaging evidence of meniscal extrusion in medial meniscus posterior root tear. Arthroscopy 26:1602–1606CrossRefPubMed

18.

Crema MD, Roemer FW, Felson DT et al (2012) Factors associated with meniscal extrusion in knees with or at risk for osteoarthritis: the multicenter osteoarthritis study. Radiology 264:494–503CrossRefPubMedPubMedCentral

19.

Wirth W, Frobell RB, Souza RB et al (2010) A three-dimensional quantitative method to measure meniscus shape, position, and signal intensity using MR images: a pilot study and preliminary results in knee osteoarthritis. Magn Reson Med 63:1162–1171CrossRefPubMed

20.

Wenger A, Englund M, Wirth W et al (2012) Relationship of 3D meniscal morphology and position with knee pain in subjects with knee osteoarthritis: a pilot study. Eur Radiol 22:211–220CrossRefPubMed

21.

Bloecker K, Guermazi A, Wirth W et al (2013) Tibial coverage, meniscus position, size and damage in knees discordant for joint space narrowing - data from the osteoarthritis initiative. Osteoarthr Cartil 21:419–427CrossRef

22.

Guermazi A, Hayashi D, Jarraya M et al (2013) Medial posterior meniscal root tears are associated with development or worsening of medial tibiofemoral cartilage damage: the multicenter osteoarthritis study. Radiology 268:814–821CrossRefPubMedPubMedCentral

23.

Bloecker K, Wirth W, Hudelmaier M, Burgkart R, Frobell R, Eckstein F (2012) Morphometric differences between the medial and lateral meniscus in healthy men - a three-dimensional analysis using magnetic resonance imaging. Cells Tissues Organs 195:353–364CrossRefPubMed

24.

Zhang F, Bierma-Zeinstra SM, Oei EHG, Turkiewicz A, Englund M, Runhaar J (2016) Factors associated with meniscal body extrusion on knee MRI in overweight and obese women. Osteoarthr Cartil. https://doi.org/10.1016/j.joca.2016.12.001

25.

Zhang F, Kumm J, Svensson F, Turkiewicz A, Frobell R, Englund M (2016) Risk factors for meniscal body extrusion on MRI in subjects free of radiographic knee osteoarthritis: longitudinal data from the Osteoarthritis Initiative. Osteoarthr Cartil 24:801–806CrossRef

26.

Bloecker K, Englund M, Wirth W et al (2011) Revision 1 size and position of the healthy meniscus, and its correlation with sex, height, weight, and bone area- a cross-sectional study. BMC Musculoskelet Disord 12:248CrossRefPubMedPubMedCentral

27.

Felson DT, Anderson JJ, Naimark A, Walker AM, Meenan RF (1988) Obesity and knee osteoarthritis. The Framingham Study. Ann Intern Med 109:18–24

28.

Felson DT, Zhang Y, Anthony JM, Naimark A, Anderson JJ (1992) Weight loss reduces the risk for symptomatic knee osteoarthritis in women. The Framingham Study. Ann Intern Med 116:535–539CrossRefPubMed

29.

Felson DT, Niu J, McClennan C et al (2007) Knee buckling: prevalence, risk factors, and associated limitations in function. Ann Intern Med 147:534–540CrossRefPubMed

30.

Kellgren JH, Lawrence JS (1957) Radiological assessment of osteo-arthrosis. Ann Rheum Dis 16:494–502CrossRefPubMedPubMedCentral

31.

Englund M, Roemer FW, Hayashi D, Crema MD, Guermazi A (2012) Meniscus pathology, osteoarthritis and the treatment controversy. Nat Rev Rheumatol 8:412–419CrossRefPubMed

32.

Arno S, Bell CP, Xia D et al (2016) Relationship between meniscal integrity and risk factors for cartilage degeneration. Knee. https://doi.org/10.1016/j.knee.2015.11.004

33.

Lee DH, Lee BS, Kim JM et al (2011) Predictors of degenerative medial meniscus extrusion: radial component and knee osteoarthritis. Knee Surg Sports Traumatol Arthrosc 19:222–229CrossRefPubMed

34.

Lerer DB, Umans HR, Hu MX, Jones MH (2004) The role of meniscal root pathology and radial meniscal tear in medial meniscal extrusion. Skelet Radiol 33:569–574CrossRef

35.

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. Osteoarthr Cartil 22:1743–1747CrossRef

36.

Cohen SB, Short CP, O’Hagan T, Wu HT, Morrison WB, Zoga AC (2012) The effect of meniscal tears on cartilage loss of the knee: findings on serial MRIs. Phys Sportsmedicine 40:66–76CrossRefPubMed

37.

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:R21CrossRefPubMedPubMedCentral

38.

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 64:556–563CrossRefPubMed

39.

Englund M, Guermazi A, Roemer FW et al (2010) Meniscal pathology on MRI increases the risk for both incident and enlarging subchondral bone marrow lesions of the knee: the MOST Study. Ann Rheum Dis 69:1796–1802CrossRefPubMed

40.

Bloecker K, Wirth W, Guermazi A, Hitzl W, Hunter DJ, Eckstein F (2015) Longitudinal change in quantitative meniscus measurements in knee osteoarthritis--data from the Osteoarthritis Initiative. Eur Radiol 25:2960–2968CrossRefPubMed

Title: Meniscal body extrusion and cartilage coverage in middle-aged and elderly without radiographic knee osteoarthritis
Authors: Fredrik Svensson
David T Felson
Fan Zhang
Ali Guermazi
Frank W Roemer
Jingbo Niu
Piran Aliabadi
Tuhina Neogi
Martin Englund
Publication date: 01-04-2019
Publisher: Springer Berlin Heidelberg
Published in: European Radiology / Issue 4/2019
Print ISSN: 0938-7994
Electronic ISSN: 1432-1084
DOI: https://doi.org/10.1007/s00330-018-5741-3

Keynote webinar | Spotlight on sleep in brain health

Springer Medicine

Meniscal body extrusion and cartilage coverage in middle-aged and elderly without radiographic knee osteoarthritis

Abstract

Objectives

Methods

Results

Conclusions

Key Points

Keynote webinar | Spotlight on sleep in brain health

Springer Medicine

Abstract

Objectives

Methods

Results

Conclusions

Key Points

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