Factors Associated with Meniscal Extrusion in Knees with or at Risk for Osteoarthritis: The Multicenter Osteoarthritis Study

Abstract

Purpose:To assess the associations of meniscal tears, knee malalignment, cartilage damage, knee effusion, and body mass index with meniscal extrusion. Materials and Methods:The Multicenter Osteoarthritis study is an observational study of individuals who have or are at risk for knee osteoarthritis (OA). The HIPAA-compliant protocol was approved by the institutional review boards of all participating centers, and written informed consent was obtained from all patients. All subjects with available baseline knee radiographs and magnetic resonance (MR) images were included. MR imaging assessment of meniscal morphologic characteristics, meniscal position, and cartilage morphologic characteristics with use of the Whole-Organ Magnetic Resonance Imaging Score system was performed by two musculoskeletal radiologists. Cross-sectional associations of severity of meniscal tears, knee malalignment, tibiofemoral cartilage damage, knee effusion, and body mass index with meniscal extrusion were assessed by using logistic regression, with multiadjustments when testing each predictor. Results:A total of 1527 subjects (2131 knees; 2116 medial and 2106 lateral menisci) were included. Medially, meniscal tears, varus malalignment, and cartilage damage were associated with meniscal extrusion, with odds ratios (ORs) of 6.3 (95% confidence interval [CI]: 5.0, 8.0), 1.3 (95% CI: 1.1, 1.7), and 1.8 (95% CI: 1.4, 2.2), respectively. Laterally, meniscal tears, valgus malalignment, and cartilage damage were associated with meniscal extrusion, with ORs of 10.3 (95% CI: 7.1, 14.9), 2.2 (95% CI: 1.5, 3.2), and 2.0 (95% CI: 1.3, 2.9), respectively. Conclusion:Meniscal tears are not the only factors associated with meniscal extrusion; other factors include knee malalignment and cartilage damage. Meniscal extrusion is probably an effect of the complex interactions among joint tissues and mechanical stresses involved in the OA process.q RSNA, 2012

Cross Sectional Study of The Pattern of Abnormalities in The Knee Joint Detected by Knee MRI in Patients Evaluated at Tikur Anbessa Specialized Hospital, Addis Ababa University, Addis Ababa, Ethiopia from April–August 2017

“…The higher frequency for both menisci seen in this study could be explained by the higher sample size of the study and the included population having osteoarthritis or risk factor for it. (20) Our study showed a higher frequency of meniscal extrusion in females, occurring in 39.1% of the female population and 23.1% in the male. This was also shown in other studies.…”

“…This was also shown in other studies. (20,21) Meniscal extrusion was also seen with higher frequency in those patients with a history of trauma (36.8%) in contrast to those without trauma (9.1%).…”

Extrusion of the medial meniscus in knee osteoarthritis assessed with a rotating clino-orthostatic permanent-magnet MRI scanner

“…Among all the other results of univariate analysis, orthostatic MME was found to significantly correlate with the WORMS score of bone spurs (osteophytes). In a large population-based cross-sectional study with over than 1,500 patients [3], clinostatic MME was associated with meniscal tears, varus malalignment, and cartilage damage.…”

“…Meniscal pathology in knee osteoarthritis (OA) has been extensively explored [1,2]. In a recent study on a large cohort of 1,527 patients with (or at risk for) knee OA, meniscal extrusion in the medial tibiofemoral (TF) compartment significantly correlated with meniscal tears, varus malalignment, and cartilage damage [3]. In other studies, meniscal extrusion was shown to be an independent predictor of TF cartilage loss [2] and degenerative subchondral bone marrow lesions [4].…”

Kinematic change of the meniscus and the tibiofemoral joint space in asymptomatic volunteers using a wide bore 3T closed MRI system

“…The extrusion of any part of a meniscus beyond the tibial plateau during extension and flexion can represent various conditions, including physiologic and pathologic conditions. Substantial meniscal extrusions can suggest meniscal degeneration and tears and are strongly associated with the progression of osteoarthritis [8,9]. Knowledge of the kinematics of the meniscus and joint space is important for understanding the pathogenesis and treatment of meniscal lesions and the development of knee prostheses.…”