Medial meniscus extrusion increases with age and BMI and is depending on different loading conditions

Achtnich, Andrea; Petersen, Wolf; Willinger, Lukas; Sauter, Andreas; Rasper, Michael; Wörtler, Klaus; Imhoff, Andreas B.; Diermeier, Theresa

doi:10.1007/s00167-018-4885-7

Cited by 79 publications

(144 citation statements)

References 32 publications

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“…reported, using ultrasound examination, that the width of MM extrusion increased with age [18], and this was similar to our results, though the subjects in the Achtnich et al study included 17 males in addition to 58 females. In our study, MMCR, which is considered an index that re ects meniscus function more directly than the MME area and MME volume, was not correlated with age in both genders.…”

Section: Discussionsupporting

confidence: 92%

Fully automatic three-dimensional MRI analysis for the cartilage and meniscus of the knee: Kanagawa Knee Study

Aoki¹,

Ozeki²,

Katano³

et al. 2020

Preprint

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Objective We have developed a fully automatic three-dimensional MRI analysis software that measures the projected cartilage area ratio (PCAR) to allow for the quantification of the cartilage in the knee. Our objectives for this cross-sectional study were to verify our software’s accuracy and to quantify cartilage and meniscus extrusion. We also examined which cartilage quantification was most affected by age and analyzed the relationship between PCAR and meniscus extrusion. Methods 108 subjects were selected for training, and Dice similarity coefficients were determined from 5 other subjects. This study included 561 subjects between 30–70 years of age. From their knee MRI data, we quantified cartilage thickness, cartilage volume, and PCAR (0.0–1.5 mm) in four regions, including the medial tibial (MT) cartilage. Furthermore, each region was divided into nine subregions. The medial central (mc) subregion was also analyzed. As a quantification for meniscus extrusion, the medial meniscus coverage ratio (MMCR) was also investigated. Results Dice similarity coefficients were 0.911 and 0.892 for the femoral and tibial cartilage and 0.916 and 0.891 for the medial and lateral meniscus. Among 48 cartilage quantifications, the highest absolute value of the correlation coefficient with age was mcMT PCAR 1.0 mm in females and mcMT cartilage thickness in males. In females, mcMT PCAR 1.0 mm was correlated with MMCR, although MMCR was not correlated with age. In males, mcMT PCAR 0.0 mm was correlated with MMCR. Conclusions Our software showed high segmentation accuracy and provided numerous quantifications of cartilage related to age and meniscus extrusion.

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Section: Discussionsupporting

confidence: 92%

Fully automatic three-dimensional MRI analysis for the cartilage and meniscus of the knee: Kanagawa Knee Study

Aoki¹,

Ozeki²,

Katano³

et al. 2020

Preprint

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“…Another finding of this study was that patients with higher BMI had greater meniscal extrusion preoperative, in agreement with previous studies. 4,34 Thus, surgeons should encourage patients to lose weight before partial medial meniscectomy, possibly reducing the meniscal extrusion and therefore reducing the odds for unsatisfactory clinical outcomes and progression of osteoarthritis after procedure.…”

Section: Discussionmentioning

confidence: 99%

Preoperative Meniscal Extrusion Predicts Unsatisfactory Clinical Outcomes and Progression of Osteoarthritis after Isolated Partial Medial Meniscectomy: A 5-Year Follow-Up Study

Novaretti

Astur

Cavalcante³

et al. 2020

J Knee Surg

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The objective of this study was to examine the association between preoperative meniscal extrusion of patients undergoing partial medial meniscectomy with clinical outcomes and progression of osteoarthritis and to determine the extent of meniscal extrusion associated with unsatisfactory clinical outcomes and progression of osteoarthritis. Ninety-five patients who underwent partial medial meniscectomy with a minimum follow-up of 5 years were retrospectively reviewed. Preoperative meniscal extrusion was evaluated with magnetic resonance imaging. Patients were assessed preoperatively and postoperatively with Lysholm and International Knee Documentation Committee (IKDC) subjective scores for clinical outcomes and with IKDC radiographic scale for osteoarthritis. An ANOVA (Analysis of Variance) was used to analyze the variations in meniscal extrusion and the clinical and radiological outcomes. A regression analysis was performed to identify factors that affect preoperative medial meniscus extrusion and that influence results after partial meniscectomy. An optimal cutoff value for meniscal extrusion associated with unsatisfactory clinical outcomes and progression of osteoarthritis was established. Significance was set at p < 0.05. The mean ± SD preoperative and postoperative Lysholm scores were 59.6 ± 15.5 versus 83.8 ± 13.1 (p < 0.001) and the mean preoperative and postoperative IKDC subjective scores were 59.4 ± 16.8 versus 82.0 ± 15.8 (p < 0.001). Meniscal extrusion greater than 2.2 mm (sensitivity, 84%; specificity, 81%) and 2.8 mm (sensitivity, 73%; specificity, 85%) was associated with unsatisfactory (poor/fair) Lysholm and IKDC subjective scores, respectively. The progression of osteoarthritis, characterized as a change of at least one category on the IKDC radiographic scale, occurred when meniscal extrusion was greater than 2.2 mm (sensitivity, 63%; specificity, 75%). Patients with higher body mass index (BMI) had significantly greater meniscal extrusion that patients with normal BMI (p < 0.001). The medial meniscus was more extruded in patients with horizontal and root tears. In conclusion, patients with preoperative meniscal extrusion of 2.2 mm or greater had unsatisfactory clinical outcomes and progression of osteoarthritis after partial medial meniscectomy at a minimum of 5 years follow-up. Higher BMI and horizontal and root tears were associated with greater preoperative meniscal extrusion.

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“…Authors concluded that US assessment of medial meniscus extrusion might be useful to evaluate radiographic OA progression. Two more studies further examined the medial meniscus extrusion: firstly, age, BMI and load-bearing were shown to correlate with medial meniscus extrusion 67 . Secondly, a cut-off value of 4.3 mm of medial meniscal extrusion for the presence of knee pain with sensitivity of 84.5% and specificity of 85.0% was established in general population 68 .…”

Section: Ultrasoundmentioning

confidence: 99%

Osteoarthritis year in review 2018: imaging

Nieminen

Casula

Nevalainen

et al. 2019

Osteoarthritis and Cartilage

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Purpose: To provide a narrative review of the most relevant original research published in 2017/2018 on osteoarthritis imaging. Methods: The PubMed database was used to recover all relevant articles pertaining to osteoarthritis and medical imaging published between 1 April 2017 and 31 March 2018. Review articles, case studies and in vitro or animal studies were excluded. The original publications were subjectively sorted based on relevance, novelty and impact. Results and conclusions: The publication search yielded 1,155 references. In the assessed publications, the most common imaging modalities were radiography (N ¼ 708) and magnetic resonance imaging (MRI) (355), followed by computed tomography (CT) (220), ultrasound (85) and nuclear medicine (17). An overview of the most important publications to the osteoarthritis (OA) research community is presented in this narrative review. Imaging studies play an increasingly important role in OA research, and have helped us to understand better the pathophysiology of OA. Radiography and MRI continue to be the most applied imaging modalities, while quantitative MRI methods and texture analysis are becoming more popular. The value of ultrasound in OA research has been demonstrated. Several multi-modality predictive models have been developed. Deep learning has potential for more automatic and standardized analyses in future OA imaging research.

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Medial meniscus extrusion increases with age and BMI and is depending on different loading conditions

Abstract: III.

Cited by 79 publications

References 32 publications

Fully automatic three-dimensional MRI analysis for the cartilage and meniscus of the knee: Kanagawa Knee Study

Fully automatic three-dimensional MRI analysis for the cartilage and meniscus of the knee: Kanagawa Knee Study

Preoperative Meniscal Extrusion Predicts Unsatisfactory Clinical Outcomes and Progression of Osteoarthritis after Isolated Partial Medial Meniscectomy: A 5-Year Follow-Up Study

Osteoarthritis year in review 2018: imaging

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